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DELTA DENTAL OF CALIFORNIA: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL OF CALIFORNIA (EIN 94-1461312)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-13
IRS object ID
201313179349302711
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2013-11-13T11:29:28-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN341851358EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CBIZ MHM LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line13625 CUMBERLAND BLVD STE 800AddressLine1
CityATLANTACity
StateGAState
ZIP Code30082ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN941461312EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF CALIFORNIABusinessNameLine1
FieldValueIRS element (for citing)
Name ControlDELTNameControl
Phone4159728300Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 FIRST STREETAddressLine1
CitySAN FRANCISCOCity
StateCAState
ZIP Code94105ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHAEL J CASTROName
TitleCFOTitle
Phone4159728300Phone
Date Signed2013-11-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCBIZ MHM LLCName
PTINP01064143PTIN
Phone7708584500Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMICHAEL J CASTRONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1100 FIRST STREETAddressLine1
CitySAN FRANCISCOCity
StateCAState
ZIP Code94105ZIPCode
FieldValueIRS element (for citing)
Gross Receipts5038249911GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.DELTADENTALINS.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1954YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionTO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS SERVICE, TECHNOLOGY AND PROFESSIONAL SUPPORT.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees2238TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income55460NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year4702919119ProgramServiceRevenuePriorYear
Program Service Revenue CY5057677275ProgramServiceRevenueCY
Investment Income Prior Year11832029InvestmentIncomePriorYear
Investment Income Current Year14623473InvestmentIncomeCurrentYear
Other Revenue Prior Year-16890494OtherRevenuePriorYear
Other Revenue Current Year-40281570OtherRevenueCurrentYear
Total Revenue Prior Year4697860654TotalRevenuePriorYear
Total Revenue Current Year5032019178TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1314736GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1369223GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year4170335413BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY4469854669BenefitsPaidToMembersCY
Salaries Etc Prior Year267733543SalariesEtcPriorYear
Salaries Etc Current Year272521799SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year198944785OtherExpensePriorYear
Other Expenses Current Year212948414OtherExpensesCurrentYear
Total Expenses Prior Year4638328477TotalExpensesPriorYear
Total Expenses Current Year4956694105TotalExpensesCurrentYear
Revenues Less Expenses Prior Year59532177RevenuesLessExpensesPriorYear
Revenues Less Expenses CY75325073RevenuesLessExpensesCY
Total Assets BOY1314658307TotalAssetsBOY
Total Assets EOY1444091984TotalAssetsEOY
Total Liabilities BOY846364394TotalLiabilitiesBOY
Total Liabilities EOY886592977TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY468293913NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY557499007NetAssetsOrFundBalancesEOY
Mission DescriptionTO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS SERVICE, TECHNOLOGY AND PROFESSIONAL SUPPORT.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense4862293259Expense
Revenue5032019178Revenue
DescriptionTHE ORGANIZATION PROVIDED DENTAL BENEFIT COVERAGE FOR 17,631,000BENEFICIARIES IN 2012, PRIMARILY THROUGH CONTRACTS WITHINDEPENDENT DENTISTS. INCLUDED WERE 7,647,000 ENROLLEES INMEDICAID, SCHIP AND OTHER PUBLICLY-SPONSORED DENTAL BENEFITPROGRAMS ADMINISTERED BY THE ORGANIZATION, AS WELL AS 1,363,000PERSONS VOLUNTARY ENROLLED IN THE TRDP PROGRAM FOR RETIREDMILITARY SERVICE PERSONNEL AND THEIR FAMILIES THAT THEORGANIZATION UNDERWRITES PURSUANT TO A CONTRACT WITH THEDEPARTMENT OF DEFENSE. THE ORGANIZATION PAID MORE THAN$4,469,855,000 FOR DENTAL CARE DURING 2012.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense1369223Expense
Grants1369223Grants
DescriptionTHE ORGANIZATION MADE GRANTS DURING 2012 TO FOSTER IMPROVED ACCESSTO DENTAL HEALTH CARE TREATMENT, TO SUPPORT PROFESSIONAL DENTALEDUCATION AND TO PROVIDE ORAL HEALTH INSTRUCTION FOR PATIENTS.Description
FieldValueIRS element (for citing)
Total Program Service Expense4863662482TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096117870NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2238NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MICHAEL J CASTRO CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4159728300TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 FIRST STREETAddressLine1
CitySAN FRANCISCOCity
StateCAState
ZIP Code94105ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (53 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
TERRY A O'TOOLE
TREASURER2.00X15682900
ROY GONELLA
DIRECTOR1.00X3100000
BEVERLY A KODAMA
DIRECTOR1.00X3282900
R KENT FARNSWORTH DDS
DIRECTOR1.00X11200000
GLEN F BERGERT CPA
DIRECTOR1.00X11102500
GREGORY D KAPLAN DDS
DIRECTOR1.00X6927000
STEVEN F MCCANN
FIRST VICE CHAIRMAN2.00X14282900
RENUKA P PATEL
CHAIRMAN3.00X12500000
JO BONITA RAINS
DIRECTOR1.00X6650000
CORAGENE I SAVIO DDS
DIRECTOR1.00X6650000
STEVEN W VOSS
DIRECTOR1.00X7632900
STEPHEN R PICKERING DDS
DIRECTOR1.00X3100000
ANDREW J REID
SECOND VICE CHAIRMAN2.00X13282900
DOUGLAS D CASSAT DDS
DIRECTOR1.00X6870500
DEVANG M GHANDI DDS
DIRECTOR1.00X9532900
THOMAS A ZIMMERMAN
DIRECTOR1.00X7667600
BARBARA J BURGEL
DIRECTOR1.00X6850000
LYNN L FRANZOI
DIRECTOR1.00X6650000
GARY D RADINE
PRESIDENT/CEO51.00400319001637189.00X
ANTHONY S BARTH
EXEC. VICE PRESIDENT/COO42.001660827050304868.00X
MICHAEL J CASTRO
EXEC. VICE PRESIDENT/CFO42.001176734019674808.00X
PATRICK S STEELE
EXEC. VICE PRESIDENT/CIO43.001236803034531657.00X
CHARLES LAMONT
EXEC. VICE PRESIDENT/CLO42.00663433901583248.00X
BELINDA MARTINEZ
SR. VICE PRESIDENT50.0080113701922098X
KEVIN JACKSON
GROUP VICE PRESIDENT50.00459504024764X
NILESH PATEL
SR. VICE PRESIDENT50.00719869014459X
ALICIA WEBER
SR. VICE PRES./CONTROLLER43.006773950600077.00X
TERRI ANDERSON
VICE PRESIDENT50.00350503061037X
DANIEL CROLEY
VICE PRESIDENT50.00321018026067X
RICK R DOERING
VICE PRESIDENT50.00563714062777X
PATRICK HENRY
SR. VICE PRESIDENT50.00445455029031X
EVA HOFFMAN
VICE PRESIDENT50.00323017033954X
KATHY JONZZON
VICE PRESIDENT50.00952520419880X
J DOUGLAS KONOVALOFF
VICE PRESIDENT50.002646260209731X
GARRETT LEAF
VICE PRESIDENT50.00388721033159X
JAMAL NASR
VICE PRESIDENT50.00379120031014X
MOHAMMADREZA NAVID
VICE PRESIDENT50.00446202015362X
DUANE PROFEIT
VICE PRESIDENT50.00324289068120X
KATHERINE WATTS
VICE PRESIDENT50.00120350042931X
TOM WONG
VICE PRESIDENT50.00410091052650X
JEFFREY M ALBUM
VICE PRESIDENT50.00384305036281X
HARI MAKKALA
VICE PRESIDENT50.00433296017651X
JEFFREY SEYBOLD
VICE PRESIDENT50.00220796011242X
JOHN YAMAMOTO
VICE PRESIDENT50.00307374028078X
STEPHEN ADAMSON
VICE PRESIDENT50.00340872034259X
THOMAS LEIBOWITZ
VICE PRESIDENT50.00308166040937X
STEPHEN LOWRY
DIRECTOR OF SALES40.00280884040418X
KEVIN O'TOOLE
DIRECTOR SALES40.00256327031416X
TERI FORESTIERI
DIRECTOR HR OPERATIONS40.00253852016517X
ELISE POMERANTZ-WATZKA
DIRECTOR COMPENSATION & BENEFITS40.00252613060214X
VALERIE LAYNE
DIR. OF NAT. AND SPEC. ACC40.00269321056688X
ROBERT BECKER
CONSULTANT/FORMER OFFICER40.0031327500X
MICHAEL KAUFMANN
CONSULTANT/FORMER OFFICER40.0025520800X
FieldValueIRS element (for citing)
Total Reportable Comp From Org27208095TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation14253915TotalOtherCompensation
Number Individuals GT100 K535NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HP ENTERPRISE SERVICES LLC
PO BOX 848433DALLASTX75284CONSULTING SERVICES10029290
ORACLE CORPORATION
12320 ORACLE BLVDCOLORADO SPRINGSCO80921SOFTWARE MAINTENANCE SERVICES6645735
CATALYST360 LLC
4 WALNUT GROVE DRHORSHAMPA19044CONSULTING SERVICES3958581
IBM
PO BOX 676623DALLASTX75267SOFTWARE MAINTENANCE SERVICES3472543
KP CORPORATION
DEPT LA 23670PASADENACA91185CONSULTING SERVICES3331546
FieldValueIRS element (for citing)
Number Of Contractors GT100 K71NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PROFESSIONAL SERVICES36368370583636837058
FEES & CONTRACTS FROM GOVERNMENT14208402171420840217
FieldValueIRS element (for citing)
Total Program Service Revenue5057677275TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column15070639TotalRevenueColumn
Related Or Exempt Function Income15070639RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities5783567Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities6230733Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-447166Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-447166TotalRevenueColumn
Related Or Exempt Function Income-447166RelatedOrExemptFunctionIncome

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column-40281570TotalRevenueColumn
Related Or Exempt Function Income-40281570RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue-40281570TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column5032019178TotalRevenueColumn
Related Or Exempt Function Income5032019178RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total898618Total
Program Services898618ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total470605Total
Program Services470605ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total4469854669Total
Program Services4469854669ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total43549798Total
Management And General43549798ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total175841783Total
Program Services135372674ProgramServices
Management And General40469109ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total3887739Total
Program Services3887739ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total37423631Total
Program Services35436413ProgramServices
Management And General1987218ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total11818848Total
Program Services10650401ProgramServices
Management And General1168447ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1707127Total
Program Services6881ProgramServices
Management And General1700246ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total1474358Total
Program Services449255ProgramServices
Management And General1025103ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total205837Total
Program Services205837ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total5002690Total
Program Services4921172ProgramServices
Management And General81518ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total30526581Total
Program Services30326379ProgramServices
Management And General200202ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total39673265Total
Program Services39640700ProgramServices
Management And General32565ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total8923495Total
Program Services8670175ProgramServices
Management And General253320ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total20601979Total
Program Services19098235ProgramServices
Management And General1503744ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total4683725Total
Program Services3704488ProgramServices
Management And General979237ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total622269Total
Program Services399270ProgramServices
Management And General222999ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total123636Total
Program Services123636ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total7271172Total
Program Services7227475ProgramServices
Management And General43697ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total30641637Total
Program Services30329609ProgramServices
Management And General312028ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total965457Total
Management And General965457ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BROKER FEES3718274137182741
CONSULTANT FEES23088643216614341427209
OUTSIDE SERVICES85725148328588243926
UBI TAX1885618856

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total-8337568Total
Program Services-5203368ProgramServices
Management And General-3134200ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total4956694105Total
Program Services4863662482ProgramServices
Management And General93031623ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY191884540BOY
EOY278492524EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY112817440BOY
EOY81802158EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY286887945BOY
EOY285577097EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY45750000BOY
EOY55750000EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY16318657BOY
EOY14937697EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis560187816LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec266335949LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY330385626BOY
EOY293851867EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY230557931BOY
EOY332092503EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY55871557BOY
EOY57440855EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY6295206BOY
EOY6295206EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY37889405BOY
EOY37852077EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1314658307BOY
EOY1444091984EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY516927508BOY
EOY556497074EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY36344253BOY
EOY32028619EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY293092633BOY
EOY298067284EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY846364394BOY
EOY886592977EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY468293913BOY
EOY557499007EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY468293913BOY
EOY557499007EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1314658307BOY
EOY1444091984EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses75325073ReconcilationRevenueExpenses
Reconciliation Unrealized Invest9983657ReconciliationUnrealizedInvest
Reconcilation Other Changes3896364ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis28204818OtherCostOrOtherBasis
Depreciation23282649Depreciation
Book Value4922169BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis503825578OtherCostOrOtherBasis
Depreciation219217281Depreciation
Book Value284608297BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis28157420OtherCostOrOtherBasis
Depreciation23836019Depreciation
Book Value4321401BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings293851867TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
ACCRUED RETIREMENT BENEFITS$83,787,939
DEFERRED COMPENSATION PLANS$37,366,389
GROUP PREFUNDING DEPOSITS$9,301,252
REFUNDABLE GROUP BALANCES$167,611,704
FieldValueIRS element (for citing)
Total Of Amounts298067284TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt3087903178TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal3087903178RevenueSubtotal
Other Revenues Not Included1944116000OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1944116000RevenueNotRptdOnFinStmt
Total Revenue Per Form9905032019178TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt3012578105TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal3012578105ExpensesSubtotal
Other Expenses Not Included1944116000OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt1944116000ExpensesNotRptdOnFinStmt
Total Expenses Per Form9904956694105TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE COMPANY IS A TAX-EXEMPT ORGANIZATION ORGANIZED UNDER SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE AND, AS SUCH, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE FINANCIAL STATEMENTS. CURRENT ACCOUNTING GUIDANCE CLARIFIES HOW UNCERTAINTIES IN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE PRESCRIBES A FINANCIAL STATEMENT RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. POSITIONS INCLUDE THOSE WITH RESPECT TO THE COMPANY'S TAX EXEMPT STATUS AND WITH RESPECT TO INCOME TAXES ON UNRELATED BUSINESS INCOME. THE COMPANY EVALUATED THE IMPACT OF THE ACCOUNTING PRONOUNCEMENT AND DETERMINED THAT IT HAD NO IMPACT ON THE COMPANY'S FINANCIAL STATEMENTS.
PART XI, LINE 4B - OTHER ADJUSTMENTS:ADMINISTRATIVE SERVICE CONTRACTS CLAIM REIMBURSEMENT REVENUE
PART XII, LINE 4B - OTHER ADJUSTMENTS:CLAIMS INCURRED FOR ADMINISTRATIVE SERVICE CONTRACTS

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (22 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
NATIONAL GUARD YOUTH FOUNDATION
1001 N FAIRFAX ST STE 205ALEXANDRIAVA22314541940978501(C)(3)6000CONTRIBUTION
NATIONAL MILITARY FAMILY ASSOCIATION
2500 N VAN DORN ST STE 102ALEXANDRIAVA22302520899384501(C)(3)20000TITLE SPONSOR OF 2012 LEADERSHIP LUNCHEON
UC REGENTS
1 SHIELDS AVE TAX ACCOUNTINGDAVISCA95616952226406501(C)(3)115397VARIOUS GRANTS
UNITED WAY CALIFORNIA CAPITAL REGION
10389 OLD PLACERVILLE RDSACRAMENTOCA95827237079003501(C)(3)429332012 MATCHING CONTRIBUTIONS
UNITED WAY OF THE BAY AREA
221 MAIN STREET SUITE 300SAN FRANCISCOCA94105941312348501(C)(3)843242012 MATCHING CONTRIBUTIONS
CALIFORNIA ACADEMY OF GENERAL DENTISTRY
73 CASTLEWOOD DRIVEPLEASANTONCA94566942557207501(C)(3)200002012 COURSE SPONSORSHIP
CDA FOUNDATION
1201 K STREET SUITE 1511SACRAMENTOCA95814680411536501(C)(3)25000CONTRIBUTION TO CDA CARES
RESERVE OFFICERS ASSOCIATION
ONE CONSTITUTION AVENUE NEWASHINGTONDC20002530132450501(C)(3)10000CONTRIBUTION ROA INDUSTRY STARS RENEWAL AND FREEDOM SPONSOR
AMERICAN RED CROSS
PO BOX 37243WASHINGTONDC20013530196605501(C)(3)10000HURRICANE SANDY RELIEF
INTERAGENCY INSTITUTE FOR FEDERAL HEALTH CARE EXECUTIVES
1500 WILSON BLVDROSSLYNVA2220907742151214600CONTRIBUTIONS
SAN FRANCISCO CHAMBER OF COMMERCE
235 MONTGOMERY STREET SUITE 760SAN FRANCISCOCA94104940834950501(C)(3)9298EXCELLENCE IN BUSINESS AWARDS, CITY BREAKFAST SPONSOR
UCLA SCHOOL OF DENTISTRY
10833 LE CONTE AVELOS ANGELESCA90024943191637501(C)(3)200002012 COURSE SPONSORSHIP
UNIVERSITY OF TEXAS SCHOOL OF DENTISTRY
7703 FLOYD CURL DRSAN ANTONIOTX78229741586031501(C)(3)10275SPONSORSHIP OF CE COURSE
TEMPLE UNIVERSITY
3340 N BROAD STREET 4TH FLOORPHILADELPHIAPA19140231365971501(C)(3)10000SPONSORSHIP OF CE COURSE
AMERICAN CANCER SOCIETY
1700 WEBSTER STREETOAKLANDCA94612941170350501(C)(3)25000RELAY FOR LIFE DONATIONCHARITABLE CONTRIBUTION
DELTA DENTAL COMMUNITY CARE FOUNDATION
100 FIRST STREETSAN FRANCISCOCA94105371570764501(C)(3)283800HEALTH, RESEARCH, AND EDUCATION GRANTS
UNITED WAY OF GREATER LOS ANGELES
523 WEST SIXTH STREETLOS ANGELESCA90015952274801501(C)(3)126232012 MATCHING CONTRIBUTIONS
HISPANIC DENTAL ASSOCIATION
3085 STEVENSON DRIVESPRINGFIELDIL62703363719494501(C)(3)100002012 CORPORATE ROUNDTABLE SPONSORSHIP
TUOLUMNE COUNTY OFFICE OF EDUCATION
175 S FAIRVIEW LNSONORACA95370946050189501(C)(3)15000HEALTH, RESEARCH, AND EDUCATION GRANT
USC SCHOOL OF DENTISTRY
925 WEST 34TH STREET - ROOM 202LOS ANGELESCA90089951642394501(C)(3)9500CONTINUING EDUCATION GRANT
WOMEN'S INITIATIVE FOR SELF EMPLOYMENT
1398 VALENCIA STREETSAN FRANCISCOCA94110943081525501(C)(3)10000GRANT FOR THE ALAS PROGRAM
MISCELLANEOUS GRANTS LESS THAN 5000
134868TO PROVIDE DENTAL EDUCATION

Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrant
STUDENT LEADERSHIP AWARDS65212500
HISPANIC SCHOLARSHIP19258105

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: THE ORGANIZATION AWARDS GRANTS FOR PROGRAMS THAT FOSTER DENTAL HEALTH AND EDUCATION. THROUGH THESE GRANTS THE ORGANIZATION HELPS FINANCE HEALTH, EDUCATION, AND RESEARCH PROJECTS IN DENTISTRY, HEALTH AND HUMAN SERVICES, AND CIVIC AND COMMUNITY AFFAIRS. THE TWO GRANTS ARE: (1) THE DENTAL HEALTH AND EDUCATION CONTRIBUTION, WHICH SUPPORTS DENTAL HEALTH AND AWARENESS PROGRAMS AND (2) THE STANDARD DENTAL RESEARCH GRANT, WHICH SUPPORTS PROFESSIONAL RESEARCH RELATED TO DENTAL HEALTH. GRANTS ARE AWARDED TO GROUPS THAT: (1) PROVIDE DENTISTRY FOR 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.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelXFirstClassOrCharterTravel
Club Dues Or FeesXClubDuesOrFees
Personal ServicesXPersonalServices
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (36 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
TERRY A O'TOOLE
TREASURER156829000000000156829000
GARY D RADINE
PRESIDENT/CEO1250004025000000253186014884201487604166908000
ANTHONY S BARTH
EXEC. VICE PRESIDENT/COO82400408000000368230500843602205006691313000
MICHAEL J CASTRO
EXEC. VICE PRESIDENT/CFO56649605500000602380194690402057603144214000
PATRICK S STEELE
EXEC. VICE PRESIDENT/CIO54075606562500397970343723801592704689968000
CHARLES LAMONT
EXEC. VICE PRESIDENT/CLO463500045000005720839014239701592706792663032793200
BELINDA MARTINEZ
SR. VICE PRESIDENT45000003080000431370190647101562702723235000
KEVIN JACKSON
GROUP VICE PRESIDENT2935560150000015948031640216000484268000
NILESH PATEL
SR. VICE PRESIDENT399996030000001987307500069590734328000
ALICIA WEBER
SR. VICE PRES./CONTROLLER38120002717500244450383260216810737402000
TERRI ANDERSON
VICE PRESIDENT2616240765000123790438830171540411540000
DANIEL CROLEY
VICE PRESIDENT23690407590008214059410201260347085000
RICK R DOERING
VICE PRESIDENT36754801700000261660410390217380626491000
PATRICK HENRY
SR. VICE PRESIDENT25234801500000431070155060135250474486000
EVA HOFFMAN
VICE PRESIDENT248316068350063510111690227850356971000
KATHY JONZZON
VICE PRESIDENT305250481000166270415392044880515132000
J DOUGLAS KONOVALOFF
VICE PRESIDENT19646404461602354601885130212180474357000
GARRETT LEAF
VICE PRESIDENT2837520937600112090135080196510421880000
JAMAL NASR
VICE PRESIDENT25732801000000217920123610186530410134000
MOHAMMADREZA NAVID
VICE PRESIDENT251812017210002229007500078620461564000
DUANE PROFEIT
VICE PRESIDENT2422960698450121480522310158890392409000
KATHERINE WATTS
VICE PRESIDENT4852606750004324039928030030163281000
TOM WONG
VICE PRESIDENT29000401100000100870325240201260462741000
JEFFREY M ALBUM
VICE PRESIDENT24722401200000170810146810216000420586000
HARI MAKKALA
VICE PRESIDENT300000012500008296010842068090450947000
JEFFREY SEYBOLD
VICE PRESIDENT52070038110013061603651075910232038000
JOHN YAMAMOTO
VICE PRESIDENT22659607260008178079520201260335452000
STEPHEN ADAMSON
VICE PRESIDENT254124077926088220148520194070375131000
THOMAS LEIBOWITZ
VICE PRESIDENT24999605100007170033605073320349103000
STEPHEN LOWRY
DIRECTOR OF SALES167305099888013691037570028480321302000
KEVIN O'TOOLE
DIRECTOR SALES175083070818010426099060215100287743000
TERI FORESTIERI
DIRECTOR HR OPERATIONS19030004000002355208745077720270369000
ELISE POMERANTZ-WATZKA
DIRECTOR COMPENSATION & BENEFITS202800041000088130448270153870312827000
VALERIE LAYNE
DIR. OF NAT. AND SPEC. ACC2121760412210159240366520200360326009000
ROBERT BECKER
CONSULTANT/FORMER OFFICER313275000000000313275000
MICHAEL KAUFMANN
CONSULTANT/FORMER OFFICER255208000000000255208000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1AFIRST 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 2012. 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 4BTHE 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 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 2012, EIGHT EXECUTIVES PARTICIPATED IN THE PLAN - ANTHONY BARTH, MICHAEL CASTRO, KATHY JONZZON, DOUGLAS KONOVALOFF, CHARLES LAMONT, BELINDA MARTINEZ, GARY RADINE, AND PATRICK STEELE. SEE ADDITIONAL NOTE IN SCHEDULE O REGARDING PAYMENTS RECEIVED BY PLAN PARTICIPANTS IN 2012.
PART I, LINE 7THE 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 L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (6 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
D DOUGLAS CASSAT DDS
PARTICIPATING PROVIDER109141DENTAL CLAIM PAYMENTS0
CORAGENE I SAVIO DDS
PARTICIPATING PROVIDER233329DENTAL CLAIM PAYMENTS0
COPOWER MANAGEMENT AND LISI
ORGANIZATION DIRECTOR, BECKY PATEL, WAS CEO/PRESIDENT OF COPOWER MANAGEMENT1234083BROKER ADMINISTRATION0
STEPHEN R PICKERING DDS
PARTICIPATING PROVIDER161083DENTAL CLAIM PAYMENTS0
(no name)
0
(no name)
0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION'S BYLAWS NAME TWO CLASSES OF "MEMBERS," "CORPORATE MEMBERS" AND "DENTIST MEMBERS." ALL CORPORATE MEMBERS ARE ALSO DIRECTORS OF THE ORGANIZATION AND SO ARE NOT "MEMBERS" AS DEFINED IN THE INSTRUCTIONS TO FORM 990, PART VI, QUESTION 6. HOWEVER, THE ORGANIZATION'S DIRECTORS ARE ELECTED BY ITS PARENT HOLDING COMPANY BOARD OF DIRECTORS, TWO OF WHOM ARE NOT ALSO DIRECTORS OF THE ORGANIZATION AND THUS MAY BE CONSIDERED "MEMBERS" PURSUANT TO THE INSTRUCTION. THE DENTIST MEMBERS HAVE A RIGHT TO VOTE UPON PROPOSED CHANGES TO THE PROPORTION OF THE DENTISTS SERVING AS DIRECTORS AND CORPORATE MEMBERS, AND SO MAY BE CONSIDERED "MEMBERS" UNDER THE INSTRUCTION.
FORM 990, PART VI, SECTION A, LINE 7ATHE ORGANIZATION'S DIRECTORS ARE ELECTED BY THE PARENT HOLDING COMPANY BOARD OF DIRECTORS, WHICH INCLUDES TWO PERSONS WHO ARE NOT ALSO DIRECTORS OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7BTHE DENTIST MEMBERS HAVE A RIGHT TO VOTE ONLY UPON PROPOSED CHANGES TO THE BYLAWS PROVISIONS THAT SPECIFY THE PROPORTION OF DENTISTS AND LAY PERSONS SERVING AS DIRECTORS AND CORPORATE MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11THE 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 ORGANIZATION'S BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12CEACH 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 15COMPENSATION PAID TO THE CEO, EXECUTIVE VICE PRESIDENTS, AND SENIOR VICE PRESIDENTS IS APPROVED BY THE EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS. THE COMMITTEE APPROVES COMPENSATION FOR THE ENSUING YEAR AFTER REVIEWING COMPARABILITY DATA PRESENTED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT, AN ASSESSMENT OF EACH OFFICER'S PERFORMANCE OVER THE PRECEDING YEAR, AND THE ORGANIZATION'S PROGRAM ACCOMPLISHMENTS FOR THE YEAR. COMPENSATION PAID TO DIRECTORS IS APPROVED BY THE EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS AFTER REVIEWING COMPARABILITY DATA IN A BENCHMARKING STUDY PREPARED AND PRESENTED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT RETAINED BY THE BOARD OF DIRECTORS. THESE PROCESSES WERE FOLLOWED FOR 2012 COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19THE 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 RTHE ORGANIZATION, REGULATED BY THE CALIFORNIA DEPARTMENT OF MANAGED HEALTH CARE, 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 37 MILLION CLAIMS. TOTAL REVENUE FOR THE ENTERPRISE EXCEEDED $7.2 BILLION IN 2012. THE ORGANIZATION AND ITS SUBSIDIARIES REPRESENT APPROXIMATELY 75% OF TOTAL ENTERPRISE REVENUES.
FORM 990, PT. VII, SEC. A, COL. (D); SCH. J, PT. II, LINE 1, COL. (B)(III):A ONE-TIME, LUMP SUM PENSION BENEFIT PAYMENT WAS RECEIVED BY THE ORGANIZATION'S EXECUTIVE VICE PRESIDENT/CLO IN 2012, PURSUANT TO THE TERMS OF THE ORGANIZATION'S SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THIS PLAN IS DESIGNED FOR THE LONG-TERM RETENTION OF SENIOR EXECUTIVES (E.G., THE EXECUTIVE VICE PRESIDENT/CLO HAS BEEN WITH THE ORGANIZATION FOR MORE THAN 27 YEARS) AND IS BASED ON A PERCENTAGE OF HIS AVERAGE ANNUAL COMPENSATION RECEIVED FOR THE THREE YEARS PRIOR TO AGE 65 OR RETIREMENT, WHICHEVER COMES FIRST, AND ON HIS LIFE EXPECTANCY AS DETERMINED PURSUANT TO THE INTERNAL REVENUE CODE. THE EXECUTIVE VICE PRESIDENT/CLO'S ANNUAL COMPENSATION, UPON WHICH THE PENSION BENEFIT PAYMENT IS BASED, HAS BEEN ESTABLISHED IN ACCORDANCE WITH THE PROCESS OUTLINED IN TREASURY REGULATION SECTION 53.4958-6 FOR ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS. THIS PROCESS INVOLVES REVIEW AND APPROVAL OF COMPENSATION BY THE ORGANIZATION'S BOARD OF DIRECTORS, RELIANCE ON COMPARABILITY DATA PROVIDED BY AN INDEPENDENT COMPENSATION CONSULTANT, AND CONTEMPORANEOUS DOCUMENTATION OF DELIBERATIONS AND DECISIONS REGARDING COMPENSATION. FEDERAL TAX LAW APPLICABLE TO THE ORGANIZATION'S SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN DOES NOT PERMIT A PARTICIPANT TO RECEIVE AND PAY TAX ON ANNUAL PAYMENTS RECEIVED FROM THE PLAN OVER THE COURSE OF A PARTICIPANT'S RETIREMENT. INSTEAD, THE ENTIRE VALUE OF THE BENEFIT BECOMES TAXABLE WHEN THE PARTICIPANT RETIRES OR REACHES AGE 65, WHICHEVER COMES FIRST. THE LUMP SUM PAYMENT SHOWN IN SCHEDULE J, PART II, LINE 1, COLUMN (B)(III) (AND CARRIED TO FORM 990, PART VII, SECTION A, COLUMN (D)) WAS THEREFORE TRIGGERED IN 2012 WHEN THE ORGANIZATION'S EXECUTIVE VICE PRESIDENT/CLO TURNED 65, AND THE ENTIRE VALUE OF THE RETIREMENT BENEFIT WAS TAXABLE IN THAT YEAR. SEE RELATED NOTE IN SCHEDULE J, PART III, WHICH DESCRIBES THE ORGANIZATION'S SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN.
FORM 990, PART XI, LINE 9:PENSION LIABILITY AND POST-RETIREMENT ADJUSTMENTS 3,896,364.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
CELEBRATION DENTAL SERVICES LLC
100 FIRST STREETSAN FRANCISCOCA94105593410497DENTAL SERVICESFLDELTA DENTAL OF CALIFORNIA
DENTEGRA INSURANCE HOLDINGS LLC
100 FIRST STREETSAN FRANCISCOCA94105943386049HOLDING COMPANYDEDENTEGRA INSURANCE COMPANY

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
DELTA DENTAL COMMUNITY CARE FOUNDATION
100 FIRST STREETSAN FRANCISCOCA94105371570764CHARITABLE ORGANIZATIONCA501(C)(3)PFDENTEGRA GROUP INC0
DELTA DENTAL OF PENNSYLVANIA
ONE DELTA DRIVEMECHANICSBURGPA17055231667011DENTAL INSURANCEPA501(C)(4)DENTEGRA GROUP INC0
DELTA DENTAL OF DELAWARE
ONE DELTA DRIVEMECHANICSBURGPA17055510228088DENTAL INSURANCEDE501(C)(4)DENTEGRA GROUP INC0
DELTA DENTAL OF WEST VIRGINIA
ONE DELTA DRIVEMECHANICSBURGPA17055550523124DENTAL INSURANCEWV501(C)(4)DENTEGRA GROUP INC0
DELTA DENTAL OF THE DISTRICT OF COLUMBIA
ONE DELTA DRIVEMECHANICSBURGPA17055521479587DENTAL INSURANCEDC501(C)(4)DENTEGRA GROUP INC0

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1PACA MANAGEMENT LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE DELTA DRIVEAddressLine1
CityMECHANICSBURGCity
StatePAState
ZIP Code17055ZIPCode
FieldValueIRS element (for citing)
EIN943277375EIN
Primary ActivityINSURANCE MANAGEMENTPrimaryActivity
Legal Domicile StateDELegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF CALIFORNIABusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeType
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner1GeneralOrManagingPartner
Percentage Ownership0.50000PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV (15 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Address Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountryPostal CodeAddressForeign/PostalCodePercentage OwnershipPercentageOwnership
DENTEGRA GROUP INC
100 FIRST STREETSAN FRANCISCOCA94105943386049HOLDING COMPANYDEN/AC0
DENTEGRA INSURANCE COMPANY
100 FIRST STREETSAN FRANCISCOCA94105751233841INSURANCE COMPANYDEC0DDC INSURANCE HOLDINGS INC
DENTEGRA INSURANCE COMPANY OF NEW ENGLAND
100 FIRST STREETSAN FRANCISCOCA94105042890218INSURANCE COMPANYMAC0DDC INSURANCE HOLDINGS INC
DELTA DENTAL INSURANCE COMPANY
100 FIRST STREETSAN FRANCISCOCA94105942761537INSURANCE COMPANYDEC0DDC INSURANCE HOLDINGS INC
ALPHA DENTAL OF NEVADA INC
100 FIRST STREETSAN FRANCISCOCA94105880244893INSURANCE COMPANYNVC0DDC INSURANCE HOLDINGS INC
ALPHA DENTAL OF UTAH INC
100 FIRST STREETSAN FRANCISCOCA94105860672505INSURANCE COMPANYUTC0DDC INSURANCE HOLDINGS INC
ALPHA DENTAL PROGRAMS INC
100 FIRST STREETSAN FRANCISCOCA94105742447512INSURANCE COMPANYTXC0DDC INSURANCE HOLDINGS INC
ALPHA DENTAL OF ALABAMA INC
100 FIRST STREETSAN FRANCISCOCA94105630796079INSURANCE COMPANYALC0DDC INSURANCE HOLDINGS INC
ALPHA DENTAL OF NEW MEXICO INC
100 FIRST STREETSAN FRANCISCOCA94105330279230INSURANCE COMPANYNMC0DDC INSURANCE HOLDINGS INC
ALPHA DENTAL OF ARIZONA INC
100 FIRST STREETSAN FRANCISCOCA94105930939835INSURANCE COMPANYAZC0DDC INSURANCE HOLDINGS INC
DENTEGRA SEGUROS DENTALES SA
INSURANCE COMPANYC0DENTEGRA INSURANCE COMPANYINSURGENTES SUR 826 PISO 15COL DEL VALLEFC DF 01300MXMX
DELTA DENTAL OF PUERTO RICO INC
660436769INSURANCE COMPANYC0DELTA DENTAL OF CALIFORNIA14 CALLE 2 SUITE 200GUAYNABORQRQ009680.46900
DELTA REINSURANCE CORPORATION
980096711INSURANCE COMPANYC0DELTA DENTAL OF PENNSYLVANIACGI TOWER 2ND FLOORWARRENSST. MICHAELBBBB0.00420
SERVICIOS DENTALES DENTEGRA SA DE CV
INSURANCE ADMINISTRATIONC0DENTEGRA INSURANCE COMPANYINSURGENTES SUR 826 PISO 15COL DEL VALLEFC DF 01300MXMX
DDC INSURANCE HOLDINGS INC
100 FIRST STREETSAN FRANCISCOCA94105274251930HOLDING COMPANYDEC0DELTA DENTAL OF CALIFORNIA1.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (25 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
DENTEGRA INSURANCE COMPANY
B10800000
DENTEGRA INSURANCE COMPANY
Q27074279
DENTEGRA INSURANCE COMPANY OF NEW ENGLAND
Q755771
DELTA DENTAL INSURANCE COMPANY
A2406575
DENTEGRA INSURANCE COMPANY
A50137
DELTA DENTAL INSURANCE COMPANY
L9312504
DELTA DENTAL INSURANCE COMPANY
M12290256
DELTA DENTAL INSURANCE COMPANY
P13346181
DELTA DENTAL INSURANCE COMPANY
Q31260147
ALPHA DENTAL OF NEVADA INC
Q54411
ALPHA DENTAL OF UTAH INC
Q18065
ALPHA DENTAL PROGRAMS INC
Q1685607
ALPHA DENTAL OF ALABAMA INC
Q1935
ALPHA DENTAL OF NEW MEXICO INC
Q3719
ALPHA DENTAL OF ARIZONA INC
Q55797
DELTA DENTAL OF PENNSYLVANIA
L12501777
DELTA DENTAL OF PENNSYLVANIA
M11357070
DELTA DENTAL OF PENNSYLVANIA
P169574
DELTA DENTAL OF PENNSYLVANIA
Q7017814
DELTA DENTAL OF DELAWARE INC
Q61342
DELTA DENTAL OF WEST VIRGINIA INC
Q55187
DELTA DENTAL OF THE DISTRICT OF COLUMBIA
Q58563
DELTA DENTAL OF DELAWARE INC
L16392
DELTA DENTAL OF WEST VIRGINIA INC
L10044
DELTA DENTAL OF THE DISTRICT OF COLUMBIA
L1848