DELTA DENTAL PLAN OF NEW JERSEY: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- DELTA DENTAL PLAN OF NEW JERSEY (EIN 22-1896118)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-10
- IRS object ID
- 202243149349303634
- 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 | 2022-11-10T11:59:27-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WithumSmithBrown PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 JEFFERSON PARK STE 400 | AddressLine1Txt |
| City | Whippany | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 079811070 | 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 | 221896118 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF NEW JERSEY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % MICHAEL RODRIGUES | InCareOfNm |
| Business Name Control | DELT | BusinessNameControlTxt |
| Phone | 9732854205 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1639 ROUTE 10 PO BOX 222 | AddressLine1Txt |
| City | PARSIPPANY | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 070540222 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL RODRIGUES | PersonNm |
| Person Title | SVP/CFO | PersonTitleTxt |
| Phone | 9732854205 | PhoneNum |
| Signature | 2022-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MICHAEL | PersonFirstNm |
| Person Last | RODRIGUES | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 000000000 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Scott J Mariani | PreparerPersonNm |
| PTIN | P00642486 | PTIN |
| Phone | 9738989494 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| 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) |
|---|---|---|
| Principal Officer | DENNIS G WILSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1639 ROUTE 10 | AddressLine1Txt |
| City | PARSIPPANY | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 070540222 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $458,373,699 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | deltadentalnj.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1969 | FormationYr |
| Legal Domicile State | NJ | LegalDomicileStateCd |
| Activity Or Mission | TO PROMOTE ORAL HEALTH TO THE GREATEST NUMBER OF PEOPLE BY PROVIDING ACCESSIBLE DENTAL BENEFIT PROGRAMS OF THE HIGHEST QUALITY, SERVICE AND VALUE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 400 | 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 | $265,223,167 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $291,612,914 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,547,456 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,395,346 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$1,476,562 | PYOtherRevenueAmt |
| CY Other Revenue | -$2,629,065 | CYOtherRevenueAmt |
| PY Total Revenue | $269,294,061 | PYTotalRevenueAmt |
| CY Total Revenue | $295,379,195 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $3,288,742 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $214,664 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $170,447,070 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $209,677,864 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $41,763,611 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $41,501,007 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $47,200,312 | PYOtherExpensesAmt |
| CY Other Expenses | $43,609,802 | CYOtherExpensesAmt |
| PY Total Expenses | $262,699,735 | PYTotalExpensesAmt |
| CY Total Expenses | $295,003,337 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,594,326 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $375,858 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $341,103,768 | TotalAssetsBOYAmt |
| Total Assets EOY | $344,405,175 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $94,270,682 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $95,307,179 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $246,833,086 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $249,097,996 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROMOTE ORAL HEALTH TO THE GREATEST NUMBER OF PEOPLE BY PROVIDING ACCESSIBLE DENTAL BENEFIT PROGRAMS OF THE HIGHEST QUALITY, SERVICE AND VALUE. THE ORGANIZATION ALSO OFFERS AFFORDABLE DENTAL COVERAGE FOR THOSE INDIVIDUALS IN NEW JERSEY WITHOUT ACCESS TO A GROUP DENTAL PLAN. THE ORGANIZATION'S PLANS PROVIDE ACCESS TO A BROAD ARRAY OF DENTAL SERVICES THROUGH ITS VAST NETWORK OF PARTICIPATING DENTISTS. THE ORGANIZATION'S PLANS OFFER QUALITY COVERAGE OPTIONS AT COMPETITIVE RATES. FOR MORE THAN 50 YEARS, DELTA DENTAL OF NEW JERSEY HAS REACHED OUT TO SERVE THE PEOPLE OF NEW JERSEY AND, MORE RECENTLY, IN CONNECTICUT. IN 1986, WE FORMED THE DELTA DENTAL OF NEW JERSEY FOUNDATION, INC. TO AID IN CREATING ACCESS TO CARE FOR THE UNDER-INSURED AND UN-INSURED, AND SUPPORT DENTAL EDUCATION PROGRAMS FOR CHILDREN, AS WELL AS DENTAL ASSISTING AND DENTAL HYGIENE SCHOLARSHIPS FOR STUDENTS PURSUING A CAREER IN THE DENTAL FIELD. EACH YEAR, OUR FOUNDATION AWARDS AT LEAST $1 MILLION TO SUPPORT WORTHWHILE N | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $286,492,257 | ExpenseAmt |
| Grant | $214,664 | GrantAmt |
| Revenue | $291,612,914 | RevenueAmt |
| Desc | EXPENSES INCURRED IN PROMOTING ORAL HEALTH TO THE GREATEST NUMBER OF PEOPLE BY PROVIDING ACCESSIBLE DENTAL BENEFIT PROGRAMS OF THE HIGHEST QUALITY, SERVICE AND VALUE; PRIMARILY THROUGH CONTRACTS WITH INDEPENDENT DENTISTS TO MEMBER SUBSCRIBERS. PLEASE ALSO REFER TO THE ORGANIZATION'S COMPLETE MISSION INCLUDED IN OUR RESPONSE TO PART III, QUESTION #1 ABOVE. | Desc |
| Total Program Service Expenses | $286,492,257 | 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 |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | 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 | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| 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 With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 54927 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 400 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | Yes (true) | ForeignFinancialAccountInd |
| Foreign Country | BD | ForeignCountryCd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | Yes (true) | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL RODRIGUES | PersonNm |
| Phone | 9732854205 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1639 ROUTE 10 | AddressLine1Txt |
| City | PARSIPPANY | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 070540222 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| DENNIS G WILSON | |||||||||
| PRESIDENT/CEO | 50.0 | 0.7 | Yes (X) | $1,913,517 | $0 | $92,547 | |||
| LORI A ACKER | |||||||||
| SVP OPERATIONS | 50.0 | 0.0 | $1,209,899 | $0 | $73,778 | Yes (X) | |||
| PAUL J DIMAIO ESQ | |||||||||
| SVP/GENERAL COUNSEL | 50.0 | 0.4 | $760,124 | $0 | $97,767 | Yes (X) | |||
| VINCENT FARINELLA | |||||||||
| VP STRATEGY & PRODUCT DEVELOP | 50.0 | 0.0 | $730,092 | $0 | $60,278 | Yes (X) | |||
| MICHAEL RODRIGUES | |||||||||
| SVP/CFO | 50.0 | 0.4 | Yes (X) | $639,375 | $0 | $64,646 | |||
| KEITH D LIBOU | |||||||||
| CHIEF CLINICAL OFFICER | 50.0 | 0.0 | $594,932 | $0 | $93,946 | Yes (X) | |||
| JEFF FURBISH | |||||||||
| VP/CSO | 50.0 | 0.0 | $546,499 | $0 | $96,122 | Yes (X) | |||
| RANDY M STODARD | |||||||||
| VP/CHIEF MARKETING OFFICER | 50.0 | 0.4 | $473,043 | $0 | $92,150 | Yes (X) | |||
| JUSTIN LAHULLIER | |||||||||
| CIO/VP INFORMATION SERVICES | 50.0 | 0.0 | $392,112 | $0 | $95,982 | Yes (X) | |||
| KEVIN BUCKMAN | |||||||||
| ACCOUNT EXECUTIVE | 50.0 | 0.0 | $377,780 | $0 | $88,641 | Yes (X) | |||
| CLAUDE RICHARDSON | |||||||||
| SVP HR (TERM 12/31/21) | 50.0 | 0.0 | $398,758 | $0 | $36,005 | Yes (X) | |||
| BARRY PETRUZZI | |||||||||
| VP UNDERWRITING | 50.0 | 0.0 | $325,044 | $0 | $96,681 | Yes (X) | |||
| DAVID ATHA | |||||||||
| ASSISTANT VICE PRESIDENT | 50.0 | 0.0 | $273,139 | $0 | $86,975 | Yes (X) | |||
| UMESH KUMAR | |||||||||
| ASSISTANT VICE PRESIDENT | 50.0 | 0.0 | $238,797 | $0 | $89,318 | Yes (X) | |||
| DOREEN PILIGIAN | |||||||||
| AVP & Associate Gen. Counsel | 50.0 | 0.0 | $268,848 | $0 | $58,829 | Yes (X) | |||
| WENDY WALKER | |||||||||
| GENERAL MANAGER (TERM 5/7/21) | 50.0 | 0.0 | $282,915 | $0 | $41,042 | Yes (X) | |||
| ROOTA ALMEIDA | |||||||||
| CHIEF INFO. SECURITY OFFICER | 50.0 | 0.0 | $271,910 | $0 | $43,318 | Yes (X) | |||
| RONALD I DEBLINGER DMD | |||||||||
| CHAIRMAN - TRUSTEE | 25.0 | 1.0 | Yes (X) | $257,321 | $0 | $33,937 | Yes (X) | ||
| GENE F NAPOLIELLO DDS | |||||||||
| TRUSTEE | 3.0 | 6.0 | $83,918 | $0 | $2,427 | Yes (X) | |||
| WILLIAM J FAULKNER | |||||||||
| TRUSTEE | 4.4 | 1.0 | $69,918 | $11,000 | $1,655 | Yes (X) | |||
| MORTON REINHART | |||||||||
| TRUSTEE | 4.9 | 1.0 | $69,918 | $11,000 | $1,350 | Yes (X) | |||
| LISA N GALLUCCI DMD | |||||||||
| TRUSTEE | 3.0 | 1.0 | $69,918 | $5,000 | $789 | Yes (X) | |||
| JOSEPH P MAZZA DMD | |||||||||
| TRUSTEE | 3.0 | 0.0 | $69,918 | $5,000 | $0 | Yes (X) | |||
| DEBRA G SALMAN DDS | |||||||||
| TRUSTEE | 3.0 | 1.0 | $69,918 | $0 | $2,567 | Yes (X) | |||
| RICHARD G BOZZA EDD | |||||||||
| TRUSTEE | 3.0 | 0.0 | $69,918 | $0 | $1,350 | Yes (X) | |||
| JAY H OYER | |||||||||
| TRUSTEE | 3.0 | 1.0 | $69,918 | $0 | $1,350 | Yes (X) | |||
| JORGE E GRACIA ESQ | |||||||||
| TRUSTEE | 3.0 | 0.0 | $63,918 | $0 | $2,294 | Yes (X) | |||
| GEORGE C MCLAUGHLIN DMD | |||||||||
| TRUSTEE | 4.8 | 1.0 | $63,918 | $0 | $789 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $10,457,531 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $32,000 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,352,100 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 93 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line1ContractorAddress/ForeignAddress/AddressLine1Txt | CityContractorAddress/ForeignAddress/CityNm | Province Or StateContractorAddress/ForeignAddress/ProvinceOrStateNm | CountryContractorAddress/ForeignAddress/CountryCd |
|---|---|---|---|---|---|---|---|---|---|
| WYSSTA SERVICES INC | |||||||||
| PO BOX 86 | STEVENS POINT | WI | 54481 | CLAIMS PROCESSING | $4,895,924 | ||||
| 8 WEST CONSULTING | |||||||||
| SYSTEMS DEVELOPER | $2,925,892 | CURRAHEEN ROAD | CORK | 0 | EI | ||||
| ENCARA INC | |||||||||
| 4818 STARKEY ROAD | ROANOKE | VA | 24018 | MARKETING | $2,306,144 | ||||
| PRESIDIO NETWORKED SOLUTIONS INC | |||||||||
| PO BOX 677638 | DALLAS | TX | 752677638 | NETWORK SOLUTIONS | $2,149,213 | ||||
| DENTAL ASSOC OF CONNECTICUT | |||||||||
| 36 PADANARAM ROAD | DANBURY | CT | 068114824 | DENTAL PROVIDER | $2,060,751 | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1073 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| DENTAL BENEFITS COVERAGE REVENUE | 524114 | $290,765,050 | $290,765,050 |
| OTHER RELATED REVENUE | 900099 | $847,864 | $847,864 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $291,612,914 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,431,740 | TotalRevenueColumnAmt |
| Exclusion | $2,431,740 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $766,133 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,395,198 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$2,629,065 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$2,629,065 | TotalRevenueColumnAmt |
| Exclusion | -$2,629,065 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $163,562,912 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $159,599,306 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,963,606 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,963,606 | TotalRevenueColumnAmt |
| Exclusion | $3,963,606 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $295,379,195 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $291,612,914 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $3,766,281 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $214,664 | TotalAmt |
| Program Services | $214,664 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $209,677,864 | TotalAmt |
| Program Services | $209,677,864 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,205,534 | TotalAmt |
| Program Services | $9,184,981 | ProgramServicesAmt |
| Management And General | $1,020,553 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,035,232 | TotalAmt |
| Program Services | $18,031,709 | ProgramServicesAmt |
| Management And General | $2,003,523 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,308,478 | TotalAmt |
| Program Services | $3,877,630 | ProgramServicesAmt |
| Management And General | $430,848 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,820,875 | TotalAmt |
| Program Services | $4,338,787 | ProgramServicesAmt |
| Management And General | $482,088 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,130,888 | TotalAmt |
| Program Services | $1,917,799 | ProgramServicesAmt |
| Management And General | $213,089 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,742 | TotalAmt |
| Program Services | $184,268 | ProgramServicesAmt |
| Management And General | $20,474 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $302,573 | TotalAmt |
| Program Services | $272,316 | ProgramServicesAmt |
| Management And General | $30,257 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,484 | TotalAmt |
| Program Services | $92,236 | ProgramServicesAmt |
| Management And General | $10,248 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,118,000 | TotalAmt |
| Program Services | $1,006,200 | ProgramServicesAmt |
| Management And General | $111,800 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,777,767 | TotalAmt |
| Program Services | $14,199,990 | ProgramServicesAmt |
| Management And General | $1,577,777 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,043,909 | TotalAmt |
| Program Services | $1,839,518 | ProgramServicesAmt |
| Management And General | $204,391 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,966,729 | TotalAmt |
| Program Services | $4,470,056 | ProgramServicesAmt |
| Management And General | $496,673 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $869,007 | TotalAmt |
| Program Services | $782,106 | ProgramServicesAmt |
| Management And General | $86,901 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$319,272 | TotalAmt |
| Program Services | -$287,345 | ProgramServicesAmt |
| Management And General | -$31,927 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,305 | TotalAmt |
| Program Services | $246,874 | ProgramServicesAmt |
| Management And General | $27,431 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,518,838 | TotalAmt |
| Program Services | $3,166,955 | ProgramServicesAmt |
| Management And General | $351,883 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $697,446 | TotalAmt |
| Program Services | $627,702 | ProgramServicesAmt |
| Management And General | $69,744 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| BROKERAGE COMMISSIONS | $11,902,472 | $10,712,225 | $1,190,247 | $0 |
| DUES & SUBSCRIPTIONS | $1,080,341 | $972,307 | $108,034 | $0 |
| RECRUITMENT & DEVELOPMENT | $298,159 | $268,343 | $29,816 | $0 |
| OTHER EXPENSES | $772,302 | $695,072 | $77,230 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $295,003,337 | TotalAmt |
| Program Services | $286,492,257 | ProgramServicesAmt |
| Management And General | $8,511,080 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,753,885 | BOYAmt |
| EOY | $7,590,307 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,071,392 | BOYAmt |
| EOY | $46,896,603 | 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 |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,661,999 | BOYAmt |
| EOY | $2,537,415 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $84,514,517 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $52,875,317 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,230,381 | BOYAmt |
| EOY | $31,639,200 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $210,176,479 | BOYAmt |
| EOY | $202,796,709 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,820,471 | BOYAmt |
| EOY | $39,569,095 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,790,949 | BOYAmt |
| EOY | $11,517,457 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $165,870 | BOYAmt |
| EOY | $115,592 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,432,342 | BOYAmt |
| EOY | $1,742,797 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $341,103,768 | BOYAmt |
| EOY | $344,405,175 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,209,216 | BOYAmt |
| EOY | $20,692,118 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,061,466 | BOYAmt |
| EOY | $74,615,061 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,270,682 | BOYAmt |
| EOY | $95,307,179 | 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 | $25,000 | BOYAmt |
| EOY | $25,000 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $270,647,561 | BOYAmt |
| EOY | $274,890,545 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$23,839,475 | BOYAmt |
| EOY | -$25,817,549 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $246,833,086 | BOYAmt |
| EOY | $249,097,996 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $341,103,768 | BOYAmt |
| EOY | $344,405,175 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $375,858 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,862,642 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $4,751,694 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,060,407 | OtherCostOrOtherBasisAmt |
| Book Value | $10,060,407 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,286,568 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,824,263 | DepreciationAmt |
| Book Value | $7,462,305 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,302,267 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,001,791 | DepreciationAmt |
| Book Value | $5,300,476 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $52,708,294 | OtherCostOrOtherBasisAmt |
| Depreciation | $44,354,044 | DepreciationAmt |
| Book Value | $8,354,250 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,156,981 | OtherCostOrOtherBasisAmt |
| Depreciation | $695,219 | DepreciationAmt |
| Book Value | $461,762 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $31,639,200 | TotalBookValueLandBuildingsAmt |
| Financial Derivatives | FinancialDerivativesGrp | |
| Closely Held Equity Interests | CloselyHeldEquityInterestsGrp |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | EQUITY SECURITIES | Desc |
| Book Value | $39,569,095 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $39,569,095 | TotalBookValueSecuritiesAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)
| DescDesc | AmtAmt |
|---|---|
| UNPAID CLAIMS | $40,806,000 |
| UNPAID CLAIMS ADJUSTMENT EXPENSES | $2,772,000 |
| DEPOSITS AND ADVANCES | $5,187,022 |
| ACCRUED PENSION COSTS | $16,885,810 |
| OTHER LIABILITIES | $8,721,714 |
| SECURITY DEPOSITS | $66,947 |
| DUE TO AFFILIATES | $175,568 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $74,615,061 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $302,073,649 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$2,862,642 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $5,653,266 | OtherRevenueAmt |
| Revenue Not Reported | $2,790,624 | RevenueNotReportedAmt |
| Revenue Subtotal | $299,283,025 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$3,903,830 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$3,903,830 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $295,379,195 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $298,977,644 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $5,653,266 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $5,653,266 | ExpensesNotReportedAmt |
| Expenses Subtotal | $293,324,378 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $1,118,000 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $560,959 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,678,959 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $295,003,337 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART X | AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE TAXPAYER AND ITS SUBSIDIARIES AND AFFILIATE FOR THE YEARS ENDED DECEMBER 31, 2021 AND DECEMBER 31, 2020; RESPECTIVELY, AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES BY ENTITY. THE FIN 48 (ASC 740) FOOTNOTE BELOW IS FROM THE ORGANIZATION'S 2021 AUDITED CONSOLIDATED FINANCIAL STATEMENTS: THE PLAN FOLLOWS THE RECOGNITION AND DISCLOSURE PROVISIONS OF THE ACCOUNTING STANDARD RELATED TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. UNDER THIS STANDARD, TAX POSITIONS ARE EVALUATED FOR RECOGNITION USING A MORE-LIKELY-THAN-NOT THRESHOLD, AND THOSE TAX POSITIONS REQUIRING RECOGNITION ARE MEASURED AT THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED UPON ULTIMATE SETTLEMENT WITH A TAXING AUTHORITY THAT HAS FULL KNOWLEDGE OF ALL RELEVANT INFORMATION. THE PLAN HAS EVALUATED THE LIKELIHOOD OF THEIR TAX POSITIONS BEING CHALLENGED AS REMOTE AND, ACCORDINGLY HAS NOT INCLUDED ANY INCOME TAX PROVISIONS, INCLUDING INTEREST AND PENALTIES, IN THE FINANCIAL STATEMENTS RELATED TO POTENTIAL VIOLATIONS. |
| SCHEDULE D, PART XI, LINE 2D | OTHER AMOUNTS INCLUDED ON AUDITED FINANCIAL STATEMENTS BUT NOT ON FORM 990: - INTERCOMPANY RENT PAID TO DISREGARDED ENTITY - $2,273,978; - EXPENSES OF DISREGARDED ENTITY - $3,379,288. |
| SCHEDULE D, PART XI, LINE 4B | OTHER AMOUNTS INCLUDED ON FORM 990 BUT NOT ON AUDITED FINANCIAL STATEMENTS: - REINSURANCE REIMBURSEMENT - $847,864; - NET CHANGE RELATED TO ACCRUED PENSION - ($4,751,694). |
| SCHEDULE D, PART XII, LINE 2D | OTHER AMOUNTS INCLUDED ON AUDITED FINANCIAL STATEMENTS BUT NOT ON FORM 990: - INTERCOMPANY RENT PAID TO DISREGARDED ENTITY - $2,273,978; - EXPENSES OF DISREGARDED ENTITY - $3,379,288. |
| SCHEDULE D, PART XII, LINE 4B | OTHER AMOUNTS INCLUDED ON AUDITED FINANCIAL STATEMENTS BUT NOT ON FORM 990: - REINSURANCE REIMBURSEMENT - $847,864; - NET INCOME OF DISREGARDED ENTITY - ($286,905). |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF NEW JERSEY FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1639 ROUTE 10 | AddressLine1Txt |
| City | PARSIPPANY | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 07054 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 222764745 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $214,664 | CashGrantAmt |
| Purpose Of Grant | PROGRAM SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, QUESTION 2 | FormAndLineReferenceDesc |
| Explanation | DELTA DENTAL OF NEW JERSEY FOUNDATION, INC. ("FOUNDATION"); A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, IS FUNDED SOLELY BY DELTA DENTAL OF NEW JERSEY, INC. THE MONIES DISBURSED BY THE FOUNDATION ARE BASED ON GRANT REQUESTS WHICH ARE REVIEWED AND APPROVED BY THE FOUNDATION BOARD OF TRUSTEES BASED ON NEED. IN THE CASE OF LARGE GRANT REQUESTS THAT MAY SPAN MULTIPLE YEARS, THE DISBURSEMENT MAY BE MADE FROM THE ORGANIZATION AND NOT ITS RELATED FOUNDATION. THE ORGANIZATION'S BOARD OF TRUSTEES' APPROVAL IS REQUIRED FOR THIS TYPE OF COMMITMENT. PROGRESS ON GRANTS OF THIS NATURE IS MONITORED BY THE ORGANIZATION WITH UPDATES PROVIDED TO THE BOARD OF TRUSTEES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | Yes (X) | FirstClassOrCharterTravelInd |
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Personal Services | Yes (X) | PersonalServicesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DENNIS G WILSON | ||||||||||||||
| PRESIDENT/CEO | $794,946 | $0 | $544,977 | $0 | $573,594 | $0 | $44,145 | $0 | $48,402 | $0 | $2,006,064 | $0 | $0 | $0 |
| LORI A ACKER | ||||||||||||||
| SVP OPERATIONS | $340,126 | $0 | $177,185 | $0 | $692,588 | $0 | $44,388 | $0 | $29,390 | $0 | $1,283,677 | $0 | $0 | $0 |
| PAUL J DIMAIO ESQ | ||||||||||||||
| SVP/GENERAL COUNSEL | $372,794 | $0 | $222,504 | $0 | $164,826 | $0 | $46,210 | $0 | $51,557 | $0 | $857,891 | $0 | $0 | $0 |
| VINCENT FARINELLA | ||||||||||||||
| VP STRATEGY & PRODUCT DEVELOP | $301,103 | $0 | $87,575 | $0 | $341,414 | $0 | $40,512 | $0 | $19,766 | $0 | $790,370 | $0 | $0 | $0 |
| MICHAEL RODRIGUES | ||||||||||||||
| SVP/CFO | $358,040 | $0 | $197,477 | $0 | $83,858 | $0 | $45,325 | $0 | $19,321 | $0 | $704,021 | $0 | $0 | $0 |
| KEITH D LIBOU | ||||||||||||||
| CHIEF CLINICAL OFFICER | $364,399 | $0 | $126,035 | $0 | $104,498 | $0 | $46,064 | $0 | $47,882 | $0 | $688,878 | $0 | $0 | $0 |
| JEFF FURBISH | ||||||||||||||
| VP/CSO | $255,262 | $0 | $274,859 | $0 | $16,378 | $0 | $46,255 | $0 | $49,867 | $0 | $642,621 | $0 | $0 | $0 |
| RANDY M STODARD | ||||||||||||||
| VP/CHIEF MARKETING OFFICER | $309,198 | $0 | $92,692 | $0 | $71,153 | $0 | $40,807 | $0 | $51,343 | $0 | $565,193 | $0 | $0 | $0 |
| JUSTIN LAHULLIER | ||||||||||||||
| CIO/VP INFORMATION SERVICES | $257,611 | $0 | $80,772 | $0 | $53,729 | $0 | $46,255 | $0 | $49,727 | $0 | $488,094 | $0 | $0 | $0 |
| KEVIN BUCKMAN | ||||||||||||||
| ACCOUNT EXECUTIVE | $83,046 | $0 | $293,295 | $0 | $1,439 | $0 | $39,214 | $0 | $49,427 | $0 | $466,421 | $0 | $0 | $0 |
| CLAUDE RICHARDSON | ||||||||||||||
| SVP HR (TERM 12/31/21) | $272,950 | $0 | $100,955 | $0 | $24,853 | $0 | $34,655 | $0 | $1,350 | $0 | $434,763 | $0 | $0 | $0 |
| BARRY PETRUZZI | ||||||||||||||
| VP UNDERWRITING | $243,238 | $0 | $76,520 | $0 | $5,286 | $0 | $44,684 | $0 | $51,997 | $0 | $421,725 | $0 | $0 | $0 |
| DAVID ATHA | ||||||||||||||
| ASSISTANT VICE PRESIDENT | $215,523 | $0 | $46,298 | $0 | $11,318 | $0 | $36,343 | $0 | $50,632 | $0 | $360,114 | $0 | $0 | $0 |
| UMESH KUMAR | ||||||||||||||
| ASSISTANT VICE PRESIDENT | $187,304 | $0 | $42,205 | $0 | $9,288 | $0 | $37,591 | $0 | $51,727 | $0 | $328,115 | $0 | $0 | $0 |
| DOREEN PILIGIAN | ||||||||||||||
| AVP & Associate Gen. Counsel | $211,990 | $0 | $44,820 | $0 | $12,038 | $0 | $41,812 | $0 | $17,017 | $0 | $327,677 | $0 | $0 | $0 |
| WENDY WALKER | ||||||||||||||
| GENERAL MANAGER (TERM 5/7/21) | $76,815 | $0 | $55,000 | $0 | $151,100 | $0 | $21,096 | $0 | $19,946 | $0 | $323,957 | $0 | $0 | $0 |
| ROOTA ALMEIDA | ||||||||||||||
| CHIEF INFO. SECURITY OFFICER | $215,517 | $0 | $54,749 | $0 | $1,644 | $0 | $38,274 | $0 | $5,044 | $0 | $315,228 | $0 | $0 | $0 |
| RONALD I DEBLINGER DMD | ||||||||||||||
| CHAIRMAN - TRUSTEE | $0 | $0 | $0 | $0 | $257,321 | $0 | $0 | $0 | $33,937 | $0 | $291,258 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I; QUESTIONS 1A AND 1B | THE ORGANIZATION'S PRESIDENT/CEO TRAVELS FIRST CLASS ON BUSINESS RELATED FLIGHTS EXCEEDING THREE HOURS TO ATTEND ORGANIZATION RELATED WORK EVENTS. THIS PROVIDES THE PRESIDENT/CEO THE ABILITY TO WORK ON ORGANIZATIONAL MATTERS DURING TRAVEL. THE EXCESS COST OVER STANDARD RELATED TO THE 1ST CLASS TRAVEL WAS NOT INCLUDED IN HIS 2021 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. THE ORGANIZATION PAID FOR FINANCIAL/TAX PLANNING SERVICES FOR CERTAIN EMPLOYEES. THE FINANCIAL/TAX PLANNING SERVICES AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S RESPECTIVE 2021 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: DENNIS G. WILSON, $750 AND PAUL J. DIMAIO, ESQ., $725. EACH OF THE FOLLOWING INDIVIDUAL'S 2021 FORM W-2 INCLUDES A GROSS-UP AMOUNT RELATED TO THE PERSONAL USAGE OF AN AUTO ALLOWANCE; DENNIS G. WILSON $9,486; LORI A. ACKER $3,382; PAUL J. DIMAIO, ESQ., $3,470; VINCENT FARINELLA, $2,838; MICHAEL RODRIGUES, $3,790; KEITH D. LIBOU $2,579; RANDY M. STODARD $2,793; CLAUDE RICHARDSON, $2,936 AND WENDY WALKER $865. IN ADDITION, CERTAIN BOARD OF TRUSTEE MEMBERS' 2021 FORMS 1099-MISC INCLUDE TAX GROSS-UP PAYMENTS RELATED TO COMPENSATION PAID TO THEM FOR PERSONAL USAGE OF AN AUTO AND/OR FINANCIAL/TAX PLANNING SERVICES. |
| SCHEDULE J, PART I; QUESTION 4A | THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT DURING CALENDAR YEAR 2021 WHICH WAS INCLUDED IN HER 2021 FORM W-2, BOX 5 AS TAXABLE MEDICARE WAGES: WENDY WALKER, $117,645. |
| SCHEDULE J, PART I; QUESTION 4B | THE AMOUNTS REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDE PARTICIPATION IN A PENSION RESTORATION SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") BECAUSE THE AMOUNTS ARE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2021 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: DENNIS G. WILSON, $498,203; LORI A. ACKER, $681,387; PAUL J. DIMAIO, ESQ., $134,617; VINCENT FARINELLA, $326,644; MICHAEL RODRIGUES, $59,451; KEITH D. LIBOU, $94,369; RANDY M. STODARD, $50,865 AND JUSTIN LAHULLIER, $53,585. PLEASE NOTE THAT THE AMOUNTS REFLECTED INCLUDE A 27% TAX ADJUSTMENT WITH RESPECT TO THE SERP PAYMENTS TO MITIGATE THE TAX INEFFICIENCY OF THE NON-QUALIFIED SERP. |
| SCHEDULE J, PART I; QUESTION 7 AND CORE FORM, PART VII | INCLUDED IN COLUMN B(II) FOR CERTAIN INDIVIDUALS IS A PAYMENT RELATED TO A PROGRESS INCENTIVE PROGRAM. UNDER THIS PROGRAM, A PAYMENT IS MADE TO THESE INDIVIDUALS WHICH IS BASED ON ESTABLISHED TARGETS, BENCHMARKS AND GOALS. IF MET, THE INDIVIDUALS RECEIVE, AS A PROGRESS INCENTIVE PAYMENT, ADDITIONAL COMPENSATION BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE ABOVE NOTED PAYMENT WAS INCLUDED IN EACH INDIVIDUAL'S 2021 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CORE FORM, PART VI, SECTION A; QUESTION 3 | THE ORGANIZATION RETAINED THE SERVICES OF AN OUTSIDE PROPERTY MANAGER TO MANAGE THE DAY TO DAY ACTIVITIES AND OPERATIONS OF ITS SINGLE MEMBER LIMITED LIABILITY COMPANY; 1639 REAL ESTATE, LLC. PAYMENTS TO THE PROPERTY MANAGER AMOUNTED TO $73,182 IN 2021. |
| CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 | MEMBERS OF THE ORGANIZATION SERVE AS THE TRUSTEES OF THE ORGANIZATION AND EXISTING MEMBERS VOTE TO ELECT NEW MEMBERS OF THE ORGANIZATION. |
| CORE FORM, PART VI, SECTION B; QUESTION 11B | THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF ITS GOVERNING BODY (ITS BOARD OF TRUSTEES) PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). AS PART OF THE TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION, TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S SENIOR MANAGEMENT AND INTERNAL WORKING GROUP TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S SENIOR MANAGEMENT, FINANCE PERSONNEL AND INTERNAL WORKING GROUP FOR REVIEW. THESE INDIVIDUALS REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S SENIOR MANAGEMENT AND INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL PRIOR TO PROVIDING IT TO EACH VOTING MEMBER OF ITS GOVERNING BODY AND FILING WITH THE IRS. |
| CORE FORM, PART VI, SECTION B; QUESTION 12 | THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS, SENIOR MANAGEMENT AND OTHER KEY PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO MEMBERS OF THE ORGANIZATION'S SENIOR MANAGEMENT. SENIOR MANAGEMENT PROVIDES THE COMPLETED QUESTIONNAIRES TO THE ORGANIZATION'S AUDIT COMMITTEE FOR ITS REVIEW AND DISCUSSION WITH RESPECT TO CONFLICTS AND ANY ASSOCIATED MITIGATING BEHAVIOR. THE AUDIT COMMITTEE THEN REPORTS TO THE ORGANIZATION'S BOARD OF TRUSTEES. |
| CORE FORM, PART VI, SECTION B; QUESTION 15 | THE ORGANIZATION'S BOARD OF TRUSTEES HAS AN EXECUTIVE COMMITTEE AND A HUMAN RESOURCES COMMITTEE. THE BOARD HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT TEAM, WHICH INCLUDES THE PRESIDENT/CHIEF EXECUTIVE OFFICER, SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER, SENIOR VICE PRESIDENT/GENERAL COUNSEL, SENIOR VICE PRESIDENT/HUMAN RESOURCES AND THE SENIOR VICE PRESIDENT/CHIEF OPERATING OFFICER. THE "TOTAL COMPENSATION" OF THE INDIVIDUALS REVIEWED INCLUDES BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THIS REVIEW IS DONE ON AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. COMPENSATION FOR THE SENIOR VICE PRESIDENT/GENERAL COUNSEL, SENIOR VICE PRESIDENT/HUMAN RESOURCES, SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER AND SENIOR VICE PRESIDENT/CHIEF OPERATING OFFICER, WHO REPRESENT SENIOR MANAGEMENT OF THE ORGANIZATION, IS REVIEWED AND APPROVED BY THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF TRUSTEES ANNUALLY, AND IS EFFECTIVE EACH JANUARY 1ST. THE PRESIDENT/CHIEF EXECUTIVE OFFICER'S PERFORMANCE IS REVIEWED BY THE EXECUTIVE AND HUMAN RESOURCES COMMITTEES OF THE BOARD OF TRUSTEES, WHICH PROVIDE INPUT TO THE FULL BOARD. COMPENSATION OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER IS DETERMINED AND APPROVED BY THE BOARD OF TRUSTEES. |
| CORE FORM, PART VI, SECTION C; QUESTION 19 | THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY. |
| CORE FORM, PART VII AND SCHEDULE J | Dennis G. Wilson is involved in the leadership and management of this organization on a full-time basis. Mr. Wilson is employed by and receives a federal form w-2 from this organization. Accordingly, his common law employer/employee relationship is with Delta Dental of New Jersey, Inc. This organization filed a 2021 federal form 4720 which included a remittance of excise tax related to Mr. Wilson's compensation in excess of $1m. In addition, Lori A. Acker is involved in the leadership and management of this organization on a full-time basis. Ms. Acker is employed by and receives a federal form w-2 from this organization. Accordingly, her common law employer/employee relationship is with Delta Dental of New Jersey, Inc. This organization filed a 2021 federal form 4720 which included a remittance of excise tax related to Ms. Acker's compensation in excess of $1m. |
| CORE FORM, PART XI; QUESTION 9 | OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDES: - NET CHANGE ARISING DURING THE PERIOD RELATED TO ACCRUED PENSION; $4,751,694. |
| CORE FORM, PART XII; QUESTION 2 | AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE TAXPAYER AND ITS SUBSIDIARIES AND AFFILIATE FOR THE YEARS ENDED DECEMBER 31, 2021 AND DECEMBER 31, 2020; RESPECTIVELY, AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES BY ENTITY. AN UNMODIFIED OPINION WAS ISSUED BY THE INDEPENDENT CPA FIRM EACH YEAR. THE ORGANIZATION'S AUDIT COMMITEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS CONSOLIDATED FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| DELTA DENTAL OF NEW JERSEY PAC | |||||||||
| 1639 ROUTE 10 | PARSIPPANY | NJ | 07054 | 223754874 | RELATED | NJ | $9,400 | $28,904 | NA |
| 1639 REAL ESTATE LLC | |||||||||
| 1639 ROUTE 10 | PARSIPPANY | NJ | 07054 | RELATED | NJ | $3,092,383 | $27,708,909 | DDNJ | |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF NJ FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1639 ROUTE 10 | AddressLine1Txt |
| City | PARSIPPANY | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 07054 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 222764745 | EIN |
| Primary Activities | PUBLIC SRVC. | PrimaryActivitiesTxt |
| Legal Domicile State | NJ | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 509(A)(3) | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DDNJ | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DDPNJ CORPORATION | ||||||||||||
| 1639 ROUTE 10 | PARSIPPANY | NJ | 07054 | 223085009 | HOLDING COMPANY | NJ | DDNJ | C CORP. | $39,375,886 | $15,668,150 | 1.00000 | Yes (true) |
| FLAGSHIP HEALTH SYSTEMS INC | ||||||||||||
| 1639 ROUTE 10 | PARSIPPANY | NJ | 07054 | 222671069 | DENTAL PLAN ORG | NJ | DDPNJ | C CORP. | Yes (true) | |||
| DELTA DENTAL OF CONNECTICUT INC | ||||||||||||
| 148 EASTERN BLVD STE 301 | GLASTONBURY | CT | 06033 | 812414649 | DENTAL PLAN ORG | CT | DDPNJ | C CORP. | Yes (true) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| DELTA DENTAL OF NJ FOUNDATION INC | ||
| B | $214,664 | COST |
| DELTA DENTAL OF CONNECTICUT INC | ||
| Q | $111,999 | COST |