DELTA PILOTS MEDICAL TRUST: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: DELTA PILOTS MEDICAL TRUST (EIN 36-6791917)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2014-05-15
IRS object ID: 201411359349302411
Schema version: 2012v2.0
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
Form 990
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-05-15T10:44:08-07:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate
Return Type	990	ReturnType
Tax Period Begin Date	2012-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	366791917	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	DELTA PILOTS MEDICAL TRUST	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	DELT	NameControl
Phone	4047152600	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1030 Delta Blvd	AddressLine1
Address Line2	Dept 216	AddressLine2
City	Atlanta	City
State	GA	State
ZIP Code	30354	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Robert Kight	Name
Title	SVP-Global HR Svcs & Lbr Relations	Title
Phone	4047152400	Phone
Date Signed	2014-04-03	DateSigned

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Robert Kight	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1030 Delta Blvd	AddressLine1
Address Line2	Dept 216	AddressLine2
City	Atlanta	City
State	GA	State
ZIP Code	30354	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	31846201	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c	X	Organization501c
Web Site	www.delta.com	WebSite
Type Of Organization Trust	X	TypeOfOrganizationTrust
Year Formation	1984	YearFormation
State Legal Domicile	GA	StateLegalDomicile
Activity Or Mission Description	Disburse payments on behalf of participants related to medical, dental, mental health and prescription drugs.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	10	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	0	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	1644989	ContributionsGrantsPriorYear
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	36818573	ProgramServiceRevenuePriorYear
Program Service Revenue CY	31838475	ProgramServiceRevenueCY
Investment Income Prior Year	7103	InvestmentIncomePriorYear
Investment Income Current Year	7726	InvestmentIncomeCurrentYear
Other Revenue Prior Year	0	OtherRevenuePriorYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	38470665	TotalRevenuePriorYear
Total Revenue Current Year	31846201	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	34895236	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	35056955	BenefitsPaidToMembersCY
Salaries Etc Prior Year	0	SalariesEtcPriorYear
Salaries Etc Current Year	0	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	1654273	OtherExpensePriorYear
Other Expenses Current Year	1499929	OtherExpensesCurrentYear
Total Expenses Prior Year	36549509	TotalExpensesPriorYear
Total Expenses Current Year	36556884	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	1921156	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-4710683	RevenuesLessExpensesCY
Total Assets BOY	8133987	TotalAssetsBOY
Total Assets EOY	4687074	TotalAssetsEOY
Total Liabilities BOY	2383608	TotalLiabilitiesBOY
Total Liabilities EOY	3647378	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	5750379	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	1039696	NetAssetsOrFundBalancesEOY
Mission Description	Disburse payments on behalf of participants related to medical, dental, mental health and prescription drugs.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	36556884	Expense
Grants	0	Grants
Revenue	31846201	Revenue
Description	Health Insurance Program: Medical, mental health, prescription drugs, and dental benefits paid to, or on behalf of participants under the Delta Pilots Medical Plan.	Description
Total Of Other Program Service Exp	0	TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt	0	TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev	0	TotalOfOtherProgramServiceRev
Total Program Service Expense	36556884	TotalProgramServiceExpense
Described In501 C3	0	DescribedIn501C3
Schedule B Required	0	ScheduleBRequired
Political Activities	0	PoliticalActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	0	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	1	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	0	Hospital
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	0	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	0	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	0	NumberOfEmployees
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	10	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	0	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	0	ConflictOfInterestPolicy
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	0	CompensationProcessCEO
Compensation Process Other	0	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	GA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	Delta Air Lines Inc	BusinessNameLine1
Business Name Line2	Corporate Benefits Department	BusinessNameLine2

Field	Value	IRS element (for citing)
Telephone Number	4047152600	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1030 Delta Blvd	AddressLine1
Address Line2	Dept 837	AddressLine2
City	Atlanta	City
State	GA	State
ZIP Code	30354	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Institutional TrusteeInstitutionalTrustee
Robert L Kight
Chairman Admin Comm, Member Invest Comm	1	0	X	0	0	0
Christopher M Collins
Member Admin Comm	1	0	X	0	0	0
Gregory S Tahvonen
Member Admin Comm	1	0	X	0	0	0
Paul A Jacobson
Member Invest Comm	1	0	X	0	0	0
Kenneth W Morge
Chair and Member, Invest Comm	1	0	X	0	0	0
Jeffery A Arinder
Member Invest Comm	1	0	X	0	0	0
Sandy P Gordon
Member Invest Comm	1	0	X	0	0	0
Craig M Meynard
Member Invest Comm	1	0	X	0	0	0
Kiko Harvey
Member Invest Comm	1	0	X	0	0	0
Garrett Chase
Member Invest Comm	1	0	X	0	0	0
Mary Anne Bell
Member Admin Subcomm	1	0	X	0	0	0
JP Morgan Chase
Trustee	1	0		14023	0	0	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	14023	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	0	TotalOtherCompensation
Number Individuals GT100 K	0	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	0	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources
Number Of Contractors GT100 K	0	NumberOfContractorsGT100K
Total Contributions	0	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
Employer Contributions	900099	18722754	18722754	0	$0
Employee Contributions	900099	13115721	13115721	0	$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Total Program Service Revenue	31838475	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	7726	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$7,726	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	0	Real
Personal	0	Personal

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	0	Securities
Other	0	Other

Field	Value	IRS element (for citing)
Total Other Revenue	0	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	31846201	TotalRevenueColumn
Related Or Exempt Function Income	31838475	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$7,726	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	35056955	Total
Program Services	35056955	ProgramServices

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	1017984	Total
Program Services	1017984	ProgramServices

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	20000	Total
Program Services	20000	ProgramServices

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	461945	Total
Program Services	461945	ProgramServices

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	36556884	Total
Program Services	36556884	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	5265707	BOY
EOY	2060780	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	2868280	BOY
EOY	2626294	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	8133987	BOY
EOY	4687074	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	390988	BOY
EOY	282794	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	1992620	BOY
EOY	3364584	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	2383608	BOY
EOY	3647378	EOY

Field	Value	IRS element (for citing)
Do Not Follow SFAS117	X	DoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

Field	Value	IRS element (for citing)
BOY	5750379	BOY
EOY	1039696	EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	5750379	BOY
EOY	1039696	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	8133987	BOY
EOY	4687074	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	-4710683	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	0	ReconciliationUnrealizedInvest
Reconcilation Donated Services	0	ReconcilationDonatedServices
Reconcilation Invest Expenses	0	ReconcilationInvestExpenses
Reconcilation Prior Adjustment	0	ReconcilationPriorAdjustment
Reconcilation Other Changes	0	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Separate	X	FinancialStatementSeparate

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	Benefit Claims Payable	Description
Amount	$3,364,584	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	3364584	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt	31846201	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	0	NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities	0	DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants	0	RecoveriesOfPriorYearGrants
Other Revenues	0	OtherRevenues
Revenue Not Rptd F990	0	RevenueNotRptdF990
Revenue Subtotal	31846201	RevenueSubtotal
Investment Expenses Not Included	0	InvestmentExpensesNotIncluded
Other Revenues Not Included	0	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	0	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	31846201	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	36556884	TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities	0	DonatedServicesUseOfFacilities
Prior Year Adjustments	0	PriorYearAdjustments
Losses Reported	0	LossesReported
Other Expenses Included	0	OtherExpensesIncluded
Expenses Not Rptd F990	0	ExpensesNotRptdF990
Expenses Subtotal	36556884	ExpensesSubtotal
Investment Expenses Not Included2	0	InvestmentExpensesNotIncluded2
Other Expenses Not Included	0	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	0	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	36556884	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

Field	Value	IRS element (for citing)
Identifier	SchD_P10_S00_L02	Identifier
Return Reference	Schedule D, Part X, Line 2	ReturnReference
Explanation	The other liability noted here encompasses the benefit claims payable, which is made up of the IBNR. Effective July 1, 2009, the Plan recognizes a tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained upon examination by the taxing authority, based on the technical merits of the positon. The Plan is exempt from federal and state income taxes under Section 401(a) of the Internal Revenue Code. Tax years that remain subject to the examination by major tax jurisdictions date back to the year ending June 30, 2011. All federal and state income tax positions taken or anticipated to be taken in the income tax returns are attributable to the plan sponsor and not the Plan. As of June 30, 2013, there are no known items which would result in a material accrual related to where the plan has federal or state attributable tax positons.	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
F990_P06_S0B_L11b	Form 990, Part VI, Section B, Line 11b	The Form 990 is completed each year by Delta Air Lines, Inc.'s Corporate Benefits Department. The analyst enters all information and gathers the necessary files and schedules for support. The return goes through two levels of managerial review; and then the return is reviewed with the Principal Officer prior to signing the form.
F990_P06_S0C_L19	Form 990, Part VI, Section C, Line 19	The financial statements of the Delta Medical Trust are made available to the public upon request.