2016-11-10T13:10:40-06:00 2015-12-31 341851358 CBIZ MHM LLC 3625 CUMBERLAND BLVD STE 800 ATLANTA GA 30082 990 2015-01-01 111980218 DELTA DENTAL OF NEW YORK INC DELT 7177668500 ONE DELTA DRIVE MECHANICSBURG PA 17055 JEANNE FOSTER V.P. FINANCE 7177668500 2016-11-10 1 CRAIG T WILLIAMS P00621386 7708584500 2016-11-10 2015 2017-02-10 21:41:12Z JEANNE FOSTER ONE DELTA DRIVE MECHANICSBURG PA 17055 413564925 0 X WWW.DELTADENTALINS.COM X 1960 NY TO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS, SERVICE, TECHNOLOGY, AND PROFESSIONAL SUPPORT. 13 10 32 0 0 0 0 0 383817497 411058247 694865 785552 26443 103354 384538805 411947153 322850 397800 337955121 362829985 3200871 3503700 0 0 0 40510006 36496769 381988848 403228254 2549957 8718899 67611502 63640210 54400488 41718418 13211014 21921792 TO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS, SERVICE, TECHNOLOGY, AND PROFESSIONAL SUPPORT. 0 0 399727761 411947153 THE ORGANIZATION PROVIDED DENTAL BENEFIT COVERAGE FOR 1,582,998BENEFICIARIES IN 2015 PRIMARILY THROUGH CONTRACTS WITH INDEPENDENTDENTISTS SERVING 794 PURCHASING GROUPS. THE ORGANIZATION PAIDMORE THAN $362.8 MILLION FOR DENTAL CARE DURING 2015. 397800 397800 THE ORGANIZATION MADE GRANTS DURING 2015 TO FOSTER IMPROVED ACCESSTO DENTAL HEALTH CARE TREATMENT, TO SUPPORT PROFESSIONAL DENTALEDUCATION, AND TO PROVIDE ORAL HEALTH INSTRUCTION FOR PATIENTS. 400125561 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 1 74822 0 1 32 1 0 0 0 0 0 0 X 13 10 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X JEANNE FOSTER VP FINANCE 7177668500 ONE DELTA DRIVE MECHANICSBURG PA 17055 MICHAEL ALFANO DMD DIRECTOR 1.00 X 4800 0 0 ANTHONY L DIMANGO DDS DIRECTOR 1.00 X 2400 0 0 THOMAS M HALTON DMD DIRECTOR 1.00 X 4800 0 0 GEORGE S KARALEKAS VICE CHAIR 1.00 X 4800 0 0 BARBARA R KATERSKY DIRECTOR 1.00 X 4800 0 0 ANDREW S LEVINE DDS DIRECTOR 1.00 X 4800 0 0 FRANCINE Y LOPEZ DIRECTOR 1.00 X 0 0 0 ROGER A MAGLIO DIRECTOR 1.00 X 4800 0 0 STACY A MAZZA DIRECTOR 1.00 X 4800 0 0 THOMAS J MCCARTIN DIRECTOR 1.00 X 4800 0 0 LYNETTE A METZ DIRECTOR 1.00 X 0 0 0 ALAN M PATRIGNANI DDS CHAIRMAN 1.00 X 18000 0 0 JAMES E SPENCER DDS DIRECTOR 1.00 X 3600 0 0 JOZEF C VERBRAEKEN SECRETARY/TREASURER 2.00 X 6000 0 0 THOMAS H WYSMULLER DIRECTOR 1.00 X 4800 0 0 GARY D RADINE PRESIDENT / CEO 4.00 56.00 X 0 4475607 95086 ANTHONY S BARTH EVP, COO 3.00 47.00 X 0 2182863 2736344 MICHAEL J CASTRO EVP, CFO 3.00 47.00 X 0 1448792 2041700 MICHAEL G HANKINSON ESQ EVP, CLO 3.00 47.00 X 0 1201766 47682 BELINDA MARTINEZ SENIOR VICE PRESIDENT 3.00 47.00 X 0 1022124 678480 ALICIA F WEBER SVP. ENTERPRISE CONTROLLER 3.00 47.00 X 0 870243 52245 RUSSELL K BRADLEY VP, CLAIMS PROCESSING 3.00 47.00 X 0 316175 24366 ROBERT P BUDD VP, SALES 18.00 32.00 X 374175 0 59208 PHILIP N ENGLE VP, INFORMATION TECHNOLOGY 18.00 32.00 X 0 355966 62008 JEANNE M FOSTER VP, FINANCE 18.00 32.00 X 0 370240 60011 RICHARD C GRAYBILL VP, UNDERWRITING 18.00 32.00 X 0 302802 50268 TIMOTHY FALLON SALES ACCOUNT EXECUTIVE 40.00 X 132330 0 22549 STEVEN GROSSMAN SALES ACCOUNT EXECUTIVE SENIOR 40.00 X 196721 0 50846 KEVIN KING SALES ACCOUNT EXECUTIVE - LABOR LIAISON 40.00 X 205101 0 42895 ROBERT MILHISLER DIRECTOR SALES 40.00 X 180106 0 46567 ROBERT SEWARD SALES ACCOUNT EXECUTIVE 40.00 X 266350 0 51275 PATRICK S STEELE FORMER EVP/CIO 0.00 0.00 X 0 755434 0 1427983 13302012 6121530 6 1 1 0 0 DIRECT PREMIUMS 524114 411058247 411058247 411058247 785552 785552 1617772 1617772 0 MISCELLANEOUS INCOME 524114 245689 245689 BAD DEBT EXPENSE 524114 -142335 -142335 103354 411947153 411947153 0 0 397800 397800 362829985 362829985 1426850 1291730 135120 1303427 1179990 123437 200121 181170 18951 412924 373820 39104 160378 145190 15188 113341 113341 26104 26104 182854 165538 17316 389599 352704 36895 183185 165837 17348 124016 112272 11744 359485 325442 34043 9314 9314 ADMINISTRATIVE FEES 22137219 20040824 2096395 COMMISSIONS 8560806 8560806 0 LICENSES, PERMITS, FEES 1547527 1400976 146551 ACA TAXES 1117487 1011661 105826 1745832 1580502 165330 403228254 400125561 3102693 0 69580 0 36460399 29863045 228837 131921 30140058 32916979 315000 315000 397628 413265 67611502 63640210 34957606 27514356 1405772 1671719 1360000 1360000 16677110 11172343 54400488 41718418 X 0 0 0 0 13211014 21921792 13211014 21921792 67611502 63640210 8718899 -8121 0 X 0 1 X 1 0 0 PREFUNDED DEPOSITS 955292 REINSURANCE DEPOSITS 3050000 PAYABLES TO AFFILIATES 7167051 11172343 X 100801806 0 100801806 311145347 311145347 411947153 92082907 0 92082907 311145347 311145347 403228254 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 FINANCIAL STATEMENT 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 PART XII, LINE 4B - OTHER ADJUSTMENTS: CLAIMS ACCRUED FOR ADMINISTRATIVE SERVICE CONTRACTS CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES REINSURANCE 81397700 0 0 0 0 0 0 81397700 0 81397700 0 0 1 0 0 0 PART I, LINE 3(E) - REINSURANCE: THE ORGANIZATION REINSURES DENTAL SERVICE CONTRACTS WITH DELTA REINSURANCE CORPORATION, A BARBADOS INSURANCE COMPANY, AS A PROGRAM SERVICE WITHIN ITS EXEMPT PURPOSE. AS INDICATED IN PART I, THE ORGANIZATION'S REINSURANCE EXPENSES WERE $81,397,700. THE ORGANIZATION'S REINSURANCE RECEIPTS WERE $74,103,675. THE NET REINSURANCE LOSS WAS $7,294,025. 1 DELTA DENTAL COMMUNITY CARE FOUNDATION 100 FIRST STREET SAN FRANCISCO CA 94105 371570764 501(C)(3) 342000 TO PROVIDE DENTAL EDUCATION AMERICAN CANCER SOCIETY 1710 WEBSTER ST OAKLAND CA 94612 131788491 501(C)(3) 50000 TO PROVIDE DENTAL EDUCATION VARIOUS 5000 5800 TO PROVIDE DENTAL EDUCATION 2 3 PART I, LINE 2: THE ORGANIZATION AWARDS GRANTS FOR PROGRAMS THAT FOSTER DENTAL HEALTH AND EDUCATION. THROUGH THESE GRANTS THE ORGANIZATION HELPS FINANCE HEALTH, EDUCATION, AND RESEARCH PROJECTS IN DENTISTRY, HEALTH AND HUMAN SERVICES, AND CIVIC AND COMMUNITY AFFAIRS. THE TWO GRANTS ARE: (1) THE DENTAL HEALTH AND EDUCATION CONTRIBUTION, WHICH SUPPORTS DENTAL HEALTH AND AWARENESS PROGRAMS AND (2) THE STANDARD DENTAL RESEARCH GRANT, WHICH SUPPORTS PROFESSIONAL RESEARCH RELATED TO DENTAL HEALTH. GRANTS ARE AWARDED TO GROUPS THAT: (1) PROVIDE DENTISTRY FOR ECONOMICALLY DISADVANTAGED PERSONS; (2) PROVIDE DENTISTRY FOR GROUPS THAT ARE DENTALLY UNDERSERVED; (3) PROVIDE EDUCATION TO ADVANCE THE AWARENESS OR THE SCIENCE OF DENTISTRY; (4) PROMOTE PUBLIC DENTAL HEALTH; AND (5) ARE INVOLVED IN COMMUNITY ACTIVITIES RELATED TO DENTAL CARE. GRANT GUIDELINES: PRIORITY WILL GO TO PROJECTS THAT FOCUS ON ISSUES RELATED TO THE DELIVERY OF ORAL HEALTH CARE, INCLUDING THOSE WITH SIGNIFICANT POTENTIAL FOR IMPROVING ORAL HEALTH AND REDUCING TREATMENT COSTS. PRIORITY CONSIDERATION WILL GO TO RESEARCHERS FROM THE DENTAL SCHOOLS IN THE ENTERPRISE STATES, BUT WILL NOT BE LIMITED TO THESE INSTITUTIONS. PRIORITY WILL GO TO TWO TYPES OF STUDIES: (1) PILOT OR FEASIBILITY STUDIES LIKELY TO ENHANCE THE INVESTIGATOR'S CHANCE FOR LONG-TERM FUNDING FROM OTHER SOURCES; AND (2) COMPLETE PROJECTS CONSIDERED TO BE OF INTEREST TO THE HEALTH, EDUCATION, AND RESEARCH FUND, FOR WHICH OTHER SOURCES OF FUNDS ARE TRADITIONALLY UNAVAILABLE OR INSUFFICIENT. PRIORITY WILL GO TO STUDIES THAT EVALUATE THE OUTCOME OF PREVENTATIVE AND TREATMENT PROCEDURES. RETROSPECTIVE STUDIES OR THOSE INVOLVING ANALYSIS OF EXISTING DATA SHOULD BE CONSIDERED, RATHER THAN LONG-TERM FOLLOW-UP STUDIES, IN ORDER TO REDUCE THE YEARS REQUIRED TO OBTAIN DATA. OVERHEAD CHARGES WITHIN EACH ELIGIBLE GRANT WILL BE LIMITED TO EIGHT PERCENT. THE FUND WILL NORMALLY MAKE ONE TO TWO STANDARD RESEARCH GRANTS PER YEAR. INDIVIDUAL GRANTS WILL GENERALLY NOT EXCEED $40,000. 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. A SCREENING COMMITTEE REVIEWS ALL APPLICATIONS, WITH FINAL GRANT DECISIONS MADE BY THE FUND'S ADMINISTRATIVE COMMITTEE. X X X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 GARY D RADINE PRESIDENT / CEO 0 1269235 0 2852481 0 353891 0 76496 0 18590 0 4570693 0 0 ANTHONY S BARTH EVP, COO 0 899123 0 1235316 0 48424 0 2708696 0 27648 0 4919207 0 0 MICHAEL J CASTRO EVP, CFO 0 566496 0 854926 0 27370 0 2017868 0 23832 0 3490492 0 0 MICHAEL G HANKINSON ESQ EVP, CLO 0 459304 0 575749 0 166713 0 23850 0 23832 0 1249448 0 0 BELINDA MARTINEZ SENIOR VICE PRESIDENT 0 463500 0 512000 0 46624 0 658854 0 19626 0 1700604 0 0 ALICIA F WEBER SVP. ENTERPRISE CONTROLLER 0 383200 0 447982 0 39061 0 31719 0 20526 0 922488 0 0 RUSSELL K BRADLEY VP, CLAIMS PROCESSING 0 252122 0 54410 0 9643 0 7950 0 16416 0 340541 0 0 ROBERT P BUDD VP, SALES 257153 0 109292 0 7730 0 41277 0 17931 0 433383 0 0 0 PHILIP N ENGLE VP, INFORMATION TECHNOLOGY 0 245192 0 99333 0 11441 0 44095 0 17913 0 417974 0 0 JEANNE M FOSTER VP, FINANCE 0 251225 0 105209 0 13806 0 43397 0 16614 0 430251 0 0 RICHARD C GRAYBILL VP, UNDERWRITING 0 212265 0 81062 0 9475 0 43245 0 7023 0 353070 0 0 TIMOTHY FALLON SALES ACCOUNT EXECUTIVE 58937 0 63792 0 9601 0 20795 0 1754 0 154879 0 0 0 STEVEN GROSSMAN SALES ACCOUNT EXECUTIVE SENIOR 95132 0 86365 0 15224 0 34409 0 16437 0 247567 0 0 0 KEVIN KING SALES ACCOUNT EXECUTIVE - LABOR LIAI 115000 0 84000 0 6101 0 27615 0 15280 0 247996 0 0 0 ROBERT MILHISLER DIRECTOR SALES 125310 0 44657 0 10139 0 31264 0 15303 0 226673 0 0 0 ROBERT SEWARD SALES ACCOUNT EXECUTIVE 67244 0 191923 0 7183 0 35995 0 15280 0 317625 0 0 0 PATRICK S STEELE FORMER EVP/CIO 0 0 0 755434 0 0 0 0 0 0 0 755434 0 0 PART I, LINE 1A FIRST CLASS BUSINESS TRAVEL IS REIMBURSED TO THE EXECUTIVE VICE PRESIDENTS, SENIOR VICE PRESIDENTS, AND GROUP VICE PRESIDENTS. FIRST CLASS BUSINESS TRAVEL IS NOT TREATED AS TAXABLE COMPENSATION. THE PRESIDENT AND EXECUTIVE VICE PRESIDENTS MAY BE REIMBURSED FOR ONE HEALTH OR SOCIAL CLUB UPON APPROVAL BY THE PRESIDENT. TWO SENIOR EXECUTIVES RECEIVED THIS BENEFIT IN 2015. THE COST OF THIS BENEFIT IS 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. THESE REIMBURSEMENTS ARE INCLUDED IN THE TAXABLE COMPENSATION OF THE REIMBURSED EMPLOYEES. PART I, LINE 4B CERTAIN EXECUTIVES PAID BY A RELATED ORGANIZATION PARTICIPATE IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PROGRAM. THE RELATED ORGANIZATION PROVIDES A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO CERTAIN OF ITS SENIOR EXECUTIVES AS SELECTED BY THE BOARD OF DIRECTORS. THE SUPPLEMENTAL RETIREMENT BENEFIT IS BASED ON EACH EXECUTIVE'S COMPENSATION AND YEARS OF SERVICE TO THE ENTERPRISE. THE BENEFIT IS SUBJECT TO THE RISK OF FORFEITURE IF REQUIRED YEARS OF SERVICE ARE NOT MET. ANNUAL DEFERRED COMPENSATION RELATED TO THIS PLAN IS REPORTED IN SCHEDULE J, PART II, COLUMN (C) FOR EACH PARTICIPANT AND REFLECTS THE CURRENT YEAR INCREASE OR DECREASE IN THE RELATED ORGANIZATION'S PENSION BENEFIT OBLIGATION ("PBO"), CALCULATED PURSUANT TO GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THE PBO INCREASE OR DECREASE INCLUDES CHANGES IN ACTUARIAL ASSUMPTIONS (E.G., APPLICABLE DISCOUNT RATE), AS WELL AS CHANGES IN COMPENSATION AND YEARS OF SERVICE. IN 2015, ANTHONY BARTH, MICHAEL CASTRO, AND BELINDA MARTINEZ PARTICIPATED IN THE PLAN. PART I, LINE 7 THE PRESIDENT OF THE ORGANIZATION, WITH BOARD OF DIRECTORS APPROVAL, MAY GRANT AN ANNUAL BONUS TO ALL MANAGEMENT EMPLOYEES. THIS BONUS, OR INCENTIVE, IS INCLUDED IN TAXABLE COMPENSATION. SCHEDULE J, PART II, LINE (II) ELEVEN OF THE ORGANIZATION'S OFFICERS ARE PAID BY A RELATED ORGANIZATION. ACCORDINGLY, THEIR COMPENSATION IS REPORTED ON LINE (II). ANDREW S LEVINE DDS KLETTER LE PARTICIPATING PROVIDER 1182463 DENTAL CLAIM PAYMENTS 0 PUBLICIS ORGANIZATION DIRECTOR FRANCINE Y. LOPEZ IS AN OFFICER OF PUBLICIS 12366501 PREMIUM REVENUE 0 ASCENA RETAIL GROUP ORGANIZATION DIRECTOR STACY MAZZA IS AN OFFICER OF ASCENA RETAIL GROUP 5650877 PREMIUM REVENUE 0 DENTSPLY INTERNATIONAL M. ALFANO IS A DIRECTOR OF DENTSPLY, ALSO A PURCHASER OF THIS ORGANIZATION 2659251 PREMIUM REVENUE 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE CLASS OF MEMBERS, DESIGNATED CORPORATE MEMBERS, WHO ARE DIRECTORS OF DENTEGRA GROUP, INC., THE ORGANIZATION'S PARENT HOLDING COMPANY. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S DIRECTORS VOTE ON PERSONS NOMINATED AS DIRECTORS FOR ENDORSEMENT TO THE CORPORATE MEMBERS, WHO ELECT THE DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE CORPORATE MEMBERS MUST APPROVE ANY CHANGES TO SPECIFIED BYLAWS PROVISIONS. FORM 990, PART VI, SECTION B, LINE 11 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 DELTA DENTAL OF PENNSYLVANIA AUDIT COMMITTEE, TO WHICH SUCH DUTIES HAVE BEEN DELEGATED. 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 EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SERVES AS THE COMPENSATION COMMITTEE AND 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 YEAR. COMPENSATION PAID TO DIRECTORS IS APPROVED BY THE EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS 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 2015 COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION ANNUALLY INCLUDES MAJOR PORTIONS OF ITS FINANCIAL STATEMENT IN A PUBLISHED ANNUAL REPORT THAT IS MADE AVAILABLE TO PERSONS OR ENTITIES KNOWN TO HAVE AN INTEREST IN THE ORGANIZATION, AND IS AVAILABLE TO THE LARGER PUBLIC UPON REQUEST. STATUTORY FINANCIAL STATEMENTS 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. PART VII, SCHEDULE J; SCHEDULE R THE ORGANIZATION, REGULATED BY THE NEW YORK DEPARTMENT OF FINANCIAL SERVICES, IS A MEMBER OF THE DELTA DENTAL OF CALIFORNIA ENTERPRISE COMPANIES, WHICH INCLUDE DELTA DENTAL OF CALIFORNIA, DELTA DENTAL OF PENNSYLVANIA AND AFFILIATED COMPANIES OPERATING IN 15 STATES, THE DISTRICT OF COLUMBIA, PUERTO RICO AND THE U.S. VIRGIN ISLANDS. THE ENTERPRISE COMPANIES COMPRISE ONE OF THE NATION'S LARGEST DENTAL BENEFITS DELIVERY SYSTEMS COVERING 33.1 MILLION ENROLLEES AND HANDLING 44.7 MILLION CLAIMS. TOTAL REVENUE FOR THE ENTERPRISE EXCEEDED $8.2 BILLION IN 2015. THE ORGANIZATION AND ITS SUBSIDIARIES REPRESENT APPROXIMATELY 5% OF TOTAL ENTERPRISE REVENUES. FORM 990, PART VII AND SCHEDULE J: EFFECTIVE JANUARY 1, 2012 DELTA DENTAL OF NEW YORK ESTABLISHED THE LONG-TERM INCENTIVE PLAN (LTIP) FOR ELIGIBLE EMPLOYEES OF THE COMPANY. THE PURPOSE OF THE LTIP IS TO PROVIDE INCENTIVE FOR ELIGIBLE EMPLOYEES' CONTRIBUTION TO THE COMPANY'S LONG-TERM SUCCESS. THE LTIP IS UNFUNDED AND ALL PAYMENTS FROM THE LTIP ARE DERIVED FROM THE EQUITY GAINS OF THE COMPANY. AS SUCH THERE IS NO GUARANTEE OF INCENTIVE PAYMENTS UNDER THE LTIP. UPON DELEGATION BY CERTAIN OFFICERS OF THE BOARD, THE CEO AND MANAGEMENT COMMITTEE HAS THE SOLE AND ABSOLUTE DISCRETION TO DETERMINE THE PERFORMANCE OBJECTIVES, BOTH FINANCIAL AND NONFINANCIAL, UPON WHICH PAYMENT OF AWARDS ARE BASED AND THE TIME PERIOD DURING WHICH PERFORMANCE SHALL BE MEASURED (LTIP CYCLE). THE CURRENT LTIP CYCLE IS JANUARY 1, 2013 THROUGH DECEMBER 31, 2015. DELTA DENTAL COMMUNITY CARE FOUNDATION - 100 FIRST STREET SAN FRANCISCO CA 94105 371570764 CHARITABLE ORGANIZATION CA 501(C)(3) PF DENTEGRA GROUP INC 0 DELTA DENTAL OF PENNSYLVANIA ONE DELTA DRIVE MECHANICSBURG PA 17055 231667011 DENTAL INSURANCE PA 501(C)(4) DENTEGRA GROUP INC 0 DELTA DENTAL OF DELAWARE INC ONE DELTA DRIVE MECHANICSBURG PA 17055 510228088 DENTAL INSURANCE DE 501(C)(4) DENTEGRA GROUP INC 0 DELTA DENTAL OF WEST VIRGINIA INC ONE DELTA DRIVE MECHANICSBURG PA 17055 550523124 DENTAL INSURANCE WV 501(C)(4) DENTEGRA GROUP INC 0 DELTA DENTAL OF CALIFORNIA 100 FIRST STREET SAN FRANCISCO CA 94105 941461312 DENTAL INSURANCE CA 501(C)(4) DENTEGRA GROUP INC 0 DELTA DENTAL OF DISTRICT OF COLUMBIA ONE DELTA DRIVE MECHANICSBURG PA 17055 521479587 DENTAL INSURANCE DC 501(C)(4) DENTEGRA GROUP INC 0 PACA MANAGEMENT LLC ONE DELTA DRIVE MECHANICSBURG PA 17055 943277375 INSURANCE MANAGEMENT DE DELTA DENTAL OF CALIFORNIA RELATED 0 0 DENTEGRA GROUP INC 100 FIRST STREET SAN FRANCISCO CA 94105 943386049 HOLDING COMPANY DE N/A C 0 DENTEGRA INSURANCE COMPANY 100 FIRST STREET SAN FRANCISCO CA 94105 751233841 INSURANCE COMPANY DE DDC INSURANCE HOLDINGS INC C 0 DENTEGRA INSURANCE COMP OF NEW ENGLAND 100 FIRST STREET SAN FRANCISCO CA 94105 042890218 INSURANCE COMPANY MA DDC INSURANCE HOLDINGS INC C 0 DELTA DENTAL INSURANCE COMPANY 100 FIRST STREET SAN FRANCISCO CA 94105 942761537 INSURANCE COMPANY DE DDC INSURANCE HOLDINGS INC C 0 ALPHA DENTAL OF NEVADA INC 100 FIRST STREET SAN FRANCISCO CA 94105 880244893 INSURANCE COMPANY NV DDC INSURANCE HOLDINGS INC C 0 ALPHA DENTAL OF UTAH INC 100 FIRST STREET SAN FRANCISCO CA 94105 860672505 INSURANCE COMPANY UT DDC INSURANCE HOLDINGS INC C 0 ALPHA DENTAL PROGRAMS INC 100 FIRST STREET SAN FRANCISCO CA 94105 742447512 INSURANCE COMPANY TX DDC INSURANCE HOLDINGS INC C 0 ALPHA DENTAL OF ALABAMA INC 100 FIRST STREET SAN FRANCISCO CA 94105 630796079 INSURANCE COMPANY AL DDC INSURANCE HOLDINGS INC C 0 ALPHA DENTAL OF NEW MEXICO INC 100 FIRST STREET SAN FRANCISCO CA 94105 330279230 INSURANCE COMPANY NM DDC INSURANCE HOLDINGS INC C 0 ALPHA DENTAL OF ARIZONA INC 100 FIRST STREET SAN FRANCISCO CA 94105 930939835 INSURANCE COMPANY AZ DDC INSURANCE HOLDINGS INC C 0 DENTEGRA SEGURO DENTALES SA INSURGENTES SUR 826 PISO 15 COL DEL VALLE FC DF 01300 MX INSURANCE COMPANY MX DENTEGRA INSURANCE COMPANY C 0 DELTA REINSURANCE CORPORATION CGI TOWER 2ND FLOOR WARRENS ST. 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