STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

DELTA DENTAL OF PENNSYLVANIA: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL OF PENNSYLVANIA (EIN 23-1667011)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-13
IRS object ID
201333179349302628
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)
EIN231667011EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF PENNSYLVANIABusinessNameLine1
FieldValueIRS element (for citing)
Name ControlDELTNameControl
Phone7177668500Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE DELTA DRIVEAddressLine1
CityMECHANICSBURGCity
StatePAState
ZIP Code17055ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJEANNE FOSTERName
TitleVP, FINANCETitle
Phone7177668500Phone
Date Signed2013-11-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
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 PersonJEANNE FOSTERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1ONE DELTA DRIVEAddressLine1
CityMECHANICSBURGCity
StatePAState
ZIP Code17055ZIPCode
FieldValueIRS element (for citing)
Gross Receipts618367213GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.DELTADENTALINS.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1964YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionTO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS, SERVICE, TECHNOLOGY, AND PROFESSIONAL SUPPORT.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees873TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year560741254ProgramServiceRevenuePriorYear
Program Service Revenue CY599848010ProgramServiceRevenueCY
Investment Income Prior Year7047850InvestmentIncomePriorYear
Investment Income Current Year10764400InvestmentIncomeCurrentYear
Other Revenue Prior Year-44329OtherRevenuePriorYear
Other Revenue Current Year-367752OtherRevenueCurrentYear
Total Revenue Prior Year567744775TotalRevenuePriorYear
Total Revenue Current Year610244658TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year289933GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY401628GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year503874051BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY541122008BenefitsPaidToMembersCY
Salaries Etc Prior Year24279707SalariesEtcPriorYear
Salaries Etc Current Year25692214SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year28974528OtherExpensePriorYear
Other Expenses Current Year30521118OtherExpensesCurrentYear
Total Expenses Prior Year557418219TotalExpensesPriorYear
Total Expenses Current Year597736968TotalExpensesCurrentYear
Revenues Less Expenses Prior Year10326556RevenuesLessExpensesPriorYear
Revenues Less Expenses CY12507690RevenuesLessExpensesCY
Total Assets BOY134319855TotalAssetsBOY
Total Assets EOY144155812TotalAssetsEOY
Total Liabilities BOY69571544TotalLiabilitiesBOY
Total Liabilities EOY68046000TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY64748311NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY76109812NetAssetsOrFundBalancesEOY
Mission DescriptionTO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS, SERVICE, TECHNOLOGY, AND PROFESSIONAL SUPPORT.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense589377714Expense
Revenue610244658Revenue
DescriptionTHE ORGANIZATION PROVIDED DENTAL BENEFIT COVERAGE FOR 2,071,973 BENEFICIARIES IN 2012 PRIMARILY THROUGH CONTRACTS WITH INDEPENDENT DENTISTS SERVING 3,210 PURCHASING GROUPS. THE ORGANIZATION PAID MORE THAN $541 MILLION FOR DENTAL CARE DURING 2012.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense401628Expense
Grants401628Grants
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 Expense589779342TotalProgramServiceExpense
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 Securities1ReportInvestOthSecurities
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 Activities1ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
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 Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109682625NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees873NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account1ForeignFinancialAccount
Name Of Foreign CountryBBNameOfForeignCountry
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs1ChangesToOrganizingDocs
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 Body0Form990ProvidedToGoverningBody
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 Line1JEANNE FOSTER VP FINANCEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7177668500TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE DELTA DRIVEAddressLine1
CityMECHANICSBURGCity
StatePAState
ZIP Code17055ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (39 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
JOSEPH P BECK JR
TREASURER1.00X1560000
RICHARD W BLOOMINGDALE
DIRECTOR1.00X1260000
KENNETH G MILLER DDS
DIRECTOR1.00X1320000
JOHN H RHODES
DIRECTOR1.00X1380000
JOHN J CHARLETTA DMD
DIRECTOR1.00X1320000
WILLIAM A DELVECCHIO DMD
DIRECTOR1.00X1320000
RONALD HELMINSKI DMD
DIRECTOR1.00X1360300
ERIC N HODGES DMD
DIRECTOR1.00X1363400
HARRY MEYERS DDS
SECRETARY1.00X000
RICHARD J CLARK DDS
DIRECTOR1.00X1320000
GLENN F BERGERT CPA
CHAIRMAN2.00X2598400
JANICE R BLACK
VICE CHAIRMAN1.00X1463400
LOUIS GREGORIO
DIRECTOR1.00X1320000
PATRICIA A MCVICKER
DIRECTOR1.00X1260000
SCOTT Q LITTLE DDS
DIRECTOR1.00X760000
JAMES SMELTZER
DIRECTOR1.00X1040300
BRUCE TERRY DMD
DIRECTOR1.00X760000
PHILIP WENGER
DIRECTOR1.00X700000
GARY D RADINE
PRESIDENT/CEO5.000400319016371855.00X
ANTHONY S BARTH
EXEC. VICE PRES./COO4.0001660827503048646.00X
MICHAEL J CASTRO
EXEC. VICE PRES./CFO4.0001176734196748046.00X
PATRICK S STEELE
EXEC. VICE PRES./CIO4.0001236803345316546.00X
CHARLES LAMONT
EXEC. VICE PRES./CLO4.000663433915832446.00X
ALICIA WEBER
SENIOR VICE PRES./CONTROLL4.0006773956000746.00X
ROY M HILLIARD
VICE PRESIDENT, SALES47.00170096092293.00X
RENEE A FISHER
VP, QUALITY ASSURANCE & TR47.002982890801283.00X
PHILIP N ENGLE
VP, INFORMATION TECHNOLOGY47.003921370698733.00X
JEANNE M FOSTER
VICE PRESIDENT, FINANCE47.003219380640403.00X
RICHARD C GRAYBILL
VP, UNDERWRITING & ACTUARI48.002729130524182.00X
KAREN L ROBINSON
DIRECTOR, OFFICE OF CORPORATE SECRETARY47.001334920287323.00X
WHITNEY H SHERBOCKER
ASSISTANT SECRETARY47.001917820509873.00X
MICHAEL G HANKINSON
VP, COMPLIANCE & REGULATORY47.002870570405483.00X
RICHARD SCHON
DIRECTOR, SALES40.00225662014512X
ROBERT D COOVER
DIRECTOR, SALES40.00334091057273X
MARTY A SHEETZ
DIRECTOR, NATIONAL AND SPECIAL ACCOUNTS40.00243734050508X
CHERYL A LERNER
DENTAL DIRECTOR40.00214977043418X
MICHAEL P ROHRBAUGH
SALES ACCOUNT EXECUTIVE40.00329040050246X
DONALD R GORDON DDS
FORMER CHAIRMAN1.001418800X
MICHAEL B LOUGHRAN
FORMER DIRECTOR1.001260000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3663054TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs15389288TotalReportableCompFrmRltdOrgs
Total Other Compensation11445092TotalOtherCompensation
Number Individuals GT100 K44NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
AEROTECK PROFESSIONAL SERIVCES
3689 COLLECTION CENTER DRIVECHICAGOIL60693TEMP EMPLOYEES524356
ARMANINO MCKENNA LLP
12667 ALCOSTA BLVD SUITE 500SAN RAMONCA94583AUDITING381025
NAUMAN SMITH SHISSLER & HALL LLP
200 NORTH THIRD STREET 18TH FLOORHARRISBURGPA17108LEGAL320307
APPLE ONE EMPLOYMENT SERVICES INC
PO BOX 29048GLENDALECA91209TEMP EMPLOYEES108656
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionDIRECT PREMIUMSDescription
Total Revenue Column599848010TotalRevenueColumn
Related Or Exempt Function Income599848010RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue599848010TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column9220252TotalRevenueColumn
Related Or Exempt Function Income9220252RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities9666703Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities8122555Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1544148Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1544148TotalRevenueColumn
Related Or Exempt Function Income1544148RelatedOrExemptFunctionIncome

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column-367752TotalRevenueColumn
Related Or Exempt Function Income-367752RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue-367752TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column610244658TotalRevenueColumn
Related Or Exempt Function Income610244658RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total401628Total
Program Services401628ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total541122008Total
Program Services541122008ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3444705Total
Management And General3444705ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total16290826Total
Program Services14966382ProgramServices
Management And General1324444ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1745331Total
Program Services1603436ProgramServices
Management And General141895ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3020999Total
Program Services2775392ProgramServices
Management And General245607ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1190353Total
Program Services1093577ProgramServices
Management And General96776ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total262765Total
Management And General262765ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total608981Total
Management And General608981ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total177651Total
Management And General177651ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total159223Total
Program Services146278ProgramServices
Management And General12945ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2803728Total
Program Services2575785ProgramServices
Management And General227943ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total7276889Total
Program Services6685278ProgramServices
Management And General591611ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1193893Total
Program Services1096830ProgramServices
Management And General97063ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total536679Total
Program Services493047ProgramServices
Management And General43632ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total22220Total
Program Services20414ProgramServices
Management And General1806ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total3783Total
Program Services3783ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total670030Total
Program Services615557ProgramServices
Management And General54473ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total365733Total
Program Services335999ProgramServices
Management And General29734ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
COMMISSIONS91136529113652
ADMINISTRATIVE FEES61228165625031497785
LICENSES, PERMITS, AND49115945122839931
BANK CHARGES43777240218135591

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total274144Total
Program Services251856ProgramServices
Management And General22288ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total597736968Total
Program Services589779342ProgramServices
Management And General7957626ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3821814BOY
EOY840817EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY50404093BOY
EOY51257437EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY3360000BOY
EOY3360000EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1219145BOY
EOY1121375EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis34577910LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec21010668LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY14033332BOY
EOY13567242EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY41525018BOY
EOY46814328EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY19506107BOY
EOY26708935EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY450346BOY
EOY485678EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY134319855BOY
EOY144155812EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY63374728BOY
EOY62250628EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY3985222BOY
EOY3624712EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2211594BOY
EOY2170660EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY69571544BOY
EOY68046000EOY
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)
BOY64748311BOY
EOY76109812EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY64748311BOY
EOY76109812EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY134319855BOY
EOY144155812EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses12507690ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-1146189ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
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

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1620279OtherCostOrOtherBasis
Book Value1620279BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis12747016OtherCostOrOtherBasis
Depreciation5334272Depreciation
Book Value7412744BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1763355OtherCostOrOtherBasis
Depreciation1746682Depreciation
Book Value16673BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis5540866OtherCostOrOtherBasis
Depreciation4804972Depreciation
Book Value735894BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis12906394OtherCostOrOtherBasis
Depreciation9124742Depreciation
Book Value3781652BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings13567242TotalOfBookValueLandBuildings

Other Securities OtherSecurities (3 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
DELTA DENTAL INSURANCE COMPANY4885C
DELTA REINSURANCE CORPORATION23653797F
DENTEGRA INSURANCE COMPANY3050253F
FieldValueIRS element (for citing)
Total Of Book Value Securities26708935TotalOfBookValueSecurities

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO SUBSIDIARIES AND AFFILIATESDescription
Amount$2,170,660Amount
FieldValueIRS element (for citing)
Total Of Amounts2170660TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt239558698TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal239558698RevenueSubtotal
Other Revenues Not Included370685960OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt370685960RevenueNotRptdOnFinStmt
Total Revenue Per Form990610244658TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt227051008TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal227051008ExpensesSubtotal
Other Expenses Not Included370685960OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt370685960ExpensesNotRptdOnFinStmt
Total Expenses Per Form990597736968TotalExpensesPerForm990

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 ACCRUED FOR ADMINISTRATIVE SERVICE CONTRACTS

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCENTRAL AMERICA AND THE CARIBBEANRegion
Number Of Offices0NumberOfOffices
Number Of Employees0NumberOfEmployees
Type Of Activities ConductedINVESTMENT IN DELTA REINSURANCE CORPORATIONTypeOfActivitiesConducted
Total Expenditures23653797TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Number Of Offices0SubtotalNumberOfOffices
Subtotal Number Of Employees0SubtotalNumberOfEmployees
Cont Number Of Offices0ContNumberOfOffices
Cont Number Of Employees0ContNumberOfEmployees
Total Number Of Offices0TotalNumberOfOffices
Total Number Of Employees0TotalNumberOfEmployees
Subtotal Amount Spent23653797SubtotalAmountSpent
Cont Amount Spent0ContAmountSpent
Total Amount Spent23653797TotalAmountSpent
Transfer To Foreign Corp0TransferToForeignCorp
Interest In Foreign Trust0InterestInForeignTrust
Own Foreign Corp1OwnForeignCorp
Passive Foreign Invest Co0PassiveForeignInvestCo
Foreign Partnership0ForeignPartnership
Boycott Countries0BoycottCountries

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
UNITED WAY OF THE CAPITAL REGION
2235 MILLINIUM WAYENOLAPA17025231352095501(C)(3)41784TO PROVIDE DENTAL EDUCATION
DELTA DENTAL COMMUNITY CARE FOUNDATION
100 FIRST STREETSAN FRANCISCOCA94105371570764501(C)(3)321700TO PROVIDE DENTAL EDUCATION
MISC SMALL DONATIONS LESS THAN 5000
38144TO PROVIDE DENTAL EDUCATION
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants21TotalNbrOf501C3AndGovtGrants

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 (21 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
GARY D RADINE
PRESIDENT/CEO0125000402500000025318601488420148760416690800
ANTHONY S BARTH
EXEC. VICE PRES./COO08240040800000036823050084360220500669131300
MICHAEL J CASTRO
EXEC. VICE PRES./CFO05664960550000060238019469040205760314421400
PATRICK S STEELE
EXEC. VICE PRES./CIO05407560656250039797034372380159270468996800
CHARLES LAMONT
EXEC. VICE PRES./CLO046350004500000572083901423970159270679266303279320
ALICIA WEBER
SENIOR VICE PRES./CONTROLL03812000271750024445038326021681073740200
ROY M HILLIARD
VICE PRESIDENT, SALES5997801033250679304899043300179325000
RENEE A FISHER
VP, QUALITY ASSURANCE & TR2197770674320110800658740142540378417000
PHILIP N ENGLE
VP, INFORMATION TECHNOLOGY316816065500098210544630154100462010000
JEANNE M FOSTER
VICE PRESIDENT, FINANCE2408180685400125800474660165740385978000
RICHARD C GRAYBILL
VP, UNDERWRITING & ACTUARI20486406000008049045944064740325331000
KAREN L ROBINSON
DIRECTOR, OFFICE OF CORPORATE SECRET1123680220810-957021740069920162224000
WHITNEY H SHERBOCKER
ASSISTANT SECRETARY154417029979073860356240153630242769000
MICHAEL G HANKINSON
VP, COMPLIANCE & REGULATORY243755036050072520263280142200327605000
RICHARD SCHON
DIRECTOR, SALES7104509110206351505016094960240174000
ROBERT D COOVER
DIRECTOR, SALES12016001936500202810423730149000391364000
MARTY A SHEETZ
DIRECTOR, NATIONAL AND SPECIAL ACCOU1304240109000043100379490125590294242000
CHERYL A LERNER
DENTAL DIRECTOR1785210230000134560288350145830258395000
MICHAEL P ROHRBAUGH
SALES ACCOUNT EXECUTIVE6156902547150127560337000165460379286000
DONALD R GORDON DDS
FORMER CHAIRMAN1418800000000014188000
MICHAEL B LOUGHRAN
FORMER DIRECTOR1260000000000012600000

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
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 4BCERTAIN EXECUTIVES PAID BY A RELATED ORGANIZATION PARTICIPATE IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PROGRAM. THE RELATED ORGANIZATION PROVIDES A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO CERTAIN OF ITS SENIOR EXECUTIVES AS SELECTED BY THE BOARD OF DIRECTORS. THE SUPPLEMENTAL RETIREMENT BENEFIT IS BASED ON EACH EXECUTIVE'S COMPENSATION AND YEARS OF SERVICE TO THE ENTERPRISE. THE BENEFIT IS SUBJECT TO THE RISK OF FORFEITURE IF REQUIRED YEARS OF SERVICE ARE NOT MET. ANNUAL DEFERRED COMPENSATION RELATED TO THIS PLAN IS REPORTED IN SCHEDULE J, PART II, COLUMN (C) FOR EACH PARTICIPANT AND REFLECTS THE CURRENT YEAR INCREASE OR DECREASE IN THE RELATED ORGANIZATION'S PENSION BENEFIT OBLIGATION ("PBO"), CALCULATED PURSUANT TO GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THE PBO INCREASE OR DECREASE INCLUDES CHANGES IN ACTUARIAL ASSUMPTIONS (E.G., APPLICABLE DISCOUNT RATE), AS WELL AS CHANGES IN COMPENSATION AND YEARS OF SERVICE. IN 2012, ANTHONY BARTH, MICHAEL CASTRO, GARY RADINE, PATRICK STEELE, AND CHARLES LAMONT PARTICIPATED IN THE PLAN. 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.
PART IIIPART II, LINE (II): SIX OF THE ORGANIZATION'S OFFICERS ARE PAID BY A RELATED ORGANIZATION. ACCORDINGLY, THEIR COMPENSATION IS REPORTED IN LINE (II).SUPPLEMENTAL INFORMATION

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
ERIC N HODGES DMD
PARTICIPATING PROVIDER156788DENTAL CLAIM PAYMENTS0
BRUCE R TERRY DMD ENDODONTIC SPE
PARTICIPATING PROVIDER214351DENTAL CLAIM PAYMENTS0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 4THE ORGANIZATION'S BYLAWS WERE AMENDED IN 2012 TO (I) DELETE THE PROVISION FOR ALTERNATE DIRECTORS AND (II) INCREASE THE PROFESSIONAL LIABILITY INSURANCE LIMITS FOR PARTICIPATING DENTISTS PURSUANT TO A CHANGE IN PENNSYLVANIA LAW.
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION HAS ONE CLASS OF MEMBERS, DESIGNATED CORPORATE MEMBERS, WHO ARE DIRECTORS OF DENTEGRA GROUP, INC., THE ORGANIZATION'S PARENT HOLDING COMPANY.
FORM 990, PART VI, SECTION A, LINE 7ATHE ORGANIZATION'S DIRECTORS VOTE ON PERSONS NOMINATED AS DIRECTORS FOR ENDORSEMENT TO THE CORPORATE MEMBERS, WHO ELECT THE DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BTHE CORPORATE MEMBERS MUST APPROVE ANY CHANGES TO SPECIFIED BYLAWS PROVISIONS.
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 AUDIT COMMITTEE OF THE 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, WHO IS AN EMPLOYEE OF DENTEGRA GROUP, INC. ("DGI"), IS REVIEWED AND APPROVED BY THE DGI DIRECTORS. EXECUTIVE VICE PRESIDENTS' COMPENSATION IS EITHER APPROVED BY THE PRESIDENT OR IN ACCORDANCE WITH THE PROCEDURE OF DELTA DENTAL OF CALIFORNIA (BY WHOM THEY ARE EMPLOYED). ALL COMPENSATION FOR THE ENSUING YEAR IS ONLY APPROVED AFTER REVIEWING COMPARABILITY DATA PRESENTED BY AN OUTSIDE COMPENSATION CONSULTANT, AN ASSESSMENT OF EACH OFFICER'S PERFORMANCE OVER THE PRECEDING YEAR, AND THE ORGANIZATION'S PROGRAM ACCOMPLISHMENTS FOR THE YEAR. THIS PROCESS WAS FOLLOWED FOR 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 PENNSYLVANIA INSURANCE DEPARTMENT, 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 9% 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.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgPublic Charity StatusPublicCharityStatus
DELTA DENTAL OF DELAWARE INC
ONE DELTA DRIVEMECHANICSBURGPA17055510228088DENTAL INSURANCEDE501(C)(4)DENTEGRA GROUP INC0
DELTA DENTAL OF WEST VIRGINIA INC
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
DELTA DENTAL COMMUNITY CARE FOUNDATION
100 FIRST STREETSAN FRANCISCOCA94105371570764CHARITABLE ORGANIZATIONCA501(C)(3)DENTEGRA GROUP INC0PF
DELTA DENTAL OF CALIFORNIA
100 FIRST STREETSAN FRANCISCOCA94105941461312DENTAL INSURANCECA501(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 Partner0GeneralOrManagingPartner
Percentage Ownership0.50000PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV (15 entries)

Address Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryEINEINPrimary ActivityPrimaryActivityLegal Domicile Foreign CountryLegalDomicileForeignCountryBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityPercentage OwnershipPercentageOwnershipControlled OrgControlledOrgAddress Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPostal CodeAddressForeign/PostalCode
DELTA REINSURANCE CORPORATION
CGI TOWER 2ND FLOORWARRENSST. MICHAELBB980096711REINSURANCEBBDELTA DENTAL OF PENNSYLVANIAC0.870900
DENTEGRA GROUP INC
943386049HOLDING COMPANYC0100 FIRST STREETSAN FRANCISCOCA94105DEN/A
DENTEGRA INSURANCE COMPANY
751233841INSURANCE COMPANYDDC INSURANCE HOLDINGS INCC0.200000100 FIRST STREETSAN FRANCISCOCA94105DE
DENTEGRA INSURANCE CO OF NEW ENGLAND
042890218INSURANCE COMPANYDDC INSURANCE HOLDINGS INCC0100 FIRST STREETSAN FRANCISCOCA94105MA
ALPHA DENTAL OF NEVADA INC
880244893INSURANCE COMPANYDDC INSURANCE HOLDINGS INCC0100 FIRST STREETSAN FRANCISCOCA94105NV
ALPHA DENTAL OF UTAH INC
860672505INSURANCE COMPANYDDC INSURANCE HOLDINGS INCC0100 FIRST STREETSAN FRANCISCOCA94105UT
ALPHA DENTAL PROGRAMS INC
742447512INSURANCE COMPANYDDC INSURANCE HOLDINGS INCC0100 FIRST STREETSAN FRANCISCOCA94105TX
ALPHA DENTAL OF ALABAMA INC
630796079INSURANCE COMPANYDDC INSURANCE HOLDINGS INCC0100 FIRST STREETSAN FRANCISCOCA94105AL
ALPHA DENTAL OF NEW MEXICO INC
330279230INSURANCE COMPANYDDC INSURANCE HOLDINGS INCC0100 FIRST STREETSAN FRANCISCOCA94105NM
ALPHA DENTAL OF ARIZONA INC
930939835INSURANCE COMPANYDDC INSURANCE HOLDINGS INCC0100 FIRST STREETSAN FRANCISCOCA94105AZ
DENTEGRA SEGUROS DENTALES SA
INSURGENTES SUR 826 PISO 15COL DEL VALLEFC DF 01300MXINSURANCE COMPANYMXDENTEGRA INSURANCE COMPANYC0
DELTA DENTAL OF PUERTO RICO
14 CALLE 2 SUITE 200GUAYNABORQ660436769INSURANCE COMPANYRQDELTA DENTAL OF CALIFORNIAC000968
SERVICIOS DENTALES DENTEGRA SA DE CV
INSURGENTES SUR 826 PISO 15COL DEL VALLEFC DF 01300MXINSURANCE ADMINISTRATIONMXDENTEGRA INSURANCE COMPANYC0
DELTA DENTAL INSURANCE COMPANY
942761537INSURANCE COMPANYDDC INSURANCE HOLDINGS INCC0100 FIRST STREETSAN FRANCISCOCA94105DE
DDC INSURANCE HOLDINGS INC
274251930HOLDING COMPANYDENTEGRA GROUP INCC0100 FIRST STREETSAN FRANCISCOCA94105DE
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
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 (9 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
DELTA DENTAL OF DELAWARE INC
L1845386
PACA MANAGEMENT LLC
Q36165850
DELTA DENTAL OF WEST VIRGINIA INC
L1493491
PACA MANAGEMENT LLC
M7469434
DELTA DENTAL INSURANCE COMPANY
M170491
DELTA DENTAL OF CALIFORNIA
L12501777
DELTA DENTAL OF CALIFORNIA
M11357070
DELTA DENTAL OF CALIFORNIA
P7017814
DELTA DENTAL OF CALIFORNIA
Q169574