FERNANDEZ HOLDINGS HEALTH TR: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- FERNANDEZ HOLDINGS HEALTH TR (EIN 82-6735744)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-10-06
- IRS object ID
- 202232799349301038
- Schema version
- 2021v4.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-10-06T12:45:38-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6565 AMERICAS PARKWAY NE STE 600 | AddressLine1Txt |
| City | ALBUQUERQUE | CityNm |
| State Abbreviation | NM | StateAbbreviationCd |
| ZIP | 87110 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 826735744 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FERNANDEZ HOLDINGS HEALTH TRUST | BusinessNameLine1Txt |
| Business Name Line2 | C/O FERNANDEZ HOLDINGS INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FERN | BusinessNameControlTxt |
| Phone | 3105930798 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1029 N SWARTHMORE AVE | AddressLine1Txt |
| City | PACIFIC PALISADES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90272 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEREMY JOHNSON | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3105930798 | PhoneNum |
| Signature | 2022-10-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JEREMY | PersonFirstNm |
| Person Last | JOHNSON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PAMELA ALEXANDERSON | PreparerPersonNm |
| PTIN | P01218925 | PTIN |
| Phone | 5058787200 | PhoneNum |
| Preparation | 2022-10-03 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | JEREMY JOHNSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1029 N SWARTHMORE AVE | AddressLine1Txt |
| City | PACIFIC PALISADES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90272 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,262,426 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Trust | Yes (X) | TypeOfOrganizationTrustInd |
| Formation | 2017 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | THE HEALTH TRUST WAS ESTABLISHED TO FUND MEDICAL AND PHARMACY BENEFITS FOR EMPLOYEES OF FERNANDEZ HOLDINGS, INC. | ActivityOrMissionDesc |
| Voting Members Governing Body | 1 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,625,031 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,262,417 | CYProgramServiceRevenueAmt |
| PY Investment Income | $42 | PYInvestmentIncomeAmt |
| CY Investment Income | $9 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $7,625,073 | PYTotalRevenueAmt |
| CY Total Revenue | $11,262,426 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $6,767,500 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $9,369,318 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $922,224 | PYOtherExpensesAmt |
| CY Other Expenses | $1,265,909 | CYOtherExpensesAmt |
| PY Total Expenses | $7,689,724 | PYTotalExpensesAmt |
| CY Total Expenses | $10,635,227 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$64,651 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $627,199 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $285,006 | TotalAssetsBOYAmt |
| Total Assets EOY | $912,205 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $285,006 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $912,205 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE HEALTH TRUST WAS ESTABLISHED TO FUND MEDICAL AND PHARMACY BENEFITS FOR EMPLOYEES OF FERNANDEZ HOLDINGS, INC., AND OTHER EMPLOYERS IN ITS CONTROLLED GROUP OF COMPANIES THAT PARTICIPATE IN THE FERNANDEZ HOLDINGS HEALTH PLAN, WHICH IS SPONSORED BY FERNANDEZ HOLDINGS, INC., FOR THE BENEFIT OF ELIGIBLE EMPLOYEES AND THEIR ELIGIBLE DEPENDENTS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Desc | THE HEALTH TRUST WAS ESTABLISHED TO FUND MEDICAL BENEFITS FOR EMPLOYEES OF FERNANDEZ HOLDINGS, INC., AND OTHER EMPLOYERS IN ITS CONTROLLED GROUP OF COMPANIES THAT PARTICIPATE IN THE FERNANDEZ HOLDINGS HEALTH PLAN, WHICH IS SPONSORED BY FERNANDEZ HOLDINGS, INC., FOR THE BENEFIT OF ELIGIBLE EMPLOYEES AND THEIR ELIGIBLE DEPENDENTS. | Desc |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 1 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEREMY JOHNSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3105711207 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1029 N SWARTHMORE AVE | AddressLine1Txt |
| City | PACIFIC PALISADES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90272 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KIRK FERNANDEZ | PersonNm |
| Title | TRUSTEE | TitleTxt |
| Average Hours Per Week | 1.00 | AverageHoursPerWeekRt |
| Average Hours Per Week Rltd Org | 39.00 | AverageHoursPerWeekRltdOrgRt |
| Individual Trustee Or Director | Yes (X) | IndividualTrusteeOrDirectorInd |
| Reportable Comp From Org | $0 | ReportableCompFromOrgAmt |
| Reportable Comp From Rltd Org | $0 | ReportableCompFromRltdOrgAmt |
| Other Compensation | $0 | OtherCompensationAmt |
| 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 | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ANTHEM BLUE CROSS LIFE AND HEALTH | |||||
| 3075 VANDERCAR WAY | CINCINNATI | OH | 45209 | MEDICAL NETWORK FEES | $529,498 |
| BENEFIT & RISK MANAGEMENT | |||||
| 80 IRON POINT CIRCLE SUITE 200 | FOLSOM | CA | 95630 | CLAIMS PROCESSING | $302,765 |
| EDGEWOOD PARTNERS INS CENTER | |||||
| 1390 WILLOW PASS ROAD | CONCORD | CA | 94520 | INSURANCE AGENTS AND BROKERS | $248,250 |
| MOSS ADAMS LLP | |||||
| 999 THIRD AVENUE SUITE 2800 | SEATTLE | WA | 98104 | AUDIT AND TAX SERVICES | $104,149 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PARTICIPANT CONTRIBUTIONS | 525100 | $6,238,576 | $6,238,576 |
| EMPLOYER CONTRIBUTIONS | 525100 | $5,023,841 | $5,023,841 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,262,417 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9 | TotalRevenueColumnAmt |
| Exclusion | $9 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,262,426 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,262,417 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $9 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,369,318 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,566 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,149 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,137,194 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,635,227 | TotalAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $201,710 | BOYAmt |
| EOY | $1,808 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,296 | BOYAmt |
| EOY | $910,397 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $285,006 | BOYAmt |
| EOY | $912,205 | 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 FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $285,006 | BOYAmt |
| EOY | $912,205 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $285,006 | BOYAmt |
| EOY | $912,205 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $285,006 | BOYAmt |
| EOY | $912,205 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $627,199 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $11,262,426 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $11,262,426 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $11,262,426 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,635,227 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,635,227 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,635,227 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE PLAN'S TRUST HAS OBTAINED A FAVORABLE TAX EXEMPTION LETTER FROM THE INTERNAL REVENUE SERVICE DATED JULY 23, 2019, THAT THE TRUST IS EXEMPT FROM FEDERAL INCOME TAXATION UNDER THE PROVISIONS OF SECTION 501(C)(9) OF THE IRC. THE PLAN ADMINISTRATOR BELIEVES THAT THE PLAN IS DESIGNED AND IS CURRENTLY BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC. IN ACCORDANCE WITH GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, THE PLAN ADMINISTRATOR HAS EVALUATED THE PLAN'S TAX POSITIONS AND DOES NOT BELIEVE THE PLAN HAS ANY UNCERTAIN TAX POSITIONS THAT REQUIRE DISCLOSURE OR ADJUSTMENT TO THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | EMPLOYEES WHO ARE APPOINTED TO WORK ON THE PLAN PER THE TRUST DOCUMENT (THE DIRECTOR OF PORTFOLIO HR AND THE VICE PRESIDENT OF FHI) REVIEWED THE 990 WITH THE TRUSTEE FOR ACCURACY AND COMPLETION. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE TRUST FOLLOWS THE CONFLICT OF INTEREST POLICY OF FERNANDEZ HOLDINGS, INC. ALL EMPLOYEES REVIEW THE POLICY AND SIGN THEIR ACKNOWLEDGMENT ON AN ANNUAL BASIS. ANYONE DEEMED TO HAVE A CONFLICT ABSTAINS FROM PARTICIPATION AND/OR VOTING ON THE MATTER AT HAND. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST VIA EMAIL. CONFLICT OF INTEREST POLICY IS AVAILABLE VIA THE ANNUAL HANDBOOK REQUIRING SIGNATURE EACH YEAR. |
| FORM 990, PART IX, LINE 11G | ADMINISTRATION FEES 529,908. WELLNESS VENDORS 56,271. CONSULTING 248,250. CONTRACT ADMINISTRATOR FEES 302,765. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| FERNANDEZ HOLDINGS INC | |||||||||
| 1029 N SWARTHMORE AVE | PACIFIC PALISADES | CA | 90272 | 275560752 | HOLDINGS AND INVESTMENT | CA | N/A | C | 0 |
| PARC ENVIRONMENTAL | |||||||||
| 2864 E DOROTHY AVE | FRESNO | CA | 93706 | 770129910 | ENVIRONMENTAL REMEDIATION | CA | N/A | C | 0 |
| PARC SPECIALITY | |||||||||
| 2864 E DOROTHY AVE | FRESNO | CA | 93706 | 943259455 | ENVIRONMENTAL REMEDIATION | CA | N/A | C | 0 |
| QUINTRON | |||||||||
| 1029 N SWARTHMORE AVE | PACIFIC PALISADES | CA | 90272 | 952639464 | AV & MANUFACTURING | CA | N/A | C | 0 |
| RA ELECTRIC | |||||||||
| 1029 N SWARTHMORE AVE | PACIFIC PALISADES | CA | 90272 | 954399249 | AV & MANUFACTURING | CA | N/A | C | 0 |
| RTS SOLUTIONZ | |||||||||
| 1029 N SWARTHMORE AVE | PACIFIC PALISADES | CA | 90272 | 473765043 | AV & VIDEO CONFERENCING | CA | N/A | C | 0 |
| SOLUTIONZ VIDEOCONFERENCING INC | |||||||||
| 1029 N SWARTHMORE AVE | PACIFIC PALISADES | CA | 90272 | 383645853 | AV & VIDEO CONFERENCING | CA | N/A | S | 0 |
| STERLING | |||||||||
| 10203 E ST | OAKLAND | CA | 94603 | 943073256 | ENVIRONMENTAL REMEDIATION | CA | N/A | C | 0 |
| UNITED AG AND TURF | |||||||||
| 6010 WEST BROADWAY | ARDMORE | OK | 73401 | 741797630 | EQUIPMENT DEALERSHIP | OK | N/A | C | 0 |
| UNITED AG AND TURF NE | |||||||||
| 216 CENTER ROAD | FAIRFIELD | ME | 04937 | 844092767 | EQUIPMENT DEALERSHIP & SERVICE | ME | N/A | C | 0 |
| FHI DEVELOPEMENT | |||||||||
| 1029 N SWARTHMORE AVE | PACIFIC PALISADES | CA | 90272 | 851318003 | LOOKS FOR AND MANAGES ACQUISITION ACTIVITY | CA | N/A | C | 0 |
| SUMMIT SOLUTIONZ INC | |||||||||
| 1029 N SWARTHMORE AVE | PACIFIC PALISADES | CA | 90272 | 872578730 | INFORMATION TECHNOLOGY SERVICES | CA | N/A | S | 0 |
| UNITED CONSTRUCTIONS & FORESTRY LLC | |||||||||
| 216 CENTER ROAD | FAIRFIELD | ME | 04937 | 871358227 | EQUIPMENT DEALERSHIP & SERVICE | CA | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
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