2024-11-07T07:06:12-06:00 2023-12-31 341851358 CBIZ ADVISORS LLC 530 HOWELL ROAD SUITE 209 GREENVILLE SC 29615 990 2023-01-01 941461312 DELTA DENTAL OF CALIFORNIA DELT 4159728300 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 ALICIA F WEBER CFO 4159748577 2024-11-06 1 0 KELLIE A LANFORD P00538614 8642412001 2023 2024-10-15 13:58:12Z ALICIA F WEBER 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 6645772100 0 X WWW.DELTADENTALINS.COM X 1954 CA TO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS, SERVICE, TECHNOLOGY AND PROFESSIONAL SUPPORT. 12 11 2212 0 1284409 86220 0 0 5728676235 6003378013 53932315 86222865 53359488 48179348 5835968038 6137780226 27456765 22617650 4794058788 5055597656 404208374 414572661 0 0 0 291003273 341047358 5516727200 5833835325 319240838 303944901 3585172780 4003642847 1112823411 1154499904 2472349369 2849142943 TO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS, SERVICE, TECHNOLOGY AND PROFESSIONAL SUPPORT. 0 0 5719322688 6136495817 THE ORGANIZATION PROVIDED DENTAL BENEFIT COVERAGE FOR 27,821,000 BENEFICIARIES IN 2023, PRIMARILY THROUGH CONTRACTS WITH INDEPENDENT DENTISTS. INCLUDED WERE PUBLICLY SPONSORED DENTAL BENEFIT PROGRAMS ADMINISTERED BY THE ORGANIZATION, AS WELL AS 1,232,000 ENROLLED IN THE FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM (FEDVIP). THE ORGANIZATION PAID MORE THAN $5.1 BILLION FOR DENTAL CARE DURING 2023. 22617650 22617650 THE ORGANIZATION MADE GRANTS DURING 2023 TO FOSTER IMPROVED ACCESS TO DENTAL HEALTH CARE TREATMENT, TO SUPPORT PROFESSIONAL DENTAL EDUCATION, AND TO PROVIDE ORAL HEALTH INSTRUCTION FOR PATIENTS. 5741940338 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 1 0 1 110798 0 1 2212 1 1 1 0 0 0 0 0 1 0 X 12 11 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X ALICIA F WEBER CFO 4159748577 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 X CASTRO MICHAEL J CHIEF EXECUTIVE OFFICER 40.00 10.00 X 6909365 0 262132 JACKSON KEVIN EXECUTIVE VICE PRESIDENT/CHIEF GROWTH OFFICER 0.00 X 4160020 0 16795 CHAVARRIA SARAH M PRESIDENT 40.00 10.00 X 3084552 0 66709 WEBER ALICIA F EXECUTIVE VICE PRESIDENT CHIEF FINANCIAL OFFICER 40.00 10.00 X 2737332 0 74060 HANKINSON MICHAEL G EXECUTIVE VICE PRESIDENT CHIEF LEGAL OFFICER 40.00 10.00 X 2237025 0 55810 TITCOMBE DOMINIC EXECUTIVE VICE PRESIDENT/CHIEF INFORMATION OFFICER 40.00 10.00 X 1918394 0 66709 RUIZ JOSEPH F VICE PRESIDENT GROWTH STRATEGY BUSINESS DEVELOPMEN 40.00 10.00 X 1771366 0 35227 NAVID MOHAMMADREZA SENIOR VICE PRESIDENT CHIEF NETWORK & BUS DEVLPMT 40.00 10.00 X 1280602 0 79051 SHERMAN BRIAN SENIOR VICE PRESIDENT CHIEF PEOPLE OFFICER 40.00 10.00 X 1110784 0 58082 MANOWSKI MICHAEL SENIOR VICE PRESIDENT CHIEF TECHNOLOGY OFFICER 40.00 10.00 X 1041871 0 52395 LEIBOWITZ THOMAS J SENIOR VICE PRESIDENT CHIEF ACTUARY 40.00 10.00 X 1001713 0 54612 SCHROEDER KURT GRAY SENIOR VICE PRESIDENT CHIEF MARKETING & COMMS OFFI 40.00 10.00 X 923265 0 61965 FEGLEY ANDREA M SENIOR VICE PRESIDENT LEGAL AFFAIRS 40.00 10.00 X 907639 0 54582 PARKER EARL JR SENIOR VICE PRESIDENT CUSTOMER OPERATIONS 10.00 40.00 X 0 796756 55490 BALTIS THOMAS VICE PRESIDENT CHIEF INFORMATION SECURITY OFFICER 40.00 10.00 X 764624 0 45325 SHEETZ MARTY A VICE PRESIDENT BUSINESS IMPLEMENTATION & CLAIMS OP 40.00 10.00 X 746556 0 50458 CROLEY DANIEL W VICE PRESIDENT CHIEF DENTAL OFFICER 40.00 10.00 X 715567 0 80564 GOLDMAN EDWARD L JR VICE PRESIDENT INFRASTRUCTURE ENGINEERING 40.00 10.00 X 708572 0 56483 PARTHASARATHY SRIPADH VICE PRESIDENT IT DEVELOPMENT 40.00 10.00 X 696773 0 64829 MACGILVRAY JENNIFER SENIOR VICE PRESIDENT QUALITY CARE AND CLAIMS 10.00 40.00 X 0 692106 64823 ALBUM JEFFREY M VICE PRESIDENT PUBLIC & GOVERNMENT AFFAIRS 40.00 10.00 X 674756 0 79907 TODI HEMANT VICE PRESIDENT DATA ANALYTICS AND INSIGHTS 40.00 10.00 X 687083 0 61913 MANER MICHAEL VICE PRESIDENT SALES 10.00 40.00 X 0 671844 64622 NAKAHARA EARL VICE PRESIDENT RISK, ETHICS AND COMPLIANCE 40.00 10.00 X 650875 0 61921 SBRAGIA RICHARD J VICE PRESIDENT FINANCE - FINANCIAL OPERATIONS 40.00 10.00 X 659505 0 50464 SANCHEZ WALTER VICE PRESIDENT INTERNAL AUDIT 40.00 10.00 X 633613 0 72236 SWAMINATHAN SHANMUGA S VICE PRESIDENT ENTERPRISE ARCHITECTURE 40.00 10.00 X 628991 0 57403 THOLIA ASHISH SENIOR DIRECTOR STRATEGY BUSINESS DEVELOPMENT 40.00 10.00 X 648992 0 32470 MARTEL LORI ANN VICE PRESIDENT PRODUCT 0.00 X 637494 0 0 O'TOOLE KEVIN M DIRECTOR SALES 40.00 10.00 X 557179 0 71631 STEELE CHRISTINA SENIOR DIRECTOR LEGAL SERVICES, SR ASSOCIATE GENER 40.00 10.00 X 503084 0 66322 STIAK MATTHEW DIRECTOR CYBER RISK OPERATIONS AND EVENT MANAGEMEN 40.00 10.00 X 475957 0 34880 KAPLAN GREGORY D DDS DIRECTOR 5.00 0.00 X 308360 0 0 YODOWITZ HEIDI CHAIR 5.00 0.00 X X 241771 0 0 BERGERT GLEN F SECOND VICE CHAIR 5.00 2.00 X X 184500 35000 0 O'TOOLE TERRY A DIRECTOR 5.00 0.00 X 186775 0 0 GONELLA ROY A FIRST VICE CHAIR 5.00 0.00 X X 156774 0 0 MCCANN STEVEN F DIRECTOR 5.00 0.00 X 156774 0 0 REID ANDREW J DIRECTOR 5.00 0.00 X 140274 0 0 FRANZOI LYNN L DIRECTOR 5.00 0.00 X 138364 0 0 LAMB JAY C DMD DIRECTOR 5.00 0.00 X 138274 0 0 ALLFORD ROBERT ALLAN DIRECTOR 5.00 0.00 X 136000 0 0 LAW IAN DIRECTOR 5.00 0.00 X 114000 0 0 PICKERING STEPHEN R DDS DIRECTOR 5.00 0.00 X 113274 0 0 41488689 2195706 2009870 1096 1 1 0 ELEVATED RESOURCES INC 3990 WESTERLY PL STE 270 NEWPORT BEACH CA 92660 CONSULTING SERVICES 44602414 QUALFON DATA SERVICES GROUP LLC 13700 OAKLAND AVE HIGHLAND PARK MI 48203 CONSULTING SERVICES 9688041 DXC TECHNOLOGY SERVICES LLC PO BOX 740868 ATLANTA GA 30374 CONSULTING SERVICES 8562592 ALITHYA FINANCIAL SOLUTIONS INC 2500 NORTHWINDS PKWY STE 600 ALPHARETTA GA 30009 CONSULTING SERVICES 8530366 ORACLE AMERICA INC PO BOX 44471 SAN FRANCISCO CA 94144 CONSULTING SERVICES 8127765 178 PROFESSIONAL SERVICES 524114 5249973365 5249973365 FEES & CONTRACTS FROM GOVERNMENT 524114 753404648 753404648 6003378013 90070959 90070959 504143780 507991874 -3848094 -3848094 -3848094 INCOME/LOSS FROM SUBSIDIARIES 524298 45331124 44046715 1284409 OTHER REVENUE 524298 63685 63685 MISC EXPENSES 524298 -6714141 -6714141 9498680 9498680 48179348 6137780226 6136495817 1284409 0 22617650 22617650 5055597656 5055597656 37752986 37752986 287066646 258442192 28624454 27852616 25188983 2663633 46024538 41479695 4544843 15875875 14207694 1668181 7375513 7360414 15099 1354975 769070 585905 2421298 2421298 9548122 9548122 21727002 21502957 224045 60938902 58624310 2314592 17306324 17273821 32503 19142144 17133566 2008578 6223751 3634754 2588997 1889624 1003346 886278 8540313 8540313 32983583 32002492 981091 3752940 3599007 153933 BROKER FEES 55385012 55385012 OUTSIDE SERVICES 41439166 40619270 819896 CONSULTANT FEES 26195554 23495667 2699887 24823135 21493049 3330086 5833835325 5741940338 91894987 0 -64632111 33177119 267261493 299932692 403715672 432521584 176973163 168390011 63267093 61073372 353091160 188898966 148282151 164192194 1681390167 1786698145 864371501 996177106 44543651 61480624 3585172780 4003642847 564836255 641749163 47189751 46506429 500797405 466244312 1112823411 1154499904 X 0 0 0 0 2472349369 2849142943 2472349369 2849142943 3585172780 4003642847 X 303944901 74834529 -1985856 X 0 1 X 1 0 54637477 31213211 23424266 64072570 46565027 17507543 234381113 111120728 123260385 164192194 INVESTMENT - OTHER SECURITIES 996177106 F 996177106 ACCRUED RETIREMENT BENEFITS 31554216 DEFERRED COMPENSATION PLANS 7507519 GROUP PREFUNDING DEPOSITS 14151147 REFUNDABLE BALANCES 313043623 DUE TO AFFILIATES 37386367 LONG-TERM LEASE LIABILITY 62601440 466244312 X 3333535769 74834529 74834529 3258701240 2879078986 2879078986 6137780226 2955022721 0 2955022721 2878812604 2878812604 5833835325 PART X, LINE 2: THE COMPANY IS A TAX-EXEMPT ORGANIZATION ORGANIZED UNDER SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE AND, AS SUCH, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE FINANCIAL STATEMENTS. CURRENT ACCOUNTING GUIDANCE CLARIFIES HOW UNCERTAINTIES IN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. POSITIONS INCLUDE THOSE WITH RESPECT TO THE COMPANY'S TAX EXEMPT STATUS AND WITH RESPECT TO INCOME TAXES ON UNRELATED BUSINESS INCOME. THE COMPANY HAS DETERMINED THAT SUCH TAX POSITIONS DO NOT RESULT IN UNCERTAINTIES REQUIRING RECOGNITION. PART XI, LINE 4B - OTHER ADJUSTMENTS: ADMINISTRATIVE SERVICE CONTRACTS CLAIM REIMBURSEMENT REVENUE INVESTMENT EXPENSES UNRELATED BUSINESS INCOME PART XII, LINE 4B - OTHER ADJUSTMENTS: CLAIMS INCURRED FOR ADMINISTRATIVE SERVICE CONTRACTS INVESTMENT EXPENSES UNRELATED BUSINESS EXPENSE PART X, LINE 1, (5) REFUNDABLE BALANCES: ON MARCH 11, 2020, THE WORLD HEALTH ORGANIZATION DECLARED A NOVEL STRAIN OF CORONAVIRUS (COVID-19) AS A GLOBAL PANDEMIC. THE COVID-19 OUTBREAK HAS CAUSED BUSINESS DISRUPTION THROUGH MANDATED AND VOLUNTARY CLOSINGS OF BUSINESSES AND SHELTER IN PLACE ORDERS. THESE DISRUPTIONS IMPACTED OUR CUSTOMERS' ABILITY TO OBTAIN DENTAL SERVICES. THE COMPANY HAS TAKEN A POSITION AND COMMITTED TO ITS CUSTOMERS, PROVIDERS, AND REGULATORS TO NOT EXCESSIVELY PROFIT FROM THE PANDEMIC. TO THIS END, IN 2020, THE COMPANY ESTABLISHED ESTIMATED RESERVES REPRESENTING EXCESS UNDERWRITING GAINS IN THE AMOUNT OF $231.3 MILLION. DURING 2021 THROUGH 2023, RESERVE AMOUNTS WERE USED TO SUPPORT CUSTOMERS THROUGH ONGOING PAYMENT RELIEF AND OTHER PROGRAMS. ALL RESERVES HAVE BEEN EXHAUSTED AS OF DECEMBER 31, 2023. IN ADDITION, CERTAIN CONTRACTS PROVIDE THAT PREMIUMS RECEIVED IN EXCESS OF CLAIMS INCURRED AND ADMINISTRATIVE FEES ARE EITHER REFUNDABLE TO THE GROUPS AT THE EXPIRATION OF THE AGREEMENTS OR APPLIED AGAINST FUTURE PREMIUM PAYMENTS. 1 ALAMEDA COUNTY COMMUNITY FOOD BANK 7900 EDGEWATER DR OAKLAND CA 94621 942960297 501 (C) (3) 10000 0 CORPORATE GIVING AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501 (C) (3) 30000 0 2023 SACRAMENTO HEART & STROKE WALK AMERICAN ONLINE GIVING FOUNDATION INC PO BOX 645725 PITTSBURGH PA 152645255 810739440 501 (C) (3) 325398 0 DDC EMPLOYEE SEEDING AMERICAN RED CROSS INC 1663 MARKET ST SAN FRANCISCO CA 94103 530196605 501 (C) (3) 100000 0 2023 GALA SPONSORSHIP ASIAN ART MUSEUM FOUNDATION 200 LARKIN ST SAN FRANCISCO CA 94102 941704765 501 (C) (3) 6000 0 CORPORATE MEMBERSHIP 2023-24 BLUE STAR FAMILIES INC 515 VERBENA CT ENCINITAS CA 92024 800369895 501 (C) (3) 45000 0 CONTRIBUTION BLUE STAR FAMILIES CELEBRATION 2023 & CAREER PROGRAM CALIFORNIA PAN-ETHNIC HEALTH NETWORK 1221 PRESERVATION PARK WAY STE 200 OAKLAND CA 94612 943306223 501 (C) (3) 15000 0 VOICES FOR CHANGE HEALTH EQUITY CONFERENCE CONSERVATION SOCIETY OF CALIFORNIA PO BOX 5238 OAKLAND CA 94605 941687847 501 (C) (3) 7500 0 WALK IN THE WILD CURE TAY-SACHS FOUNDATION INC 2409 E LUKE AVE PHOENIX AZ 85016 260256621 501 (C) (3) 8000 0 TAKE A HIKE TAY SACHS 2024 CURRY SENIOR CENTER 333 TURK ST SAN FRANCISCO CA 94102 237362588 501 (C) (3) 15000 0 CORPORATE SPONSORSHIP DELTA DENTAL COMMUNITY CARE FOUNDATION 560 MISSION ST STE 1300 SAN FRANCISCO CA 94105 371570764 501 (C) (3) 21478707 0 ENTERPRISE CONTRIBUTION TO DDCCF DISABLED AMERICAN VETERANS 860 DOLWICK DR ERLANGER KY 41018 310263158 501 (C) (4) 50000 0 2023 WINTER SPORTS CLINIC SPONSORSHIP FEEDING AMERICA 161 NORTH CLARK ST SUITE 700 CHICAGO IL 60601 363673599 501 (C) (3) 6000 0 CONTRIBUTION GOLD STAR SPOUSES OF THE UNITED STATES INC 5000 MORNING SPLASH AVE LAS VEGAS NV 89131 871792320 501 (C) (3) 20000 0 CONTRIBUTION HENRY M JACKSON FOUNDATION 6720 A ROCKLEDGE DR STE 100 BETHESDA MD 20817 521317896 501 (C) (3) 10000 0 CONTRIBUTION JACOBS & CUSHMAN SAN DIEGO FOOD BANK 9850 DISTRIBUTION AVE SAN DIEGO CA 92121 204374795 501 (C) (3) 35000 0 HOLIDAY FOOD DRIVE SPONSORSHIP LABOR FOUNDATION FOR UNION WORKERS 240 SOUTH MARKET ST SAN JOSE CA 951132382 475183726 501 (C) (3) 5100 0 GOLD SPONSORSHIP LOVEALL FOUNDATION FOR CHILDREN 4120 DOUGLAS BLVD 306-304 GRANITE BAY CA 95746 680435070 501 (C) (3) 6000 0 DIAMOND SPONSORSHIP CHALLENGE CHARITY GOLF EVENT MEALS ON WHEELS SAN FRANCISCO 2142 JERROLD AVE SAN FRANCISCO CA 94124 941741155 501 (C) (3) 40000 0 STAR CHEFS & VINTNERS GALA MILITARY OFFICERS ASSOCIATION OF AMERICA 201 N WASHINGTON ST ALEXANDRIA VA 223142539 464219250 501 (C) (3) 28600 0 CONTRIBUTION FOR CAREER FAIR & GOLFER SPONSORSHIP NATIONAL MILITARY FAMILY ASSOCIATION 2800 EISENHOWER AVE STE 250 ALEXANDRIA VA 22314 520899384 501 (C) (3) 25000 0 OPERATION PURPLE CAMPS OUTWARD BOUND INC 1133 ROUTE 55 STE 10 LAGRANGEVILLE NY 125405052 042375956 501 (C) (3) 30000 0 CONTRIBUTION FOR VETERAN OUTDOOR TRN'G SYMPOSIUM PETS FOR VETS INC 560 IRIS WAY HAMPSTEAD NC 284432966 271250302 501 (C) (3) 6000 0 CONTRIBUTION RAPHAEL HOUSE OF SAN FRANCISCO INC 1065 SUTTER ST SAN FRANCISCO CA 94109 943141608 501 (C) (3) 10000 0 2023 GALA RICHMONDERMET AID FOUNDATION 447 SUTTER ST STE 714 SAN FRANCISCO CA 94108 943232222 501 (C) (3) 20000 0 YEAR-LONG SPONSORSHIP FOR 2023 SACRAMENTO FOOD BANK & FAMILY SERVICES 1951 BELL AVE SACRAMENTO CA 95838 943315566 501 (C) (3) 17500 0 RUN TO FEED THE HUNGRY SPONSORSHIP 2023 SF MARIN FOOD BANK 900 PENNSYLVANIA AVE SAN FRANCISCO CA 94107 943041517 501 (C) (3) 12500 0 ONE BIG TABLE SPONSORSHIP SPECIAL OLYMPICS NORTHERN CALIFORNIA INC 3480 BUSKIRK AVE 340 PLEASANT HILL CA 94523 680363121 501 (C) (3) 25000 0 NOR/CAL FALL GAMES ST JOHNS WELL CHILD AND FAMILY CENTER INC 808 WEST 58TH ST LOS ANGELES CA 90037 954067758 501 (C) (3) 15000 0 MOVABLE FEAST- SPONSORSHIP ST VINCENT SENIOR CITIZEN NUTRITION PROGRAM INC 2303 MIRMAR ST LOS ANGELES CA 90057 953696693 501 (C) (3) 15000 0 HOLLYWOOD UNDER THE STARS ST VINCENT DE PAUL SOCIETY PO BOX 150527 SAN RAFAEL CA 94915 941207701 501 (C) (3) 10000 0 PENNIES FROM HEAVEN GALA TRIUMPH CANCER FOUNDATION 2443 FAIR OAKS BLVD 345 SACRAMENTO CA 95825 453968833 501 (C) (3) 15000 0 TRIUMPH UNCORKED SPONSORSHIP UNIVERSITY OF FLORIDA 1250 EAST CAMPUS OFFICE BLDG GAINESVILLE FL 326113200 596002052 501 (C) (3) 10000 0 UNIVERSITY OF FLORIDA CE COURSE THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON 7500 CAMBRIDGE ST SUITE 6152 HOUSTON TX 77054 741761309 501 (C) (3) 10000 0 PACE CENTER: CDE EDUCATIONAL GRANT SUPPORT WARRIOR EXPEDITIONS 6621 FAIRWAY VIEW ROANOKE VA 24018 465201997 501 (C) (3) 20000 0 CONTRIBUTION 34 1 PART I, LINE 2: THE ORGANIZATION AWARDS GRANTS AND PROVIDES OTHER ASSISTANCE THROUGH CONTRIBUTIONS AND/OR SPONSORSHIPS FOR PROGRAMS THAT FOSTER DENTAL HEALTH AND EDUCATION, AS WELL AS COMMUNITY SUPPORT. THROUGH THESE GRANTS, CONTRIBUTIONS AND SPONSORSHIPS, THE ORGANIZATION HELPS FINANCE HEALTH, EDUCATION, AND RESEARCH PROJECTS IN DENTISTRY, HEALTH AND HUMAN SERVICES, AND CIVIC AND/OR COMMUNITY ACTIVITIES. INDIVIDUAL GRANTS, CONTRIBUTIONS AND/OR SPONSORSHIPS WILL GENERALLY NOT EXCEED $100,000 WITH EXCEPTION OF THE CONTRIBUTION MADE TO THE DELTA DENTAL COMMUNITY CARE FOUNDATION. GRANTS WILL BE LIMITED TO ONE-YEAR PROJECTS, SUBJECT TO RENEWAL. EXCEPT IN SPECIAL CASES, AN ORGANIZATION/ENTITY WILL NOT BE ELIGIBLE FOR MORE THAN ONE GRANT DURING ANY YEAR. X X X 1 1 X X X X 1 0 0 0 0 0 0 1 0 CASTRO MICHAEL J CHIEF EXECUTIVE OFFICER 1423077 0 5037406 0 448882 0 230073 0 32059 0 7171497 0 0 0 JACKSON KEVIN EXECUTIVE VICE PRESIDENT/CHIEF GROWT 0 0 2161459 0 1998561 0 16795 0 0 0 4176815 0 0 0 CHAVARRIA SARAH M PRESIDENT 875000 0 2191210 0 18342 0 34650 0 32059 0 3151261 0 0 0 WEBER ALICIA F EXECUTIVE VICE PRESIDENT CHIEF FINAN 848558 0 1821731 0 67043 0 57050 0 17010 0 2811392 0 0 0 HANKINSON MICHAEL G EXECUTIVE VICE PRESIDENT CHIEF LEGAL 674039 0 1494755 0 68231 0 34650 0 21160 0 2292835 0 0 0 TITCOMBE DOMINIC EXECUTIVE VICE PRESIDENT/CHIEF INFOR 589231 0 1296017 0 33146 0 34650 0 32059 0 1985103 0 0 0 RUIZ JOSEPH F VICE PRESIDENT GROWTH STRATEGY BUSIN 59878 0 0 0 1711488 0 31759 0 3468 0 1806593 0 0 0 NAVID MOHAMMADREZA SENIOR VICE PRESIDENT CHIEF NETWORK 519615 0 699678 0 61309 0 53221 0 25830 0 1359653 0 0 0 SHERMAN BRIAN SENIOR VICE PRESIDENT CHIEF PEOPLE O 521587 0 543311 0 45886 0 34650 0 23432 0 1168866 0 0 0 MANOWSKI MICHAEL SENIOR VICE PRESIDENT CHIEF TECHNOLO 463739 0 566818 0 11314 0 34650 0 17745 0 1094266 0 0 0 LEIBOWITZ THOMAS J SENIOR VICE PRESIDENT CHIEF ACTUARY 414712 0 512874 0 74127 0 37801 0 16811 0 1056325 0 0 0 SCHROEDER KURT GRAY SENIOR VICE PRESIDENT CHIEF MARKETIN 429423 0 485886 0 7956 0 34650 0 27315 0 985230 0 0 0 FEGLEY ANDREA M SENIOR VICE PRESIDENT LEGAL AFFAIRS 409615 0 490135 0 7889 0 36759 0 17823 0 962221 0 0 0 PARKER EARL JR SENIOR VICE PRESIDENT CUSTOMER OPERA 0 360298 0 428420 0 8038 0 34650 0 20840 0 852246 0 0 BALTIS THOMAS VICE PRESIDENT CHIEF INFORMATION SEC 352345 0 410384 0 1895 0 34650 0 10675 0 809949 0 0 0 SHEETZ MARTY A VICE PRESIDENT BUSINESS IMPLEMENTATI 327114 0 411539 0 7903 0 34650 0 15808 0 797014 0 0 0 CROLEY DANIEL W VICE PRESIDENT CHIEF DENTAL OFFICER 353468 0 352106 0 9993 0 49159 0 31405 0 796131 0 0 0 GOLDMAN EDWARD L JR VICE PRESIDENT INFRASTRUCTURE ENGINE 344442 0 348967 0 15163 0 34650 0 21833 0 765055 0 0 0 PARTHASARATHY SRIPADH VICE PRESIDENT IT DEVELOPMENT 311769 0 379193 0 5811 0 41531 0 23298 0 761602 0 0 0 MACGILVRAY JENNIFER SENIOR VICE PRESIDENT QUALITY CARE A 0 369615 0 308742 0 13749 0 34650 0 30173 0 756929 0 0 ALBUM JEFFREY M VICE PRESIDENT PUBLIC & GOVERNMENT A 325298 0 312779 0 36679 0 62135 0 17772 0 754663 0 0 0 TODI HEMANT VICE PRESIDENT DATA ANALYTICS AND IN 337963 0 341474 0 7646 0 34650 0 27263 0 748996 0 0 0 MANER MICHAEL VICE PRESIDENT SALES 0 323564 0 346872 0 1408 0 38286 0 26336 0 736466 0 0 NAKAHARA EARL VICE PRESIDENT RISK, ETHICS AND COMP 336904 0 304268 0 9703 0 34650 0 27271 0 712796 0 0 0 SBRAGIA RICHARD J VICE PRESIDENT FINANCE - FINANCIAL O 328075 0 314600 0 16830 0 34650 0 15814 0 709969 0 0 0 SANCHEZ WALTER VICE PRESIDENT INTERNAL AUDIT 297897 0 282952 0 52764 0 40355 0 31881 0 705849 0 0 0 SWAMINATHAN SHANMUGA S VICE PRESIDENT ENTERPRISE ARCHITECTU 316080 0 303237 0 9674 0 38339 0 19064 0 686394 0 0 0 THOLIA ASHISH SENIOR DIRECTOR STRATEGY BUSINESS DE 298487 0 296127 0 54378 0 9900 0 22570 0 681462 0 0 0 MARTEL LORI ANN VICE PRESIDENT PRODUCT 0 0 0 0 637494 0 0 0 0 0 637494 0 0 0 O'TOOLE KEVIN M DIRECTOR SALES 198011 0 348282 0 10886 0 40009 0 31622 0 628810 0 0 0 STEELE CHRISTINA SENIOR DIRECTOR LEGAL SERVICES, SR A 306149 0 195576 0 1359 0 34650 0 31672 0 569406 0 0 0 STIAK MATTHEW DIRECTOR CYBER RISK OPERATIONS AND E 288487 0 181083 0 6387 0 34650 0 230 0 510837 0 0 0 KAPLAN GREGORY D DDS DIRECTOR 308360 0 0 0 0 0 0 0 0 0 308360 0 0 0 YODOWITZ HEIDI CHAIR 241771 0 0 0 0 0 0 0 0 0 241771 0 0 0 BERGERT GLEN F SECOND VICE CHAIR 184500 35000 0 0 0 0 0 0 0 0 184500 35000 0 0 O'TOOLE TERRY A DIRECTOR 186775 0 0 0 0 0 0 0 0 0 186775 0 0 0 GONELLA ROY A FIRST VICE CHAIR 156774 0 0 0 0 0 0 0 0 0 156774 0 0 0 MCCANN STEVEN F DIRECTOR 156774 0 0 0 0 0 0 0 0 0 156774 0 0 0 PART I, LINE 1A FIRST CLASS BUSINESS TRAVEL IS REIMBURSED TO THE CEO, EXECUTIVE VICE PRESIDENTS, AND SENIOR VICE PRESIDENTS. FIRST CLASS BUSINESS TRAVEL IS NOT TREATED AS TAXABLE COMPENSATION. TRAVEL FOR COMPANIONS WAS PROVIDED TO ONE HIGHEST COMPENSATED EMPLOYEE. THE COST OF THIS BENEFIT WAS INCLUDED IN TAXABLE COMPENSATION. FINANCIAL AND TAX PLANNING EXPENSES ARE REIMBURSED TO EMPLOYEES AT THE DIRECTOR OR ABOVE LEVELS OF MANAGEMENT. A COMPANY POLICY OUTLINES THE MAXIMUM REIMBURSEMENT ALLOWED FOR EACH MANAGEMENT LEVEL. ONE OFFICER, EIGHT KEY EMPLOYEES, AND TWO HIGHEST COMPENSATED EMPLOYEES RECEIVED REIMBURSEMENT IN 2023. THESE REIMBURSEMENTS ARE INCLUDED IN THE TAXABLE COMPENSATION OF THE REIMBURSED EMPLOYEES. PART I, LINE 4A DURING 2023, THREE EXECUTIVES, KEVIN L. JACKSON, LORI ANN MARTEL, AND JOSEPH F. RUIZ RECEIVED A SEVERANCE PAYMENT UPON SEPARATION FROM THE ORGANIZATION. THIS PAYMENT IS INCLUDED ON SCHEDULE J AND REPORTED IN PART II, COLUMN (B)(III). PART I, LINE 7: THE CEO OF THE ORGANIZATION, WITH BOARD OF DIRECTORS APPROVAL, MAY GRANT AN ANNUAL BONUS TO ALL MANAGEMENT EMPLOYEES. THESE AMOUNTS ARE INCLUDED IN TAXABLE COMPENSATION. DELTA DENTAL OF CALIFORNIA MAINTAINS A LONG-TERM INCENTIVE PLAN (LTIP) FOR ELIGIBLE EMPLOYEES OF THE ORGANIZATION, LINKING COMPENSATION TO THE COMPANY'S PERFORMANCE. USING SUCCESS METRICS SUCH AS REVENUES, NET GAIN AS A PERCENTAGE OF REVENUES, AND OTHERS, ALLOWS THE COMPANY TO ACCURATELY MEASURE ITS GROWTH, INFORM ON PROGRESS OF ITS BUSINESS TRANSFORMATION, AND EMPOWER CONTINUED SUCCESS. THE LTIP IS UNFUNDED AND ALL PAYMENTS FROM THE LTIP ARE DERIVED FROM THE GAINS OF THE COMPANY. AS SUCH, THERE IS NO GUARANTEE OF INCENTIVE PAYMENTS UNDER THE LTIP. THE CEO MAKES RECOMMENDATIONS TO THE COMPENSATION COMMITTEE FOR ITS REVIEW AND APPROVAL REGARDING THE PERFORMANCE OBJECTIVES, BOTH FINANCIAL AND NON-FINANCIAL, UPON WHICH PAYMENT OF AWARDS ARE BASED AND THE TIME PERIOD DURING WHICH PERFORMANCE SHALL BE MEASURED. EACH LTIP PLAN SPANS THREE YEARS, OVERLAPPING WITH CURRENT PLANS. THESE AMOUNTS ARE INCLUDED IN TAXABLE COMPENSATION. PART II, ROW (II): SOME OF THE ORGANIZATION'S OFFICERS ARE PAID BY A RELATED ORGANIZATION. ACCORDINGLY, THEIR COMPENSATION IS REPORTED ON ROW (II). GREGORY D KAPLAN DDS PARTICIPATING PROVIDER 668747 DENTAL CLAIM PAYMENTS 0 BRENT KAPLAN FAMILY MEMBER OF A CURRENT DIRECTOR 411690 ADMINISTRATIVE MANAGEMENT AND ADVISORY SERVICES 0 FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION AMENDED ITS BYLAWS TO REQUIRE EITHER THE CHAIR OR VICE CHAIR OF THE BOARD TO BE INDEPENDENT PER THE INTERNAL REVENUE SERVICE DEFINITION CONTAINED IN THE INSTRUCTIONS TO FORM 990. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S BYLAWS NAME TWO CLASSES OF "MEMBERS," "CORPORATE MEMBERS AND "DENTIST MEMBERS." ALL CORPORATE MEMBERS ARE ALSO DIRECTORS OF THE ORGANIZATION AND SO ARE NOT "MEMBERS" AS DEFINED IN THE INSTRUCTIONS TO FORM 990, PART VI, QUESTION 6. HOWEVER, THE ORGANIZATION'S DIRECTORS ARE ELECTED BY ITS PARENT HOLDING COMPANY BOARD OF DIRECTORS, TWO OF WHOM ARE NOT ALSO DIRECTORS OF THE ORGANIZATION AND THUS MAY BE CONSIDERED "MEMBERS" PURSUANT TO THE INSTRUCTIONS. THE DENTIST MEMBERS HAVE A RIGHT TO VOTE UPON PROPOSED CHANGES TO THE PROPORTION OF THE DENTISTS SERVING AS DIRECTORS AND CORPORATE MEMBERS, AND SO MAY BE CONSIDERED "MEMBERS" UNDER THE INSTRUCTIONS. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S DIRECTORS ARE ELECTED BY THE PARENT HOLDING COMPANY BOARD OF DIRECTORS, WHICH INCLUDES TWO PERSONS WHO ARE NOT ALSO DIRECTORS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B THE DENTIST MEMBERS HAVE A RIGHT TO VOTE ONLY UPON PROPOSED CHANGES TO THE BYLAWS PROVISIONS THAT SPECIFY THE PROPORTION OF DENTISTS AND LAY PERSONS SERVING AS DIRECTORS AND CORPORATE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S CFO AND LEGAL COUNSEL OVERSEE THE COMPLETION OF THE FORM 990, AND, PRIOR TO FILING, REVIEW IT WITH THE PRESIDENT/CEO AND WITH THE ORGANIZATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY, AND BETWEEN ANNUAL STATEMENTS IS REQUIRED TO DISCLOSE ANY NEW POSITION OR RELATIONSHIP FORMED THAT POTENTIALLY RAISES A CONFLICT OF INTEREST. LEGAL COUNSEL REVIEWS THESE DISCLOSURES AND REPORTS THE INFORMATION TO THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PAID TO THE CEO AND EXECUTIVE VICE PRESIDENTS IS APPROVED BY THE COMPENSATION COMMITTEE OF THE ORGANIZATION. THE COMPENSATION COMMITTEE APPROVES COMPENSATION FOR THE ENSUING YEAR AFTER REVIEWING COMPARABILITY DATA PRESENTED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT, AN ASSESSMENT OF EACH OFFICER'S PERFORMANCE OVER THE PRECEDING YEAR, AND THE ORGANIZATION'S PROGRAM ACCOMPLISHMENTS FOR THE PRIOR YEAR. COMPENSATION PAID TO DIRECTORS IS ALSO APPROVED BY THE COMPENSATION COMMITTEE AFTER REVIEWING COMPARABILITY DATA IN A BENCHMARKING STUDY PREPARED AND PRESENTED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT RETAINED BY THE BOARD OF DIRECTORS. THESE PROCESSES WERE FOLLOWED FOR 2023 COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENT AVAILABLE TO PERSONS OR ENTITIES KNOWN TO HAVE AN INTEREST IN THE ORGANIZATION. STATUTORY FINANCIAL STATEMENTS FOR SUBSIDIARY COMPANIES ARE INCLUDED IN QUARTERLY AND ANNUAL RETURNS TO STATE DEPARTMENTS OF INSURANCE REGULATING THE ORGANIZATION WHICH RETURNS ARE AVAILABLE TO THE PUBLIC. THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. FORM 990, PART VII; SCHEDULE J; SCHEDULE R THE ORGANIZATION, REGULATED BY THE CALIFORNIA DEPARTMENT OF MANAGED HEALTH CARE, IS A MEMBER OF THE DELTA DENTAL OF CALIFORNIA ENTERPRISE COMPANIES, WHICH INCLUDE DELTA DENTAL OF CALIFORNIA, DELTA DENTAL OF PENNSYLVANIA AND AFFILIATED COMPANIES. THE ENTERPRISE OFFERS DENTAL COVERAGE IN ALL 50 STATES, THE DISTRICT OF COLUMBIA, PUERTO RICO, AND THE U.S. VIRGIN ISLANDS, WITH A LOCAL PRESENCE IN COMMUNITIES ACROSS THE COUNTRY, PROVIDING GROUPS AND INDIVIDUALS WITH QUALITY, COST-EFFECTIVE DENTAL INSURANCE, AND SUPERIOR CUSTOMER SERVICE. THE ENTERPRISE COMPANIES COMPRISE ONE OF THE NATION'S LARGEST DENTAL BENEFITS DELIVERY SYSTEMS COVERING 40.6 MILLION ENROLLEES AND PROCESSING 60 MILLION CLAIMS. TOTAL REVENUE FOR THE ENTERPRISE EXCEEDED $10.5 BILLION IN 2023. THE ORGANIZATION REPRESENTS APPROXIMATELY 59% OF TOTAL ENTERPRISE REVENUES. FORM 990, PART XI, LINE 9: PENSION LIABILITY AND POST-RETIREMENT ADJUSTMENTS 4,351,675. NET INCOME FROM DISREGARDED ENTITY -266,382. ADOPTION OF NEW ACCOUNTING STANDARD -6,071,149. 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