2014-11-12T11:45:12-06:00 2013-12-31 WithumSmithBrown PC 465 South St Ste 200 Morristown NJ 079606497 990 2013-01-01 222764745 DELTA DENTAL OF NEW JERSEY FOUNDATION INC % JAMES SULESKI DELT 9732854029 1639 ROUTE 10 PO BOX 222 Suite PARSIPPANY NJ 070540222 JAMES SULESKI VP/ASST TREASURER 9738989494 2014-11-10 true Anthony J Panico P00365556 9738989494 2013 2015-11-30 17:44:51Z DENNIS G WILSON 1639 ROUTE 10 PARSIPPANY NJ 070540222 910950 false X DELTADENTALNJ.COM X 1986 NJ TO PROMOTE AND ASSIST PUBLIC SERVICE EDUCATIONAL PROJECTS DEVOTED TO THE ENHANCEMENT OF DENTAL HEALTH AND RESEARCH PROGRAMS AND VARIOUS ORAL HEALTH EDUCATIONAL ACTIVITIES. 12 7 0 0 0 1900000 900000 15825 10950 0 0 0 0 1915825 910950 963640 1712818 0 0 1425 1425 0 0 0 37967 37951 1003032 1752194 912793 -841244 1919235 1077991 0 0 1919235 1077991 X FOR MORE THAN 40 YEARS, DELTA DENTAL OF NEW JERSEY HAS REACHED OUT TO SERVE THE PEOPLE OF NEW JERSEY AND MORE RECENTLY IN CONNECTICUT. IT IS OUR MISSION TO PROMOTE ORAL HEALTH TO THE GREATEST NUMBER OF PEOPLE BY PROVIDING ACCESSIBLE DENTAL BENEFIT PROGRAMS OF THE HIGHEST QUALITY, SERVICE, AND VALUE. 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 NON-PROFIT ORGANIZATIONS WORKING TO PROVIDE DENTAL CARE AND EDUCATION TO NEW JERSEY'S AND CONNECTICUT'S UNDERSERVED POPULATIONS. COMMUNITY OUTREACH AND EMPLOYEE INVOLVEMENT - FOR OVER 15 YEARS, DELTA DENTAL HAS BEEN A PREMIER SPONSOR OF SPECIAL OLYMPICS-NJ. OUR EMPLOYEES VOLUNTEER TO ASSIST AT GAMES AND COMPETITIONS THR false false 1712818 1712818 10950 EXPENSES INCURRED IN SUPPORTING THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES, INCLUDING EDUCATIONAL PROGRAMS, CHARITABLE FUNDING AND HEADSTART, OF DELTA DENTAL OF NEW JERSEY; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(4) TAX-EXEMPT ORGANIZATION. 1712818 true true false false false false false false false false false false false false false true false true false false false false false false false false false true false true false false false false false false false false false false false false false true false false false true 3 0 true 0 false false false false false false false false false false false X 12 7 false false false false true true false true true false false true true true true true false true true false NJ X JAMES SULESKI 9732854029 1639 ROUTE 10 PARSIPPANY NJ 070540222 X GENE NAPOLIELLO DDS PRESIDENT/CHAIRMAN - TRUSTEE 6.0 3.0 X X 0 48878 1557 GERALD A SYDELL DDS VICE CHAIRMAN - TRUSTEE 1.0 7.0 X X 0 92320 1557 DENNIS G WILSON VP - TRUSTEE (EEF 9/4/13) 0.7 50.0 X X 0 195740 34967 WALTER VANBRUNT VP - TRUSTEE (1/1/13 - 9/3/13) 0.7 50.0 X X 0 1174507 80262 DIANE BELLE VP/ASST SECRETARY - TRUSTEE 6.0 44.0 X X 0 167460 51079 JAMES SULESKI VP/ASST TREASURER - TRUSTEE 0.4 50.0 X X 0 373465 81584 CARL CHAITYN DDS SECRETARY - TRUSTEE 1.0 3.0 X X 0 46825 1557 HENRY F HENDERSON JR TREASURER - TRUSTEE 1.0 3.4 X X 0 48275 1557 RONALD DEBLINGER DMD TRUSTEE 1.0 20.0 X 0 162523 1557 HONORABLE VICTOR FRIEDMAN TRUSTEE 1.0 0.0 X 1425 0 0 W THOMAS MARGETTS ESQ TRUSTEE 1.0 5.4 X 0 56164 1557 GEORGE C MCLAUGHLIN DMD TRUSTEE 1.0 4.8 X 0 52825 921 DONALD SCOTT NAVARRO DDS TRUSTEE 0.6 50.0 X 0 267067 88915 DOUGLAS G SANBORN ESQ VP/GENERAL COUNSEL - ASST. 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AND ITS AFFILIATES, WHICH INCLUDES THIS ORGANIZATION FOR THE YEARS ENDED DECEMBER 31, 2013 AND DECEMBER 31, 2012; RESPECTIVELY, AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES BY ENTITY. THE FIN 48 (ASC 740) FOOTNOTE BELOW IS FROM THE ORGANIZATION'S 2013 CONSOLIDATED AUDITED 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. THE PLAN HAS NO OPEN YEARS PRIOR TO 2010. true BLOOMFIELD HEALTH CAREERS FOUNDATION 504 WATCHUNG AVENUE BLOOMFIELD NJ 07003 223134467 501(C)(3) 6000 PROGRAM SUPPORT BURLINGTON COUNTY COLLEGE 601 PEMBERTON BROWNS MILLS ROAD PEMBERTON NJ 08068 237292149 501(C)(3) 6000 PROGRAM SUPPORT BOYS & GIRLS CLUBS OF NEWARK 500 BROAD STREET NEWARK NJ 07003 221515405 501(C)(3) 30000 PROGRAM SUPPORT CORNELL SCOTT-HILL HEALTH CORPORATION 400 COLUMBUS AVENUE NEW HAVEN CT 06519 060870990 501(C)(3) 10000 PROGRAM SUPPORT CONNECTICUT FOUNDATION FOR DENTAL OUTREACH 835 WEST QUEEN STREET SOUTHINGTON CT 06489 261437861 501(C)(3) 25000 PROGRAM SUPPORT EASTCONN HEAD START 376 HARTFORD TURNPIKE HAMPTON CT 06247 061023768 501(C)(3) 21114 PROGRAM SUPPORT EVA'S VILLAGE 393 MAIN STREET PATERSON NJ 07501 222424542 501(C)(3) 25000 PROGRAM SUPPORT CONNECTICUT DEPARTMENT OF PUBLIC HEALTH 410 CAPITOL AVENUE HARTFORD CT 06106 066000078 501(C)(3) 10500 PROGRAM SUPPORT HOSPITAL FOR SPECIAL CARE 2150 CORBIN AVENUE NEW BRITAIN CT 06053 061464179 501(C)(3) 15000 PROGRAM SUPPORT JERSEY SHORE UNIVERSITY MEDICAL CENTER FDN 4900 ROUTE 33 NEPTUNE NJ 07753 222342452 501(C)(3) 25000 PROGRAM SUPPORT JFK MEDICAL CENTER 65 JAMES STREET EDISON NJ 08818 226019101 501(C)(3) 25056 PROGRAM SUPPORT KINDERSMILE FOUNDATION 248 LORRAINE AVE UPPER MONTCLAIR NJ 07043 562635166 501(C)(3) 20000 PROGRAM SUPPORT MATHENY MEDICAL & EDUCATIONAL CTR HIGHLAND AVE PO BOX 339 PEAPACK NJ 07977 221482276 501(C)(3) 50000 PROGRAM SUPPORT MIDDLESEX COUNTY COLLEGE FOUNDATION 2600 WOODBRIDGE AVENUE PO BOX 3050 EDISON NJ 08818 226079662 501(C)(3) 6000 PROGRAM SUPPORT OCEAN HEALTH INITIATIVES 500 RIVER AVENUE SUITE 200 LAKEWOOD NJ 08701 061691342 501(C)(3) 35000 PROGRAM SUPPORT PATERSON PUBLIC SCHOOLS 176 BROADWAY PATERSON NJ 07505 226002199 501(C)(3) 28000 PROGRAM SUPPORT SOMERSET MEDICAL CENTER FDN 110 REHILL AVENUE SOMERVILLE NJ 08876 223294408 501(C)(3) 7500 PROGRAM SUPPORT TRI-COUNTY COMMUNITY ACTION PARTNERSHIP 110 COHANSEY STREET BRIDGETON NJ 08302 221942357 501(C)(3) 25000 PROGRAM SUPPORT TUNXIS COMMUNITY COLLEGE 271 SCOTT SWAMP ROAD FARMINGTON CT 06032 066268897 501(C)(3) 10106 PROGRAM SUPPORT UNIVERSITY OF BRIDGEPORT 126 PARK AVENUE BRIDGEPORT CT 06604 060646936 501(C)(3) 25000 PROGRAM SUPPORT YOUTH CONSULTATION SERVICES 284 BROADWAY NEWARK NJ 07104 221487560 501(C)(3) 25000 PROGRAM SUPPORT ZUFALL HEALTH CENTER 17 SOUTH WARREN STREET DOVER NJ 07801 223125397 501(C)(3) 30000 PROGRAM SUPPORT UNIVERSITY OF MEDICINE AND DENTISTRY OF NJ 110 BERGEN STREET NEWARK NJ 07103 237313160 501(C)(3) 1035000 PROGRAM SUPPORT CONNECTICUT PUBLIC BROADCASTING 1049 ASYLUM AVENUE HARTFORD CT 06105 060758938 501(C)(3) 10000 PROGRAM SUPPORT DENTAL LIFELINE NETWORK 25 KENNEDY BLVD EAST BRUNSWICK NJ 08816 222469940 501(C)(3) 25000 PROGRAM SUPPORT MORRISTOWN MEDICAL CENTER FOUNDATION 475 SOUTH STREET MORRISTOWN NJ 07960 223392808 501(C)(3) 75000 PROGRAM SUPPORT NEWARK BETH ISRAEL MEDICAL CENTER FDN 201 LYONS AVENUE NEWARK NJ 07112 222587176 501(C)(3) 25000 PROGRAM SUPPORT STRATFORD HEALTH DEPARTMENT 468 BIRDSEYE STREET STRATFORD CT 06615 066002103 501(C)(3) 20000 PROGRAM SUPPORT CATHEDRAL KITCHEN 1514 FEDERAL STREET CAMDEN NJ 08105 223114500 501(C)(3) 15000 PROGRAM SUPPORT 29 0 SCHEDULE I, PART I, QUESTION 2 FROM TIME TO TIME, THE ORGANIZATION PARTICIPATES INDIRECTLY IN THE GRANTING OF SCHOLARSHIPS FOR PROGRAMS TO EDUCATE DENTISTS AND DEVELOP DENTAL ASSISTANTS. WHEN THIS IS DONE, IT TAKES THE FORM OF A GRANT TO THE DIRECT ADMINISTERING ORGANIZATION WHICH WILL DETERMINE RECIPIENTS BASED UPON DEMONSTRATED FINANCIAL NEED. X X X X X false true false false false false false true false DENNIS G WILSON VP - TRUSTEE (EEF 9/4/13) 0 149313 0 51 0 46376 0 27159 0 7808 0 230707 0 0 WALTER VANBRUNT VP - TRUSTEE (1/1/13 - 9/3/13) 0 516864 0 185141 0 472502 0 46410 0 33852 0 1254769 0 0 DIANE BELLE VP/ASST SECRETARY - TRUSTEE 0 135386 0 28914 0 3160 0 35827 0 15252 0 218539 0 0 JAMES SULESKI VP/ASST TREASURER - TRUSTEE 0 239441 0 63143 0 70881 0 46410 0 35174 0 455049 0 0 RONALD DEBLINGER DMD TRUSTEE 0 0 0 0 0 162523 0 0 0 1557 0 164080 0 0 DONALD SCOTT NAVARRO DDS TRUSTEE 0 201903 0 45992 0 19172 0 56363 0 32552 0 355982 0 0 DOUGLAS G SANBORN ESQ VP/GENERAL COUNSEL - ASST. SEC 0 318037 0 81957 0 220870 0 46410 0 34272 0 701546 0 0 SCHEDULE J, PART I; QUESTION 4B THE AMOUNTS REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDE PARTICIPATION IN A PENSION RESTORATION PLAN BECAUSE THE AMOUNTS ARE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2013 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: WALTER VANBRUNT, $ 415,706; JAMES SULESKI, $42,866 AND DOUGLAS G. SANBORN, ESQ., $188,848. PLEASE NOTE THAT THE AMOUNTS REFLECTED INCLUDE A GROSS UP FOR 50% OF THE TAX LIABILITY WITH RESPECT TO THE SERP PAYMENTS. 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 MANAGEMENT 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 MANAGEMENT INCENTIVE PAYMENT, ADDITIONAL COMPENSATION BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE ABOVE NOTED PAYMENT WAS INCLUDED IN EACH INDIVIDUAL'S 2013 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. CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 DELTA DENTAL OF NEW JERSEY FOUNDATION, INC. IS AN AFFILIATE OF DELTA DENTAL OF NEW JERSEY, INC. DELTA DENTAL OF NEW JERSEY, INC. HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF TRUSTEES. CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION IS AN AFFILIATE OF DELTA DENTAL OF NEW JERSEY, INC. THIS 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. AS PART OF THE TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED WITHUMSMITH+BROWN, PC, 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 VARIOUS OTHER INDIVIDUALS OF THE ORGANIZATION 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 FINANCE PERSONNEL AND OTHER INDIVIDUALS FOR THEIR REVIEW. DELTA DENTAL OF NEW JERSEY, INC.'S SENIOR MANAGEMENT AND OTHER 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 DELTA DENTAL OF NEW JERSEY, INC.'S SENIOR MANAGEMENT AND VARIOUS OTHER INDIVIDUALS FOR FINAL REVIEW AND APPROVAL PRIOR TO PROVIDING IT TO EACH VOTING MEMBER OF THIS ORGANIZATION'S GOVERNING BODY. CORE FORM, PART VI, SECTION B; QUESTION 12 DELTA DENTAL OF NEW JERSEY FOUNDATION, INC. IS AN AFFILIATE OF DELTA DENTAL OF NEW JERSEY, INC. 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 DELTA DENTAL OF NEW JERSEY, INC.'S SENIOR MANAGEMENT TEAM. DELTA DENTAL OF NEW JERSEY, INC.'S SENIOR MANAGEMENT PROVIDES THE COMPLETED QUESTIONNAIRES TO DELTA DENTAL OF NEW JERSEY, INC.'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 14 THE ORGANIZATION IS CURRENTLY IN THE PROCESS OF ADOPTING A FORMAL WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. THE ORGANIZATION CURRENTLY FOLLOWS STATE AND INTERNAL REVENUE SERVICE RULES AND REGULATIONS WITH RESPECT TO DOCUMENT RETENTION AND DESTRUCTION POLICIES AND PROCEDURES. CORE FORM, PART VI, SECTION B; QUESTION 15 DELTA DENTAL OF NEW JERSEY FOUNDATION, INC. HAS NO PAID EMPLOYEES. ALL MEMBERS OF THE ORGANIZATION'S SENIOR MANAGEMENT TEAM ARE EMPLOYEES OF DELTA DENTAL OF NEW JERSEY, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(4) TAX-EXEMPT ORGANIZATION. PLEASE REFER TO THE DELTA DENTAL OF NEW JERSEY, INC. FORM 990 FOR FURTHER EXPLANATION (FEID: 22-1896118). 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 XII; QUESTION 2 THE ORGANIZATION IS AN AFFILIATE OF DELTA DENTAL OF NEW JERSEY, INC. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF DELTA DENTAL OF NEW JERSEY, INC. AND ITS AFFILIATES, WHICH INCLUDES THIS ORGANIZATION FOR THE YEARS ENDED DECEMBER 31, 2013 AND DECEMBER 31, 2012; RESPECTIVELY, AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES BY ENTITY. AN UNQUALIFIED OPINION WAS ISSUED BY THE INDEPENDENT CPA FIRM EACH YEAR. DELTA DENTAL OF NEW JERSEY INC.'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. DELTA DENTAL OF NEW JERSEY INC 1639 ROUTE 10 PARSIPPANY NJ 07054 221896118 DENTAL SVCS. 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