2014-10-03T10:42:10-05:00 2013-12-31 420714325 MCGLADREY LLP 801 NICOLLET MALL SUITE 1100 MINNEAPOLIS MN 55402 990 2013-01-01 840568337 COLORADO DENTAL SERVICE INC COLO 8002330860 4582 SO ULSTER STREET NO 800 DENVER CO 80237 DAVID BEAL CFO AND TREASURER 8002330860 2014-09-23 1 TODD A JACKSON P00092672 6123324300 2013 2015-11-30 17:44:51Z DELTA DENTAL OF COLORADO KATHRYN ANN PAUL 4582 SO ULSTER STREET NO 800 DENVER CO 80237 309290962 0 X WWW.DELTADENTALCO.COM X 1958 CO TO IMPROVE THE ORAL HEALTH OF THE COMMUNITIES WE SERVE. 15 11 123 0 5768 0 0 0 284720024 299276094 3142982 3866637 189419 5768 288052425 303148499 6894176 4455023 249715351 263588413 11673045 12449461 0 0 0 16013422 20567290 284295994 301060187 3756431 2088312 99423940 103850234 25930494 26055401 73493446 77794833 X DELTA DENTAL OF COLORADO (DDCO) WAS FORMED AS A 501(C)(4) ORGANIZATION IN ORDER TO IMPROVE THE ORAL HEALTH OF THE COMMUNITIES IT SERVES. BECAUSE PEOPLE WITH DENTAL INSURANCE OVER TIME HAVE BETTER ORAL HEALTH OUTCOMES, DELTA DENTAL OF COLORADO DEVOTES ITSELF TO PROVIDING HIGH QUALITY, AFFORDABLE DENTAL INSURANCE TO AS MANY COLORADOANS AS POSSIBLE. UNFORTUNATELY, THERE ARE MANY PEOPLE FOR WHOM DENTAL INSURANCE IS NOT POSSIBLE. FOR THESE PEOPLE, DELTA DENTAL HAS A NUMBER OF DIFFERENT PROGRAMS ESTABLISHED TO PROVIDE THEM WITH ORAL HEALTH EDUCATION, DIRECT PATIENT DENTAL SERVICES, AND FREE DENTAL INSURANCE SO THAT GOOD ORAL HEALTH WILL ALSO BE ACHIEVABLE FOR THEM. 0 0 290365349 299276094 PROVISION OF RISK AND SELF-FUNDED PLANS TO SUBSCRIBERS. DELTA DENTAL OF COLORADO DEVOTES ITSELF TO ITS MISSION OF IMPROVING THE ORAL HEALTH OF COLORADO'S PEOPLE. BECAUSE PEOPLE WITH DENTAL INSURANCE ARE OVER TWICE AS LIKELY TO VISIT A DENTIST REGULARLY, DELTA DENTAL OF COLORADO WORKS HARD TO MAKE DENTAL INSURANCE AS AFFORDABLE AND ACCESSIBLE AS POSSIBLE, AND TO THAT END, INSURES OVER ONE MILLION PEOPLE IN COLORADO. THE REVENUE GENERATED IS USED TO FUND THE COMMUNITY BENEFIT EFFORTS DESCRIBED IN LINE 4B. 6583000 4455023 COMMUNITY BENEFIT PROGRAMSBECAUSE DENTAL INSURANCE IS NOT POSSIBLE FOR EVERYONE, DELTA DENTAL OF COLORADO DEVOTES SIGNIFICANT RESOURCES AND MONEY TO PROVIDING DENTAL SERVICES AND DENTAL HYGIENE INFORMATION TO AS A MANY PEOPLE AS POSSIBLE; PARTICULARLY THOSE UNDERSERVED POPULATIONS, WHERE ORAL DISEASE IS MORE PREVALENT. TO THAT END, DELTA DENTAL OF COLORADO, OVER THE PAST ELEVEN YEARS, HAS DEVOTED 55% OF ITS NET GAIN TO ITS COMMUNITY BENEFIT PROGRAM AND THE DELTA DENTAL OF COLORADO FOUNDATION. IN 2013, DELTA DENTAL OF COLORADO DONATED $3,628,000 TO THE DELTA DENTAL OF COLORADO FOUNDATION. IT ALSO SPENT $830,023 ON A NUMBER OF INITIATIVES THROUGH ITS COMMUNITY BENEFIT PROGRAM. THESE PROGRAMS INCLUDED NUMEROUS COMMUNITY EVENTS WHERE COMPANY EMPLOYEES PROVIDED FREE ORAL HYGIENE SUPPLIES AND ORAL HEALTH INSTRUCTION TO OVER 20,000 PEOPLE. IT ALSO INCLUDED $250,000 TO DEVELOP AN EDUCATIONAL ORAL HEALTH THEATER TROUPE. THIS THEATER TROUPE, CALLED "THE LAND OF SMILES" PUT ON FREE PERFORMANCES AT COLORADO GRAMMAR SCHOOLS AND TAUGHT CHILDREN THE IMPORTANCE OF GOOD ORAL HEALTH AND HOW TO TAKE CARE OF THEIR TEETH. FIFTY-FIVE SCHOOLS AND OVER 15,000 CHILDREN WERE REACHED THROUGH THE FREE "LAND OF SMILES" PROGRAM. FREE ORAL HYGIENE SUPPLIES WERE ALSO PROVIDED TO ALL OF THE STUDENTS.IN ALIGNMENT WITH OUR COMMITMENT TO COLORADO'S COMMUNITIES, DELTA DENTAL OF COLORADO ENCOURAGES ITS EMPLOYEES TO VOLUNTEER THEIR SERVICES TO OTHER CHARITABLE ORGANIZATIONS DOING WORK IN COLORADO. TO THAT END, DELTA DENTAL OF COLORADO DONATES $5,000 TO ANY CHARITABLE ORGANIZATION DOING WORK IN COLORADO ON WHICH ANY OF ITS LEADERSHIP TEAM SERVES ON THE BOARD OF DIRECTORS. DELTA DENTAL OF COLORADO ALSO HAS A DEEP COMMITMENT TO THE UNITED WAY MILE-HIGH CHAPTER, AND IN 2013 HAD 100% CAMPAIGN PARTICIPATION FROM ITS EMPLOYEES AND BOARD. 296948349 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 1 20599 0 1 123 1 1 1 0 0 0 0 0 X 15 11 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X X GREG VOCHIS 7204894715 4582 SO ULSTER STREET NO 800 DENVER CO 80237 KATHRYN ANN PAUL CEO/PRESIDENT 43.00 2.00 X X 511767 0 39159 DOUGLAS BERKEY - DMD MPH MS CHAIR 5.00 2.00 X X 40274 0 1274 MARILYN E TAYLOR VICE CHAIR 5.00 3.00 X X 23524 0 1911 JONATHAN M ANDERSON - DDS TRUSTEE 4.00 X 21847 0 1720 CYNTHIA ANNE EVANS TRUSTEE 4.00 X 25269 0 2019 JOHN PAUL HOPKINS TRUSTEE 4.00 X 28750 0 0 DENISE KAY KASSEBAUM - DDS MS TRUSTEE 4.00 X 17750 0 0 VICTOR LAZZARO JR TRUSTEE 4.00 X 27602 0 852 MARY NOONAN TRUSTEE 4.00 X 27853 0 671 LARAE ORULLIAN TRUSTEE 4.00 X 23264 0 2055 DONALD S SAFER - DDS MS TRUSTEE 4.00 2.00 X 19712 0 462 GAIL SCHOETTLER - PHD TRUSTEE 4.00 2.00 X 26250 0 359 THOMAS B SWAIN - DDS TRUSTEE 4.00 X 26750 0 0 WALT VOGL - DDS TRUSTEE 4.00 X 18250 0 0 MARK WEHRLE - CPA TRUSTEE 4.00 X 26020 0 1770 DAVID ANDREW BEAL CFO/TREASURER 45.00 X 256207 0 44710 LINDA MARIE ARNESON COO/SECRETARY 45.00 X 282240 0 39221 JESSICA JEAN LAWHEAD VICE PRESIDENT 45.00 X 285417 0 43336 BARBARA BLACKBURN SPRINGER - JD VICE PRESIDENT 22.50 22.50 X 153637 104304 46196 TRICIA HEMSKY DIRECTOR OF CLIENT SERVICE 45.00 X 168039 0 35929 LORRIE KOHLE MANAGER OF STRATEGIC ALLIA 45.00 X 157883 0 17646 MICHAEL OKUJI - DDS DENTAL DIRECTOR 45.00 X 193088 0 26680 STEPHANIE RAUZI SENIOR ACCOUNT EXECUTIVE 45.00 X 181884 0 38733 ROBERT MARK THOMPSON DIRECTOR OF SALES 45.00 X 199955 0 44233 2743232 104304 388936 23 0 1 0 DELTA DENTAL OF VIRGINIA 4818 STARKEY ROAD SW ROANOKE VA 24018 CLAIMS PROCESSING 1764000 GREENRUBINO 1938 FAIRVIEW AVE E STE 200 SEATTLE WA 98102 ADVERTISING & MEDIA 1762084 DELOITTE CONSULTING LLP PO BOX 7247 6447 PHILADELPHIA PA 19170 STRATEGIC PLANNING 906904 OFFICESCAPES 9900 E 51ST AVE DENVER CO 80238 OFFICE RENOVATION EQUIPMENT 895227 LEGACY PARTNERS II STANFORD PLACE 4000 E THIRD AVE SUITE 600 FOSTER CITY CA 94404 OFFICE RENT & RENOVATION 851786 29 RISK PLAN PREMIUMS 524114 146011230 146011230 SELF FUNDED PLAN PREMIUMS 524114 142712972 142712972 ADMINISTRATION - SELF FUNDED PLAN 524298 10134825 10134825 PATIENT DIRECT REVENUE 524114 417067 417067 299276094 2464779 2464779 7544091 230 6142463 0 1401628 230 1401858 1401858 VISION PREMIUMS 524298 5768 5768 5768 303148499 299276094 5768 3866637 4455023 4455023 263588413 263588413 2049991 2000165 49826 7594652 7410062 184590 441607 430874 10733 1775157 1732011 43146 588054 411638 176416 146955 117564 29391 82166 65733 16433 115708 115708 264080 264080 3017410 2112186 905224 2572272 2572272 113394 79376 34018 1436512 1149210 287302 594555 475644 118911 205902 41180 164722 66235 66235 1391658 768537 623121 COMMISSIONS 5587929 5587929 DATA PROCESSING 2614049 2091239 522810 POSTAGE & MAILING 1753361 1402689 350672 COMMUNITY BENEFIT PROGR 456604 456604 148500 148500 301060187 296948349 4111838 0 4548762 2337761 2536282 180276 13674463 15514467 577820 589662 10255839 5060568 4362770 5195271 73380223 79718433 20010 20010 323610 294354 99423940 103850234 4368585 9515961 6515000 3628000 2485242 1914147 12561667 10997293 25930494 26055401 X 73493446 77794833 73493446 77794833 99423940 103850234 X 2088312 2156060 57015 X 0 1 X 1 0 1698545 615929 1082616 6567259 4099218 2468041 1990035 345421 1644614 5195271 PROVISION FOR UNPAID CLAIMS 10997293 10997293 1 DELTA DENTAL OF COLORADO FOUNDATION 4582 S ULSTER ST SUITE 800 DENVER CO 80237 841389431 501(C)(3) 3628000 SUPPORTED ORGANIZATION OF THE COMPANY LIVE WELL COLORADO 1490 LAFAYETTE ST STE 404 DENVER CO 80218 262464764 501(C)(3) 10000 SUPPORT LOCAL ORGANIZATION CHILDRENS MUSEUM OF DENVER INC 2121 CHILDRENS MUSEUM DRIVE DENVER CO 802113939 840658142 501(C)(3) 201660 SUPPORT OF CULTURE AND HUMANITIES MAKE A WISH FOUNDATION 7951 E MAPLEWOOD AVE STE 126 GREENWOOD VILLAGE CO 80111 742273004 501(C)(3) 8030 SUPPORT LOCAL ORGANIZATION MILE HIGH UNITED WAY 2505 18TH ST DENVER CO 802113939 840404235 501(C)(3) 15000 SUPPORT LOCAL ORGANIZATION NATIONAL NETWORK FOR ORAL HEALTH 181 EAST 56TH AVE STE 501 DENVER CO 80216 841186592 501(C)(3) 20000 SUPPORT LOCAL CHAPTER OF NATIONAL ORGANIZATION ORAL HEALTH COLORADO 1985 UNION ST LAKEWOOD CO 80215 900137772 501(C)(3) 199851 SUPPORT LOCAL ORGANIZATION SAFEHOUSE DENVER INC 1649 DOWNING ST DENVER CO 80218 840745911 501(C)(3) 8500 SUPPORT LOCAL ORGANIZATION VOLUNTEERS OF AMERICA 2660 LARIMER ST DENVER CO 80205 840430995 501(C)(3) 6000 SUPPORT LOCAL ORGANIZATION COLORADO BUSINESS COMMITTEE FOR THE ARTS 130 WEST 12TH AVE DENVER CO 80204 742368958 501(C)(3) 6200 SUPPORT LOCAL ORGANIZATION BOYS & GIRLS CLUBS OF METRO DENVER 2017 W 9TH AVE DENVER CO 80204 840510404 501(C)(3) 10000 SUPPORT LOCAL ORGANIZATION GOODWILL INDUSTRIES OF DENVER 6850 N FEDERAL BLVD DENVER CO 80221 840405513 501(C)(3) 7000 SUPPORT LOCAL ORGANIZATION JUVENILE DIABETES RESEARCH FND-ROCKY MTN CHAPTER 5613 DTC PRKWY SUITE 810 GREENWOOD VILLAGE CO 80111 231907729 501(C)(3) 10000 SUPPORT LOCAL CHAPTER OF NATIONAL ORGANIZATION COLORADO MISSION OF MERCY 430 COLORADO AVE PUEBLO CO 81004 271586585 501(C)(3) 35000 SUPPORT LOCAL ORGANIZATION DENVER ART MUSEUM 100 W 14TH AVE PKWY DENVER CO 80204 846038240 501(C)(3) 112000 SUPPORT LOCAL ORGANIZATION AMERICAN RED CROSS - MILE HIGH CHAPTER 444 SHERMAN ST DENVER CO 80203 530196605 501(C)(3) 30000 SUPPORT LOCAL ORGANIZATION 29 PART I, LINE 2: THE COMPANY HAS PROCEDURES TO ASCERTAIN THAT ALL GRANTS ARE MADE TO 501C3 ORGANIZATIONS AND ARE PROPERLY APPROVED BY MANAGEMENT. ADDITIONALLY, THE ORGANIZATION REQUIRES PERIODIC REPORTS TO ASCERTAIN THAT SUBSTANTIAL GRANTS ARE USED FOR THEIR PROPER INTENDED PURPOSE. X X X X 0 0 0 1 0 1 0 0 0 KATHRYN ANN PAUL CEO/PRESIDENT 390248 0 119195 0 2324 0 33500 0 5659 0 550926 0 0 0 DAVID ANDREW BEAL CFO/TREASURER 245601 0 9537 0 1069 0 30724 0 13986 0 300917 0 0 0 LINDA MARIE ARNESON COO/SECRETARY 238943 0 41066 0 2231 0 31240 0 7981 0 321461 0 0 0 JESSICA JEAN LAWHEAD VICE PRESIDENT 225218 0 57968 0 2231 0 29983 0 13353 0 328753 0 0 0 BARBARA BLACKBURN SPRINGER - JD VICE PRESIDENT 115138 104304 37072 0 1427 0 27855 0 18341 0 199833 104304 0 0 TRICIA HEMSKY DIRECTOR OF CLIENT SERVICE 135314 0 32430 0 295 0 17400 0 18529 0 203968 0 0 0 LORRIE KOHLE MANAGER OF STRATEGIC ALLIA 100574 0 56762 0 547 0 15846 0 1800 0 175529 0 0 0 MICHAEL OKUJI - DDS DENTAL DIRECTOR 190729 0 1011 0 1348 0 11944 0 14736 0 219768 0 0 0 STEPHANIE RAUZI SENIOR ACCOUNT EXECUTIVE 99512 0 82157 0 215 0 17947 0 20786 0 220617 0 0 0 ROBERT MARK THOMPSON DIRECTOR OF SALES 165893 0 33750 0 312 0 22414 0 21819 0 244188 0 0 0 PART I, LINE 5 THE COMPANY HAS AN INCENTIVE COMPENSATION PLAN AND A SALES INCENTIVE PLAN WHICH PROVIDES AN ANNUAL BONUS FOR ALL ELIGIBLE EMPLOYEES IF THE COMPANY REACHES CERTAIN GOALS INCLUDING A MINIMUN NET GAIN GOAL. ALL ACTIVE FULL TIME EMPLOYEES ARE ELIGIBLE FOR ONE OF THE INCENTIVE PLANS. THE COMPANY ALSO HAS A LONG-TERM INCENTIVE PROGRAM FOR EXECUTIVES, WHICH IS BASED ON BOTH A MEMBERSHIP GROWTH AND RETURN ON REVENUE FACTOR. THE LONG-TERM INCENTIVE PROGRAM HAS THREE-YEAR TARGETS AND PAYOUTS, AND IN MARCH OF 2013 THE PLAN ENDING DECEMBER 31, 2012 WAS PAID. PART I, LINE 6 SEE NARRATIVE FOR LINE 5A ABOVE. 4TH AVENUE FAMILY DENTISTRY LLC THOMAS B SWAIN, DELTA DIRECTOR & 1 OF 3 OWNERS OF 4TH AVE FAMILY DENTISTRY 107094 4TH AVENUE FAMILY DENTISTRY PARTICIPATES WITH DELTA DENTAL USING A STANDARD DENTAL PROVIDER CONTRACT, AND IS PAID FOR DENTAL SERVICES PROVIDED TO PATIENTS. 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS WHO ARE DEFINED AS PARTICIPATING DENTISTS WHO ARE ENGAGED IN THE PRACTICE OF DENTISTRY IN THE STATE OF COLORADO. THE PARTICIPATING DENTISTS ARE THOSE THAT HAVE SIGNED A PARTICIPATING DENTIST AGREEMENT WITH THE ORGANIZATION AS PRESCRIBED BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION HAVE THE AUTHORITY TO ELECT THE BOARD OF TRUSTEES AT THE ANNUAL MEETING OF THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN MATTERS OF THE ORGANIZATION ARE SUBJECT TO A VOTE OF THE MEMBERS. A QUORUM OF 2% OF THE MEMBERSHIP IS REQUIRED. FORM 990, PART VI, SECTION B, LINE 11 WE ENGAGE AN INDEPENDENT CPA TAX PROFESSIONAL TO PREPARE OUR 990, AND BOARD MEMBERS GENERALLY FEEL THIS IS THE APPROPRIATE FIDUCIARY PROCESS. THE AUDIT, INVESTMENT AND FINANCE COMMITTEE'S ROLE THEN IS TO EVALUATE THE FIRM HIRED TO PREPARE THE RETURN AND TO DETERMINE IT IS APPROPRIATELY FILED. WE HAVE TAKEN THOSE STEPS WITH OUR AUDIT, INVESTMENT AND FINANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 12C DDCO CONDUCTS ANNUAL COMPLIANCE TRAINING, WHICH IS MANDATORY FOR ALL EMPLOYEES TO ATTEND. THE CONFLICTS OF INTEREST POLICY IS DISCUSSED AT THIS TRAINING. ON AN ANNUAL BASIS, ALL EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT AND SUBMIT ANY POTENTIAL OR PERCEIVED CONFLICT OF INTEREST. RECEIPT OF ALL SIGNED & COMPLETED FORMS ARE TRACKED IN AN EXCEL FILE; ORIGINAL FORMS ARE KEPT IN THE PERSONNEL FILE IN THE HUMAN RESOURCES OFFICE. ANY REPORTED POTENTIAL OR PERCEIVED CONFLICTS ARE REVIEWED AND, IF NECESSARY, EMPLOYEES AND THEIR MANAGER ARE ADVISED TO REMOVE THEMSELVES FROM ANY SITUATION INVOLVING THE POTENTIAL CONFLICT. ADDITIONALLY, ALL NEW EMPLOYEES RECEIVE COMPLIANCE TRAINING AND ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT. EMPLOYEES ARE INSTRUCTED TO COMPLETE A NEW CONFLICT OF INTEREST STATEMENT DURING THE COURSE OF THE YEAR, SHOULD THEIR SITUATION CHANGE. THE CONFLICT OF INTEREST POLICY AND STATEMENT FORMS ARE POSTED ON THE COMPANY INTRANET. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES THAT IS RESPONSIBLE FOR SETTING THE COMPENSATION OF THE PRESIDENT AND CEO. THE COMMITTEE ENGAGES THE SERVICES OF A THIRD PARTY TO PROVIDE RANGES OF COMPENSATION THAT ARE APPRORPRIATE FOR THE DUTIES REQUIRED BY THE POSITION OF THE PRESIDENT, AS WELL AS THE POSITIONS OF THE VICE PRESIDENTS. THE CEO AND PRESIDENT OF THE CORPORATION IS RESPONSIBLE FOR THE COMPENSATION PROCESS OF THE REMAINING OFFICERS OF THE ORGANIZATION. THE ORGANIZATION ENGAGES A THIRD PARTY TO PROVIDE RANGES OF ACCEPTABLE INCREASES AND COMPENSATION LEVELS OF AVERAGE SALARIES BY SALARY GRADE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAINTAINS COPIES OF THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS THAT ARE AVAILABLE FOR PUBLIC INSPECTION FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). THE ORGANIZATION HAS A STATEMENT ON ITS WEBSITE, WWW.DELTADENTALCO.COM, THAT INFORMS THE PUBLIC THAT THESE DOCUMENTS ARE AVAILABLE FOR PUBLIC INSPECTION AT ITS CORPORATE HEADQUARTERS. THE ORGANIZATION'S ANNUAL REPORT IS ALSO POSTED ON ITS WEBSITE, WHICH STATES THAT "COMPLETE AUDITED FINANCIAL STATEMENTS ARE AVAILABLE FOR INSPECTION AT OUR CORPORATE OFFICES UPON REQUEST". FORM 990, PART XI, LINE 9: UNRECOGNIZED ACTUARIAL GAINS ON OPEB 57,015. DELTA DENTAL PLAN OF COLORADO FOUNDATION 4582 S ULSTER ST 800 DENVER CO 80237 841389431 DENTAL HEALTH AND EDUCATION CO 501(C)(3) LINE 11A, I N/A 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 DELTA DENTAL PLAN OF COLORADO FOUNDATION INC B 3628000 ACTUAL COST DELTA DENTAL PLAN OF COLORADO FOUNDATION INC O 240492 ACTUAL COST