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DELTA PILOTS MEDICAL TRUST: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
DELTA PILOTS MEDICAL TRUST (EIN 36-6791917)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-04-25
IRS object ID
201321159349300047
Schema version
2011v1.2
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)
Timestamp2013-04-25T11:48:55-07:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN366791917EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1DELTA PILOTS MEDICAL TRUSTBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlDELTNameControl
Phone4047152600Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11030 Delta BlvdAddressLine1
Address Line2Dept 216AddressLine2
CityAtlantaCity
StateGAState
ZIP Code30354ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRobert KightName
TitleVP-Global HR Svcs & Labor RelationsTitle
Phone4047152400Phone
Date Signed2013-04-25DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRobert L KightNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11030 Delta BlvdAddressLine1
Address Line2Dept 216AddressLine2
CityAtlantaCity
StateGAState
ZIP Code30354ZIPCode
FieldValueIRS element (for citing)
Gross Receipts38470665GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.delta.comWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1984YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionDisburse payments on behalf of participants related to medical, dental, mental health and prescription drugs.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year1644989ContributionsGrantsCurrentYear
Program Service Revenue Prior Year41443049ProgramServiceRevenuePriorYear
Program Service Revenue CY36818573ProgramServiceRevenueCY
Investment Income Prior Year5378InvestmentIncomePriorYear
Investment Income Current Year7103InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year41448427TotalRevenuePriorYear
Total Revenue Current Year38470665TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year37449660BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY34895236BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1266092OtherExpensePriorYear
Other Expenses Current Year1654273OtherExpensesCurrentYear
Total Expenses Prior Year38715752TotalExpensesPriorYear
Total Expenses Current Year36549509TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2732675RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1921156RevenuesLessExpensesCY
Total Assets BOY7037695TotalAssetsBOY
Total Assets EOY8133987TotalAssetsEOY
Total Liabilities BOY3208472TotalLiabilitiesBOY
Total Liabilities EOY2383608TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3829223NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5750379NetAssetsOrFundBalancesEOY
Mission DescriptionDisburse payments on behalf of participants related to medical, dental, mental health and prescription drugs.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense36549509Expense
Grants0Grants
Revenue38470665Revenue
DescriptionHealth 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 Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense36549509TotalProgramServiceExpense
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 Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
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 Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
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 Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy0ConflictOfInterestPolicy
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Delta Air Lines IncBusinessNameLine1
Business Name Line2Corporate Benefits DepartmentBusinessNameLine2
FieldValueIRS element (for citing)
Telephone Number4047152600TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11030 Delta BlvdAddressLine1
Address Line2Dept 837AddressLine2
CityAtlantaCity
StateGAState
ZIP Code30354ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationInstitutional TrusteeInstitutionalTrustee
Robert L Kight
Chairman Admin Comm, Member Invest Comm1X000
Christopher M Collins
Member Admin Comm1X000
Gregory S Tahvonen
Member Admin Comm1X000
Paul Jacobson
Member Invest Comm1X000
Kenneth W Morge
Chair, Member Invest Comm1X000
Anthony Charaf
Member Invest Comm1X000
Sandy P Gordon
Member Invest Comm1X000
Gail A Grimmett
Member Invest Comm1X000
Kiko Harvey
Member Invest Comm1X000
Nathaniel Pieper
Member Invest Comm1X000
Michael O Randolfi
Member Invest Comm1X000
Beverly Hord
Member Admin Subcomm1X000
JP Morgan Chase
Trustee11428000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org14280TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants1644989GovernmentGrants
All Other Contributions0AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions1644989TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Employer Contributions90009924015385240153850$0
Employee Contributions90009912803188128031880$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue36818573TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column7103TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$7,103ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other0Other
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column38470665TotalRevenueColumn
Related Or Exempt Function Income36818573RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$7,103ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total34895236Total
Program Services34895236ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1209207Total
Program Services1209207ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total19000Total
Program Services19000ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total426066Total
Program Services426066ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total36549509Total
Program Services36549509ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4547927BOY
EOY5265707EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2489768BOY
EOY2868280EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7037695BOY
EOY8133987EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY332047BOY
EOY390988EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2876425BOY
EOY1992620EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3208472BOY
EOY2383608EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY3829223BOY
EOY5750379EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3829223BOY
EOY5750379EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7037695BOY
EOY8133987EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses1921156ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionBenefit Claims PayableDescription
Amount$1,992,620Amount
FieldValueIRS element (for citing)
Total Of Amounts1992620TotalOfAmounts
Total Revenue38470665TotalRevenue
Total Expenses36549509TotalExpenses
Excess Or Deficit For Year1921156ExcessOrDeficitForYear
Net Unrealized GL On Investments0NetUnrealizedGLOnInvestments
Donated Services And Facilities0DonatedServicesAndFacilities
Investment Expenses0InvestmentExpenses
Prior Period Adjustments0PriorPeriodAdjustments
Other$0OtherAmount
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS1921156ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt38470665TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments0NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues0OtherRevenues
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal38470665RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99038470665TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt36549509TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal36549509ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99036549509TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierSchD_P10_S00_L02Identifier
Return ReferenceSchedule D, Part X, Line 2ReturnReference
ExplanationThe 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 position. 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 examination by major tax jurisdictions date back to the year ending June 30, 2007. 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, 2012, there are no known items which would result in a material accrual related to where the Plan has federal or state attributable tax positions.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11bThe Form 990 is completed each year by Delta Air Lines, Inc's Corporate Benefits Department. An 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 return.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19The financial statements of the Delta Pilots Medical Trust are made available to the public upon request.