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 521479587 DELTA DENTAL OF THE DISTRICT OF COLUMBIA 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 3850784 0 X WWW.DELTADENTALINS.COM X 1985 DC TO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS, SERVICE, TECHNOLOGY, AND PROFESSIONAL SUPPORT. 5 5 0 0 0 0 0 0 4113541 3875194 0 0 -21892 -24410 4091649 3850784 82000 114800 0 0 5600 4800 0 0 0 4004049 3731184 4091649 3850784 0 0 1911060 2483752 1806996 2379688 104064 104064 TO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS, SERVICE, TECHNOLOGY, AND PROFESSIONAL SUPPORT. 0 0 3396116 3850784 THE ORGANIZATION IS THE GENERAL AGENT FOR DENTAL INSURANCECONTRACTS PROVIDING COVERAGE FOR 142,824 BENEFICIARIES IN 2015PRIMARILY THROUGH CONTRACTS WITH INDEPENDENT DENTISTS SERVING 68PURCHASING GROUPS. 114800 114800 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. 3510916 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 7947 0 1 0 0 0 0 0 0 0 X 5 5 0 0 1 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 X ALAN H SINGER DDS DIRECTOR - CHAIRMAN 1.00 X 0 0 0 CHRISTINA KREUTZIGER DIRECTOR - TREASURER 1.00 X 0 0 0 ALECIA BROWN DIRECTOR - SECRETARY 1.00 X 800 0 0 OTHO MILBOURNE CEBS DIRECTOR 1.00 X 800 0 0 DONALD CLARK DIRECTOR 1.00 X 800 0 0 ADOLPH W JOHNSON DDS DIRECTOR 1.00 X 800 0 0 JOHN H PALMER DDS DIRECTOR 1.00 X 800 0 0 ELIZABETH STROUD DIRECTOR 1.00 X 800 0 0 KIM WHITTINGTON DIRECTOR 1.00 X 0 0 0 GARY D RADINE PRESIDENT / CEO 1.00 59.00 X 0 4475607 95086 ANTHONY S BARTH EVP / COO 1.00 49.00 X 0 2182863 2736344 MICHAEL J CASTRO EVP / CFO 1.00 49.00 X 0 1448792 2041700 MICHAEL G HANKINSON ESQ EVP / CLO 1.00 49.00 X 0 1201766 47682 BELINDA MARTINEZ SENIOR VICE PRESIDENT 1.00 49.00 X 0 1022124 678480 ALICIA F WEBER SVP, ENTERPRISE CONTROLLER 1.00 49.00 X 0 870243 52245 RUSSELL K BRADLEY VP, CLAIMS PROCESSING 1.00 49.00 X 0 316175 24366 PHILIP N ENGLE VP, INFORMATION TECHNOLOGY 1.00 49.00 X 0 355966 62008 JEANNE M FOSTER VP, FINANCE 1.00 49.00 X 0 370240 60011 RICHARD C GRAYBILL VP, UNDERWRITING 1.00 49.00 X 0 302802 50268 PATRICK S STEELE FORMER EVP / CIO 0.00 0.00 X 0 755434 0 4800 13302012 5848190 0 1 1 0 0 ADMIN FEES (INSURED) 524298 2654565 2654565 ADMIN FEES (ASC) 524298 1220629 1220629 3875194 BAD DEBT EXPENSE 524298 -2257 -2257 MISC EXPENSE 524298 -22153 -22153 -24410 3850784 3850784 0 0 114800 114800 4800 4800 28694 28694 53141 48109 5032 31337 28369 2968 10372 9390 982 606 549 57 ADMINISTRATIVE FEES 2871915 2599944 271971 COMMISSIONS 467285 467285 DDPA DUES, MEMBERSHIPS 85595 77489 8106 BANK SERVICE CHARGES 75644 68481 7163 106595 96500 10095 3850784 3510916 339868 0 150562 129197 761810 1277369 998688 1077186 1911060 2483752 83823 68872 34789 93005 1688384 2217811 1806996 2379688 X 0 0 0 0 104064 104064 104064 104064 1911060 2483752 0 0 X 0 1 X 1 0 0 FUNDS HELD FOR THE ACCOUNTS OF OTHERS 1277369 PREFUNDED DEPOSITS 6000 PAYABLE TO AFFILIATES 934442 2217811 X 3850784 0 3850784 0 3850784 3850784 0 3850784 0 3850784 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. 1 DELTA DENTAL COMMUNITY CARE FOUNDATION 100 FIRST STREET SAN FRANCISCO CA 94105 371570764 501(C)(3) 114000 TO PROVIDE DENTAL EDUCATION MISC 5000 800 TO PROVIDE DENTAL EDUCATION 1 1 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. 0 1 0 0 0 0 0 0 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 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 PATRICK S STEELE FORMER EVP / CIO 0 0 0 755434 0 0 0 0 0 0 0 755434 0 0 PART I, LINE 3 COMPENSATION PAID TO THE CEO IS APPROVED BY THE EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS. THE COMMITTEE APPROVES COMPENSATION FOR THE ENSUING YEAR AFTER REVIEWING COMPARABILITY DATA PRESENTED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT, AN ASSESSMENT OF THE CEO'S PERFORMANCE OVER THE PRECEDING YEAR, AND THE ORGANIZATION'S PROGRAM ACCOMPLISHMENTS FOR THE YEAR. 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 II, COLUMN (II) THE ORGANIZATION'S OFFICERS ARE PAID BY A RELATED ORGANIZATION. ACCORDINGLY, THEIR COMPENSATION IS REPORTED IN COLUMN (II). FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS WERE AMENDED IN 2015 TO RESTRUCTURE THE BOARD AND REDUCE THE NUMBER OF DIRECTORS FROM NOT LESS THAN SEVEN, NOR MORE THAN 13 TO NOT LESS THAN THREE, NOR MORE THAN SEVEN. DIRECTOR TENURE WAS ALSO AMENDED TO BE FOR A PERIOD OF ONE YEAR. IN ADDITION, THE DUTY TO NOMINATE DIRECTORS AND OFFICERS WAS SHIFTED TO THE SECRETARY OF DENTEGRA GROUP, INC. WITH THE ELIMINATION OF THE NOMINATING COMMITTEE. 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. 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 DISTRICT OF COLUMBIA DEPARTMENT OF INSURANCE, SECURITIES, AND BANKING, 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 LESS THAN 1% OF TOTAL ENTERPRISE REVENUES. 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