DELTA DENTAL OF W VIRGINIA INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- DELTA DENTAL OF W VIRGINIA INC (EIN 55-0523124)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-12
- IRS object ID
- 201403169349300310
- Schema version
- 2013v3.0
- 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 | 2014-11-12T07:34:51-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 341851358 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CBIZ MHM LLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3625 CUMBERLAND BLVD STE 800 | AddressLine1 |
| City | ATLANTA | City |
| State | GA | State |
| ZIP Code | 30082 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550523124 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF WEST VIRGINIA INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DELT | BusinessNameControlTxt |
| Phone | 7177668500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE DELTA DRIVE | AddressLine1 |
| City | MECHANICSBURG | City |
| State | PA | State |
| ZIP Code | 17055 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEANNE FOSTER | PersonNm |
| Person Title | VP, FINANCE | PersonTitleTxt |
| Phone | 7177668500 | PhoneNum |
| Signature | 2014-11-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CRAIG T WILLIAMS | PreparerPersonNm |
| PTIN | P00621386 | PTIN |
| Phone | 7708584500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JEANNE FOSTER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE DELTA DRIVE | AddressLine1 |
| City | MECHANICSBURG | City |
| State | PA | State |
| ZIP Code | 17055 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,578,264 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.DELTADENTALINS.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1962 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | TO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS, SERVICE, TECHNOLOGY, AND PROFESSIONAL SUPPORT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 0 | 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 | $6,648,988 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,285,074 | CYProgramServiceRevenueAmt |
| PY Investment Income | $126,248 | PYInvestmentIncomeAmt |
| CY Investment Income | $74,146 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$17,104 | PYOtherRevenueAmt |
| CY Other Revenue | -$10,310 | CYOtherRevenueAmt |
| PY Total Revenue | $6,758,132 | PYTotalRevenueAmt |
| CY Total Revenue | $7,348,910 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $32,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $77,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $1,395,495 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $1,524,126 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,000 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $600 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,994,765 | PYOtherExpensesAmt |
| CY Other Expenses | $5,500,420 | CYOtherExpensesAmt |
| PY Total Expenses | $6,428,260 | PYTotalExpensesAmt |
| CY Total Expenses | $7,102,146 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $329,872 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $246,764 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,674,553 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,072,538 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,073,010 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,100,252 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,601,543 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,972,286 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS, SERVICE, TECHNOLOGY, AND PROFESSIONAL SUPPORT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,976,419 | ExpenseAmt |
| Revenue | $7,348,910 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDED DENTAL BENEFIT COVERAGE FOR 135,954BENEFICIARIES IN 2013 PRIMARILY THROUGH CONTRACTS WITH INDEPENDENTDENTISTS SERVING 290 PURCHASING GROUPS. THE ORGANIZATION PAIDMORE THAN $1.5 MILLION FOR DENTAL CARE DURING 2013. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $77,000 | ExpenseAmt |
| Grant | $77,000 | GrantAmt |
| Desc | THE ORGANIZATION MADE GRANTS DURING 2013 TO FOSTER IMPROVED ACCESSTO DENTAL HEALTH CARE TREATMENT TO SUPPORT PROFESSIONAL DENTALEDUCATION AND TO PROVIDE ORAL HEALTH INSTRUCTION FOR PATIENTS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $7,053,419 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | Yes (1) | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 1585 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEANNE FOSTER VP FINANCE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7177668500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE DELTA DRIVE | AddressLine1 |
| City | MECHANICSBURG | City |
| State | PA | State |
| ZIP Code | 17055 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| CHARLES M MATTHEWS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $600 | $0 | $0 | ||
| EVERETTE E SULLIVAN | |||||||
| SECRETARY/TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RONALD N WALTERS | |||||||
| VICE CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES S WILSON DDS | |||||||
| CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| NANCY L KEATLEY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GARY D RADINE | |||||||
| PRESIDENT | 1.00 | $0 | $6,058,064 | $92,378 | 59.00 | Yes (X) | |
| ANTHONY S BARTH | |||||||
| EVP/CHIEF OPERATING OFFICER | 1.00 | $0 | $1,771,842 | $607,191 | 49.00 | Yes (X) | |
| MICHAEL J CASTRO | |||||||
| EVP/CHIEF FINANCIAL OFFICER | 1.00 | $0 | $1,264,357 | $543,005 | 49.00 | Yes (X) | |
| PATRICK S STEELE | |||||||
| EVP/CHIEF INFORMATION OFFICER | 1.00 | $0 | $1,178,273 | $1,204,354 | 49.00 | Yes (X) | |
| CHARLES LAMONT ESQ | |||||||
| EVP/CHIEF LEGAL OFFICER | 1.00 | $0 | $1,255,769 | $64,803 | 49.00 | Yes (X) | |
| ALICIA F WEBER | |||||||
| SENIOR VICE PRES./CONTROLL | 1.00 | $0 | $726,496 | $115,513 | 49.00 | Yes (X) | |
| MICHAEL G HANKINSON | |||||||
| SVP, COMPLIANCE & REGULATOR | 1.00 | $0 | $534,445 | $63,959 | 49.00 | Yes (X) | |
| JEANNE M FOSTER | |||||||
| VICE PRESIDENT, FINANCE | 1.00 | $0 | $337,678 | $79,862 | 49.00 | Yes (X) | |
| PHILIP N ENGLE | |||||||
| VP, INFORMATION TECHNOLOGY | 1.00 | $0 | $316,864 | $101,998 | 49.00 | Yes (X) | |
| RENEE A FISHER | |||||||
| VP, QUALITY ASSURANCE & TR | 1.00 | $0 | $323,794 | $121,413 | 49.00 | Yes (X) | |
| RICHARD C GRAYBILL | |||||||
| V.P. UNDERWRITING & ACTUAR | 1.00 | $0 | $282,866 | $75,421 | 49.00 | Yes (X) | |
| WHITNEY H SHERBOCKER | |||||||
| ASSISTANT SECRETARY | 1.00 | $0 | $201,689 | $68,679 | 49.00 | Yes (X) | |
| KAREN L ROBINSON | |||||||
| ASSISTANT SECRETARY | 1.00 | $0 | $141,772 | $37,241 | 49.00 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $600 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $14,393,909 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $3,175,817 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| DIRECT PREMIUMS | $6,344,532 | $6,344,532 |
| ADMINISTRATIVE INCOME | $940,542 | $940,542 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,285,074 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $79,978 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $79,978 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,223,522 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,229,354 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$5,832 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$5,832 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$5,832 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| MISC INCOME | -$33 | -$33 |
| BAD DEBT EXPENSE | -$10,277 | -$10,277 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | -$10,310 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,348,910 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,348,910 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,000 | TotalAmt |
| Program Services | $77,000 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,524,126 | TotalAmt |
| Program Services | $1,524,126 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $600 | TotalAmt |
| Management And General | $600 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,920 | TotalAmt |
| Management And General | $31,920 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,749 | TotalAmt |
| Program Services | $4,347 | ProgramServicesAmt |
| Management And General | $402 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,717 | TotalAmt |
| Program Services | $9,810 | ProgramServicesAmt |
| Management And General | $907 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,075 | TotalAmt |
| Program Services | $11,969 | ProgramServicesAmt |
| Management And General | $1,106 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,100 | TotalAmt |
| Program Services | $1,007 | ProgramServicesAmt |
| Management And General | $93 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,996 | TotalAmt |
| Program Services | $89,996 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| COMMISSIONS | $2,970,321 | $2,970,321 | |
| ADMINISTRATIVE FEES | $2,216,615 | $2,216,615 | |
| LICENSES, PERMITS, FEES | $59,699 | $54,648 | $5,051 |
| BANK SERVICE CHARGES | $37,457 | $34,288 | $3,169 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,771 | TotalAmt |
| Program Services | $59,292 | ProgramServicesAmt |
| Management And General | $5,479 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,102,146 | TotalAmt |
| Program Services | $7,053,419 | ProgramServicesAmt |
| Management And General | $48,727 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,060,424 | BOYAmt |
| EOY | $1,575,043 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,879,645 | BOYAmt |
| EOY | $1,863,909 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,315,053 | BOYAmt |
| EOY | $3,224,864 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $370,000 | BOYAmt |
| EOY | $370,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,431 | BOYAmt |
| EOY | $38,722 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,674,553 | BOYAmt |
| EOY | $7,072,538 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,400,942 | BOYAmt |
| EOY | $2,454,715 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,186 | BOYAmt |
| EOY | $77,321 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,000,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,583,882 | BOYAmt |
| EOY | $1,568,216 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,073,010 | BOYAmt |
| EOY | $4,100,252 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,601,543 | BOYAmt |
| EOY | $2,972,286 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,601,543 | BOYAmt |
| EOY | $2,972,286 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,674,553 | BOYAmt |
| EOY | $7,072,538 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $246,764 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $123,979 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENT IN DELTA RE. CORP. | Desc |
| Book Value | $370,000 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $370,000 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| PREFUNDED DEPOSITS | $68,216 |
| REINSURANCE DEPOSITS | $1,500,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,568,216 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $7,348,910 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,348,910 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $7,348,910 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $7,102,146 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $7,102,146 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $7,102,146 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | 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 EVALUATED THE IMPACT OF THE ACCOUNTING PRONOUNCEMENT AND DETERMINED THAT IT HAS NO IMPACT ON THE COMPANY'S FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, | RegionTxt |
| Offices | 0 | OfficesCnt |
| Employee | 0 | EmployeeCnt |
| Type Of Activities Conducted | PROGRAM SERVICES | TypeOfActivitiesConductedTxt |
| Specific Services Provided | REINSURANCE | SpecificServicesProvidedTxt |
| Region Total Expenditures | $15,783,566 | RegionTotalExpendituresAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continutation Total Office | 0 | ContinutationTotalOfficeCnt |
| Continutation Total Employee | 0 | ContinutationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $15,783,566 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $15,783,566 | TotalSpentAmt |
| Transfer To Foreign Corp | 0 | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | Yes (1) | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | 0 | PassiveForeignInvestmestCoInd |
| Foreign Partnership | 0 | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3(E) - REINSURANCE: | FormAndLineReferenceDesc |
| Explanation | 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 $15,783,566. THE ORGANIZATION'S REINSURANCE RECEIPTS WERE $13,717,130. THE NET REINSURANCE LOSS WAS $2,066,436. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| DELTA DENTAL COMMUNITY CARE FOUNDATION | |||||||
| 100 FIRST STREET | SAN FRANCISCO | CA | 94105 | 371570764 | 501(C)(3) | $76,000 | TO PROVIDE DENTAL EDUCATION |
| MISC DONATIONS LESS THAN 5000 | |||||||
| $1,000 | TO PROVIDE DENTAL EDUCATION | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | 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 INDIGENTS; (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. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | Yes (X) | FirstClassOrCharterTravelInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Personal Services | Yes (X) | PersonalServicesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GARY D RADINE | ||||||||||||||
| PRESIDENT | $0 | $1,250,004 | $0 | $2,500,000 | $0 | $2,308,060 | $0 | $75,867 | $0 | $16,511 | $0 | $6,150,442 | $0 | $0 |
| ANTHONY S BARTH | ||||||||||||||
| EVP/CHIEF OPERATING OFFICER | $0 | $824,004 | $0 | $906,000 | $0 | $41,838 | $0 | $582,670 | $0 | $24,521 | $0 | $2,379,033 | $0 | $0 |
| MICHAEL J CASTRO | ||||||||||||||
| EVP/CHIEF FINANCIAL OFFICER | $0 | $566,496 | $0 | $624,000 | $0 | $73,861 | $0 | $520,154 | $0 | $22,851 | $0 | $1,807,362 | $0 | $0 |
| PATRICK S STEELE | ||||||||||||||
| EVP/CHIEF INFORMATION OFFICER | $0 | $540,756 | $0 | $595,000 | $0 | $42,517 | $0 | $1,186,651 | $0 | $17,703 | $0 | $2,382,627 | $0 | $0 |
| CHARLES LAMONT ESQ | ||||||||||||||
| EVP/CHIEF LEGAL OFFICER | $0 | $467,065 | $0 | $650,000 | $0 | $138,704 | $0 | $47,100 | $0 | $17,703 | $0 | $1,320,572 | $0 | $0 |
| ALICIA F WEBER | ||||||||||||||
| SENIOR VICE PRES./CONTROLL | $0 | $373,200 | $0 | $329,000 | $0 | $24,296 | $0 | $91,383 | $0 | $24,130 | $0 | $842,009 | $0 | $0 |
| MICHAEL G HANKINSON | ||||||||||||||
| SVP, COMPLIANCE & REGULATOR | $0 | $336,942 | $0 | $98,000 | $0 | $99,503 | $0 | $41,460 | $0 | $22,499 | $0 | $598,404 | $0 | $0 |
| JEANNE M FOSTER | ||||||||||||||
| VICE PRESIDENT, FINANCE | $0 | $238,752 | $0 | $84,000 | $0 | $14,926 | $0 | $72,212 | $0 | $7,650 | $0 | $417,540 | $0 | $0 |
| PHILIP N ENGLE | ||||||||||||||
| VP, INFORMATION TECHNOLOGY | $0 | $231,121 | $0 | $74,100 | $0 | $11,643 | $0 | $86,107 | $0 | $15,891 | $0 | $418,862 | $0 | $0 |
| RENEE A FISHER | ||||||||||||||
| VP, QUALITY ASSURANCE & TR | $0 | $208,059 | $0 | $107,531 | $0 | $8,204 | $0 | $108,768 | $0 | $12,645 | $0 | $445,207 | $0 | $0 |
| RICHARD C GRAYBILL | ||||||||||||||
| V.P. UNDERWRITING & ACTUAR | $0 | $204,996 | $0 | $67,650 | $0 | $10,220 | $0 | $69,188 | $0 | $6,233 | $0 | $358,287 | $0 | $0 |
| WHITNEY H SHERBOCKER | ||||||||||||||
| ASSISTANT SECRETARY | $0 | $159,031 | $0 | $33,968 | $0 | $8,690 | $0 | $53,957 | $0 | $14,722 | $0 | $270,368 | $0 | $0 |
| KAREN L ROBINSON | ||||||||||||||
| ASSISTANT SECRETARY | $0 | $113,782 | $0 | $29,021 | $0 | -$1,031 | $0 | $31,954 | $0 | $5,287 | $0 | $179,013 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 2013. 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 2013, ANTHONY BARTH, MICHAEL CASTRO, GARY RADINE, AND PATRICK STEELE 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. THESE AMOUNTS ARE INCLUDED IN TAXABLE COMPENSATION. |
| SCHEDULE J, PART II, LINE (II) | THE ORGANIZATION'S OFFICERS ARE PAID BY A RELATED ORGANIZATION. ACCORDINGLY, THEIR COMPENSATION IS REPORTED IN LINE (II). |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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, WHO IS AN EMPLOYEE OF DENTEGRA GROUP, INC. ("DGI"), IS REVIEWED AND APPROVED BY THE DGI DIRECTORS. EXECUTIVE VICE PRESIDENTS' COMPENSATION IS EITHER APPROVED BY THE PRESIDENT OR IN ACCORDANCE WITH THE PROCEDURE OF DELTA DENTAL OF CALIFORNIA (BY WHOM THEY ARE EMPLOYED). ALL COMPENSATION FOR THE ENSUING YEAR IS ONLY APPROVED AFTER REVIEWING COMPARABILITY DATA PRESENTED BY AN OUTSIDE COMPENSATION CONSULTANT, AN ASSESSMENT OF EACH OFFICER'S PERFORMANCE OVER THE PRECEDING YEAR, AND THE ORGANIZATION'S PROGRAM ACCOMPLISHMENTS FOR THE YEAR. THIS PROCESS WAS FOLLOWED FOR 2013 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. |
| FORM 990, PART VII; SCHEDULE J; SCHEDULE R | THE ORGANIZATION, REGULATED BY THE WEST VIRGINIA OFFICES OF THE INSURANCE COMMISSIONER, 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 26 MILLION ENROLLEES AND HANDLING 39 MILLION CLAIMS. TOTAL REVENUE FOR THE ENTERPRISE EXCEEDED $7.1 BILLION IN 2013. THE ORGANIZATION AND ITS SUBSIDIARIES REPRESENT LESS THAN 1% OF TOTAL ENTERPRISE REVENUES. |
| FORM 990, PT. VII, SEC. A, COL. (E); SCH. J, PT. II, LINE (II), COL. B(III) | AS A RESULT OF REACHING AGE 65 IN 2011, MR. RADINE WAS NO LONGER ELIGIBLE TO PARTICIPATE IN THE COMPANY'S EXECUTIVE SUPPLEMENTAL PENSION PLAN (ESPP). MR. RADINE'S EMPLOYMENT AGREEMENT PROVIDED MR. RADINE BE PAID A CASH INCENTIVE IN LIEU OF CONTINUED ESPP PARTICIPATION UNTIL A LONG-TERM INCENTIVE PLAN WENT INTO EFFECT IN 2013. THE CASH INCENTIVE WAS AN ACTUARIAL CALCULATION AS IF MR. RADINE HAD REMAINED IN THE ESPP DURING CALENDAR YEAR 2012. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 THE DISTRICT OF COLUMBIA | ||||||||||
| ONE DELTA DRIVE | MECHANICSBURG | PA | 17055 | 521479587 | DENTAL INSURANCE | DC | 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 NEW YORK | ||||||||||
| ONE DELTA DRIVE | MECHANICSBURG | PA | 17055 | 111980218 | DENTAL INSURANCE | NY | 501(C)(4) | DENTEGRA GROUP INC | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PACA MANAGEMENT LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE DELTA DRIVE | AddressLine1 |
| City | MECHANICSBURG | City |
| State | PA | State |
| ZIP Code | 17055 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 943277375 | EIN |
| Primary Activities | INSURANCE MANAGEMENT | PrimaryActivitiesTxt |
| Legal Domicile State | DE | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF CALIFORNIA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (15 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Address Line1ForeignAddress/AddressLine1 | CityForeignAddress/City | Province Or StateForeignAddress/ProvinceOrState | CountryForeignAddress/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Postal CodeForeignAddress/PostalCode | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | C | 0 | DDC INSURANCE HOLDINGS INC | ||||||||
| DENTEGRA INSURANCE CO OF NEW ENGLAND | |||||||||||||||||
| 100 FIRST STREET | SAN FRANCISCO | CA | 94105 | 042890218 | INSURANCE COMPANY | MA | C | 0 | DDC INSURANCE HOLDINGS INC | ||||||||
| DELTA DENTAL INSURANCE COMPANY | |||||||||||||||||
| 100 FIRST STREET | SAN FRANCISCO | CA | 94105 | 942761537 | INSURANCE COMPANY | DE | C | 0 | DDC INSURANCE HOLDINGS INC | ||||||||
| ALPHA DENTAL OF NEVADA INC | |||||||||||||||||
| 100 FIRST STREET | SAN FRANCISCO | CA | 94105 | 880244893 | INSURANCE COMPANY | NV | C | 0 | DDC INSURANCE HOLDINGS INC | ||||||||
| ALPHA DENTAL OF UTAH INC | |||||||||||||||||
| 100 FIRST STREET | SAN FRANCISCO | CA | 94105 | 860672505 | INSURANCE COMPANY | UT | C | 0 | DDC INSURANCE HOLDINGS INC | ||||||||
| ALPHA DENTAL PROGRAMS INC | |||||||||||||||||
| 100 FIRST STREET | SAN FRANCISCO | CA | 94105 | 742447512 | INSURANCE COMPANY | TX | C | 0 | DDC INSURANCE HOLDINGS INC | ||||||||
| ALPHA DENTAL OF ALABAMA INC | |||||||||||||||||
| 100 FIRST STREET | SAN FRANCISCO | CA | 94105 | 630796079 | INSURANCE COMPANY | AL | C | 0 | DDC INSURANCE HOLDINGS INC | ||||||||
| ALPHA DENTAL OF NEW MEXICO INC | |||||||||||||||||
| 100 FIRST STREET | SAN FRANCISCO | CA | 94105 | 330279230 | INSURANCE COMPANY | NM | C | 0 | DDC INSURANCE HOLDINGS INC | ||||||||
| ALPHA DENTAL OF ARIZONA INC | |||||||||||||||||
| 100 FIRST STREET | SAN FRANCISCO | CA | 94105 | 930939835 | INSURANCE COMPANY | AZ | C | 0 | DDC INSURANCE HOLDINGS INC | ||||||||
| DENTEGRA SEGUROS DENTALES SA | |||||||||||||||||
| INSURANCE COMPANY | C | 0 | DENTEGRA INSURANCE COMPANY | INSURGENTES SUR 826 PISO 15 | COL DEL VALLE | FC DF 01300 | MX | MX | |||||||||
| DELTA DENTAL OF PUERTO RICO | |||||||||||||||||
| 660436769 | INSURANCE COMPANY | C | 0 | DELTA DENTAL OF CALIFORNIA | 14 CALLE 2 SUITE 200 | GUAYNABO | RQ | RQ | 00968 | ||||||||
| DELTA REINSURANCE CORPORATION | |||||||||||||||||
| 980096711 | REINSURANCE | C | 0 | DELTA DENTAL OF PENNSYLVANIA | CGI TOWER 2ND FLOOR | WARRENS | ST. MICHAEL | BB | BB | 0.06250 | |||||||
| SERVICIOS DENTALES DENTEGRA SA DE CV | |||||||||||||||||
| INSURANCE ADMINISTRATION | C | 0 | DENTEGRA INSURANCE COMPANY | INSURGENTES SUR 826 PISO 15 | COL DEL VALLE | FC DF 01300 | MX | MX | |||||||||
| DDC INSURANCE HOLDINGS INC | |||||||||||||||||
| 100 FIRST STREET | SAN FRANCISCO | CA | 94105 | 274251930 | HOLDING COMPANY | DE | C | 0 | DELTA DENTAL OF CALIFORNIA | ||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt |
|---|---|
| DELTA DENTAL OF PENNSYLVANIA | |
| M | $1,547,789 |
| DELTA REINSURANCE COMPANY | |
| S | $13,717,130 |
| DELTA REINSURANCE COMPANY | |
| R | $15,783,566 |
| DELTA DENTAL OF CALIFORNIA | |
| P | $39,116 |
| DELTA DENTAL OF CALIFORNIA | |
| M | $13,665 |