2012-10-18T19:44:34-05:00 2011-12-31 ERNST & YOUNG US LLP 55 MERCHANT ST SUITE 1900 C-120 HONOLULU HI 96813 990 2011-01-01 990107971 HAWAII DENTAL SERVICE % CHERYL TAKITANI-SMITH HAWA 8085211431 700 Bishop Street Honolulu HI 96813 FAYE KURREN 2012-10-18 Allison Toma 8085312037 2011 2016-02-24 21:20:13Z Faye W Kurren PresidentCEO 700 BISHOP STREET SUITE 700 HONOLULU HI 96813 230680762 false X www.deltadentalhi.org X 1962 HI PROMOTE AND ENCOURAGE THE BETTERMENT OF THE GENERAL MEDICAL AND DENTAL HEALTH OF THE PUBLIC FOR THE COMMON GOOD AND GENERAL WELFARE OF THE COMMUNITY. 13 6 98 0 242595 191231 875 0 177962143 182496411 7700909 4113361 55014 277429 185718941 186887201 2094869 1535028 157009216 164709135 8389671 8451269 0 0 0 4407625 4428566 171901381 179123998 13817560 7763203 132075695 144353905 18416409 28473858 113659286 115880047 X SEE SCHEDULE O. false false 172175804 1535028 182530395 TO PROMOTE AND ENCOURAGE THE BETTERMENT OF THE GENERAL MEDICAL AND DENTAL HEALTH OF THE PUBLIC OF THE COMMON GOOD AND GENERAL WELFARE OF THE COMMUNITY. SEE SCHEDULE O - FORM 990, PART III, LINE 4A FOR PROGRAM SERVICE ACCOMPLISHMENTS. 172175804 false false false false false false false false false true false false false true false false true false false false false false false false false false true false true false false false false false true true true false false false false false true true true false true 2800 0 true 98 true true true false false false false false X 13 6 false false false false true true true true true false false true true true true true true true true false X CHERYL TAKITANI-SMITH 8085211431 700 BISHOP STREET SUITE 700 HONOLULU HI 96813 T Kimo Blaisdell 1.0 X 0 0 0 Paul Chang 1.0 X 0 0 0 Norman S Chun 1.0 X 0 0 0 Harold J Dias Jr 1.0 X 0 0 0 Clay R Hiramoto 1.0 X 0 0 0 John I Kotake 1.0 X 0 0 0 Kim James Lawler 1.0 X 0 0 0 Susan A Li 1.0 X 0 0 0 Gary K Nakata 1.0 X 0 0 0 Garrett B K Oka 1.0 X 0 0 0 Michael J O'Malley 1.0 X 0 0 0 Casey Z Tamashiro 1.0 X 0 0 0 Jon Yoshino 1.0 X 0 0 0 Faye W Kurren 40.0 X 556572 0 351484 Cheryl Takitani-Smith 40.0 X 211045 0 58010 JODI NAKAYAMA 1.0 X 0 0 Kathy Fay 40.0 X 210403 0 83386 Tom Delaney 40.0 X 148596 0 37905 Robert Sherman 40.0 X 155092 0 32100 Paul Amog 40.0 X 143333 0 30138 Jim Johnson 40.0 X 127191 0 40316 Lynette Arakawa 40.0 X 123416 0 52785 1675648 0 686124 12 false true false Ernst Young LLP 55 Merchant Street 1900 Honolulu HI 96813 Accounting services 161413 Strategic Communications PO Box 283137 Honolulu HI 968283137 Advertising 408214 Watson Wyatt Co PO Box 741909 Atlanta GA 303741909 Broker 105369 Benefit Plan Solutions 680 Iwilei Road 528 Honolulu HI 96817 Broker 218361 Servco Employee Benefit Consulting 700 Bishop Street 1400 Honolulu HI 96813 BROKER 109404 5 0 Subscriptions Earned 621300 182495561 182495561 MEMBERSHIP DUES 621300 850 850 182496411 2754070 2754070 0 0 44939804 213048 43580513 213048 1359291 0 1359291 1359291 0 0 0 PROFESSIONAL SERVICES 621300 242595 242595 FMG - VA HERO 900099 3922 3922 ALL OTHER REVENUE 900099 30912 30912 277429 186887201 182531245 242595 4113361 1535028 1535028 0 0 164709135 164709135 1470901 1470901 0 5104811 2783361 2321450 764913 431220 333693 648950 390246 258704 461694 211271 250423 0 92531 92531 239166 239166 15707 15707 0 524819 524819 93878 93878 384986 384986 518394 378056 140338 125345 47464 77881 0 538436 214773 323663 128817 25146 103671 0 21782 2120 19662 0 0 139253 139253 216305 161047 55258 COMMISSION FEES 877739 877739 DUES & SUBSCRIPTIONS 284061 284061 BANK CHARGES 74137 74137 UBTI TAX 63712 63712 89498 24212 65286 179123998 172175804 6948194 0 0 0 30596440 38746650 0 0 11369284 9335462 0 0 0 0 0 0 0 0 1262698 3098067 5413858 5088630 379644 325228 88467629 92848498 0 0 0 0 0 0 0 0 132075695 144353905 6022413 9906285 0 0 2088890 2076380 0 0 0 0 0 0 0 0 0 0 10305106 16491193 18416409 28473858 X 113659286 115880047 0 0 0 0 113659286 115880047 132075695 144353905 X 7763203 -5542442 X false true true X 1363581 1272089 91492 3186890 2966428 220462 863387 850113 13274 325228 0 Claims payable to dentists 11649785 Refundable group subscriptions 4841408 16491193 true Aloha United Way 200 North Vineyard Blvd Suite 700 Honolulu HI 96817 990073494 501(C)(3) 11000 General support University of Hawaii Foundation 2444 Dole Street Bachman Hall 105 Honolulu HI 96822 990085260 501(C)(3) 21762 Support dental hygiene education program Hawaii Dental Service Foundation 700 Bishop Street Suite 700 Honolulu HI 96813 990246999 501(C)(4) 1451846 Support organizations programs 2 1 Form 990, Schedule I Description of Organization's Procedures for Monitoring the Use of Grants THE PURPOSE OF THE GRANTS AWARDED BY HAWAII DENTAL SERVICE (HDS) ARE REVIEWED AND APPROVED BY HDS CEO EXCEPT FOR GRANTS TO HDS FOUNDATION, WHICH ARE APPROVED BY THE HDS BOARD OF DIRECTORS. HDS FOUNDATION CHAIR REPORTS ON THE USE OF GRANTS TO HDS BOARD OF DIRECTORS. OTHER GRANTS ARE AWARDED TO VARIOUS PUBLIC CHARITABLE ORGANIZATIONS TO SUPPORT THE EXEMPT FUNCTIONS OF THE ORGANIZATIONS AND ARE NOT MONITORED. X X X X true true X X X X X false true false false false false false true false Faye W Kurren 381666 0 150255 0 24651 0 342898 0 8586 0 908056 0 0 0 Kathy Fay 158428 0 51975 0 0 0 72475 0 10911 0 293789 0 0 0 Cheryl Takitani-Smith 155835 0 51975 0 3235 0 44208 0 13802 0 269055 0 0 0 Tom Delaney 138185 0 10411 0 0 0 29537 0 8368 0 186501 0 0 0 Robert Sherman 145894 0 9198 0 0 0 26309 0 5791 0 187192 0 0 0 Paul Amog 135000 0 0 0 8333 0 18349 0 11789 0 173471 0 0 0 Jim Johnson 119614 0 7577 0 0 0 27262 0 13054 0 167507 0 0 Lynette Arakawa 114770 0 7996 0 650 0 41475 0 11310 0 176201 0 0 0 Supplemental Compensation Information SCHEDULE J, PART I, LINE 1A: HDS HAS A CORPORATE MEMBERSHIP IN A SOCIAL CLUB IN WHICH THE CLUB REQUIREMENTS DICTATE THAT AN INDIVIDUAL BE IDENTIFIED TO AUTHORIZE TRANSACTIONS. AS SUCH, HDS'S CEO HAS BEEN DESIGNATED AS THE AUTHORIZED INDIVIDUAL. ONLY BUSINESS TRANSACTIONS ARE ALLOWED AND SUBSTANTIATED BY PROPER DOCUMENTATION. DISCRETIONARY SPENDING ACCOUNT: THE CEO RECEIVES AN ALLOWANCE OF $6,000 ANNUALLY FOR BUSINESS USE OF PERSONAL AUTOMOBILE. THIS AMOUNT HAS BEEN INCLUDED IN FORM W-2 AS COMPENSATION. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: CEO RECEIVES GROSS UP PAYMENTS FOR LIFE INSURANCE PREMIUMS OVER $50,000 AND PARKING OVER INTERNAL REVENUE SERVICE LIMITS. VP FINANCIAL AFFAIRS RECEIVES GROSS UP PAYMENT FOR PARKING EXCEEDING INTERNAL REVENUE SERVICE LIMITS. DIRECTOR OF UNDERWRITING RECEIVES A HOUSING ALLOWANCE. THE PAYMENTS TO THE INDIVIDUALS ABOVE ARE INCLUDED IN THEIR W-2S AS COMPENSATION. SCHEDULE J, PART I, LINE 4B: ON DECEMBER 31, 2009, THE BOARD OF DIRECTORS APPROVED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) FOR HDS'S PRESIDENT & CEO, FAYE KURREN. THE EXPENSE RECOGNIZED FOR THE SERP AMOUNTED TO THE INCREASE OF $282,144 IN 2011 DUE TO INCREASE IN THE NET PRESENT VALUE OF THE PROJECTED BENEFIT OBLIGATION FROM 1/1/2011 TO 12/31/2011 AND INCREASES IN DEFINED PLAN BENEFITS BASED ON QUALIFIED ASSUMPTIONS AS REVIEWED BY THE ACTUARIES AND INCLUDED IN THE ACTUARIAL REPORT. SCHEDULE J, PART I, LINE 7: HDS HAS AN INCENTIVE BONUS PLAN DETAILING THE BONUS CALCULATION WHEN THE COMPANY ACHIEVES CERTAIN PERFORMANCE STANDARDS AND STRATEGIC GOALS. BONUS AMOUNT VARIES EACH YEAR DEPENDING ON PERFORMANCE AND ACHIEVEMENT OF STRATEGIC GOALS. BONUS AMOUNT FOR OFFICERS ARE PRESENTED TO AND APPROVED BY THE BOD COMPENSATION COMMITTEE WHICH IS DOCUMENTED IN MINUTES. BONUS PAYMENTS FOR MANAGEMENT AND STAFF ARE CALCULATED BY HUMAN RESOURCES AND APPROVED BY OFFICERS. IN PRIOR YEARS THE ORGANIZATION INADVERTENTLY DID NOT INCLUDE THE BENEFIT RELATED TO THE INDIVIDUAL'S PARTICIPATION IN THE DEFINED BENEFIT PLAN ON PART VII OR SCHEDULE J, PART II. FOLLOWING ARE THE AMOUNTS THAT SHOULD HAVE BEEN REPORTED IN 2008, 2009 AND 2010. THE OVERALL PENSION EXPENSE WAS REPORTED ON FORM 990, PART IX. 2008 KATHY FAY $50,670 FAYE KURREN $32,001 CHERYL TAKITANI-SMITH $39,471 TOM DELANEY $23,984 ROBERT SHERMAN NONE LYNETTE ARAKAWA $23,906 JIM JOHNSON $15,025 ROQUE ARANADOR $12,413 2009 KATHY FAY $65,277 FAYE KURREN $40,314 CHERYL TAKITANI-SMITH $53,919 TOM DELANEY $28,954 ROBERT SHERMAN $10,559 LYNETTE ARAKAWA $28,730 JIM JOHNSON $18,018 ROQUE ARANADOR $15,154 2010 KATHY FAY $66,767 FAYE KURREN $46,645 CHERYL TAKITANI-SMITH $45,423 TOM DELANEY $32,713 ROBERT SHERMAN $18,350 LYNETTE ARAKAWA $33,656 JIM JOHNSON $20,733 ROQUE ARANADOR $17,122 NORMAN S CHUN Director 459373 DENTAL SVCS TO HDS SUBSCRIBERS false John I Kotake Director 358734 DENTAL SVCS TO HDS SUBSCRIBERS false Kim James Lawler Director 227224 DENTAL SVCS TO HDS SUBSCRIBERS false Garrett BK Oka Director 171059 DENTAL SVCS TO HDS SUBSCRIBERS false Casey Tamashiro Director 281411 DENTAL SVCS TO HDS SUBSCRIBERS false Paul Chang Officer is Dir of HDS 2519082 PREMIUM FOR DENTAL PLAN false Susan Li Officer is Dir of HDS 3003066 PREMIUM FOR DENTAL PLAN false ORGANIZATION'S MISSION STATEMENT FORM 990, PART I & PART III, LINE 1 HAWAII DENTAL SERVICE OPERATES FOR THE PROMOTION OF THE COMMON GOOD AND GENERAL WELFARE OF THE PEOPLE. ITS GOAL IS TO INNOVATE AND CONDUCT PROGRAMS FOR DENTAL CARE AND TO MAKE AVAILABLE, IN A BROAD SCALE, THE BENEFITS OF THE SCIENCE OF DENTISTRY TO MEMBERS OF THE PUBLIC. DENTAL COVERAGE IS AVAILABLE TO THE GENERAL PUBLIC AS HAWAII DENTAL SERVICE MAINTAINS AN ENROLLMENT POLICY THAT IS OPEN TO INDIVIDUALS AND FAMILIES, AS WELL AS SMALL AND LARGE GROUPS. IN ADDITION, HAWAII DENTAL SERVICE PROVIDES FUNDING TO HAWAII DENTAL SERVICE FOUNDATION THAT GRANTS ORGANIZATIONS WHICH HAVE PROGRAMS IN PLACE TO SUPPORT ORAL HEALTH INITIATIVES IN THE COMMUNITY. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A HAWAII DENTAL SERVICE (HDS) OFFERS AND ADMINISTERS DENTAL CARE PROGRAMS TO SUBSCRIBER GROUPS AND INDIVIDUALS THROUGHOUT THE STATE OF HAWAII. THE TERMS OF THE AGREEMENTS GENERALLY PROVIDE THAT THE SUBSCRIBER GROUPS OR INDIVIDUALS PAY HDS A STIPULATED AMOUNT, INCLUDING AN ADMINISTRATIVE FEE, WHICH IS USED TO PAY FOR DENTAL SERVICES AND EXPENSES OF ADMINISTERING THE DENTAL SERVICE CONTRACTS. IN ADDITION, HDS FUNDED $1,451,846 TO HDS FOUNDATION IN 2011 TO SUPPORT ORAL HEALTH INITIATIVES IN THE COMMUNITY. AUDITED FINANCIAL STATEMENTS FORM 990, PART IV, LINE 12B THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF HAWAII DENTAL SERVICE, HAWAII DENTAL SERVICE FOUNDATION, AND HAWAII CLIENT SERVICES CORPORATION. THE AUDIT COMMITTEE, WHICH CONSISTS OF BOARD MEMBERS, SELECTS THE AUDITORS AND REVIEWS THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. GOVERNANCE, MANAGEMENT AND DISCLOSURE SECTION A. GOVERNING BODY AND MANAGEMENT FORM 990, PART VI, LINE 6 MEMBERSHIP IN THE CORPORATION IS COMPRISED OF DENTIST AND PUBLIC MEMBERS. DENTIST MEMBERSHIP IS AVAILABLE TO ALL DENTISTS AND DENTAL SURGEONS WHO HAVE BEEN DULY LICENSED TO PRACTICE IN THE STATE OF HAWAII BY THE BOARD OF DENTAL EXAMINERS OF THE STATE OF HAWAII. APPLICATION IS MADE IN WRITING AND APPROVED BY THE BOARD OF DIRECTORS. CERTAIN ORGANIZATIONS (COMPANIES, ORGANIZATIONS, OR ENTITIES CONTRACTING WITH HDS FOR DENTAL BENEFITS FOR AT LEAST 2 CONSECUTIVE YEARS WITH MORE THAN 100 OR MORE ELIGIBLE SUBSCRIBERS AT THE TIME OF SUCH DESIGNATION) ARE INVITED TO BECOME PUBLIC MEMBERS AND APPROVED BY THE BOARD OF DIRECTORS. BOTH MEMBERSHIPS OF THE CORPORATION MAY AT ANY TIME DEPOSE OR REMOVE FROM OFFICE ANY DIRECTOR, WITH OR WITHOUT CAUSE, EXCEPT AS SUCH REMOVAL WOULD BE CONTRARY TO LAW. ELECT BOARD MEMBERS FORM 990, PART VI, LINE 7A DENTISTS AND PUBLIC MEMBERS RESPECTIVELY ELECT DENTISTS AND PUBLIC DIRECTORS TO THE BOARD OF DIRECTORS FOR A THREE YEAR TERM. DUE TO STAGGERED TERMS 1/3 OF DIRECTORS ARE ELECTED ANNUALLY. APPROVAL OF DECISIONS FORM 990, PART VI, LINE 7B AMENDMENTS TO THE BYLAWS REQUIRE APPROVAL OF NOT LESS THAN A MAJORITY OF EACH CLASS OF MEMBERSHIP. SECTION B. POLICIES APPROVED COPY OF FORM 990 FORM 990, PART VI, LINE 11B THE RETURN IS THOROUGHLY REVIEWED BY THE CONTROLLER PRIOR TO FINAL REVIEW WITH THE VP-FINANCIAL AFFAIRS AND PRESIDENT. A COPY OF FORM 990 IS PROVIDED TO BOARD OF DIRECTORS PRIOR TO FILING. WRITTEN CONFLICT OF INTEREST POLICY FORM 990, PART VI, LINE 12C PURSUANT TO THE HDS CONFLICTS OF INTEREST POLICY, EMPLOYEES AND DIRECTORS OF HDS ARE PROVIDED WITH THE CONFLICTS OF INTEREST POLICY AND ARE REQUIRED TO SUBMIT A CONFLICTS OF INTEREST DISCLOSURE STATEMENT ANNUALLY. COMPLIANCE DEPARTMENT REVIEWS THE ANNUAL CONFLICTS OF INTEREST DISCLOSURE STATEMENTS AND REPORTS POTENTIAL CONFLICTS OF INTERESTS TO THE HDS BOARD OF DIRECTORS. THE BOARD OF DIRECTORS ARE NOT ALLOWED TO PARTICIPATE IN DELIBERATIONS OR VOTE ON ISSUES/TRANSACTIONS WHICH THEY HAVE A CONFLICT OF INTEREST. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, LINE 15A & 15B COMPENSATION FOR OFFICERS ARE DETERMINED BASED ON ADVICE FROM AN INDEPENDENT COMPENSATION CONSULTANT WHO USES DELTA DENTAL PLANS ASSOCIATION SURVEY AND THE HAWAII EMPLOYERS COUNCIL SURVEYS FOR COMPARABLE POSITIONS. THE INDEPENDENT CONSULTANT ALSO USES THEIR OWN COMPENSATION SURVEY AS APPROPRIATE TO PROVIDE ADVICE. OFFICER COMPENSATION IS PRESENTED TO AND APPROVED BY THE BOD COMPENSATION COMMITTEE. AMOUNTS ARE DOCUMENTED IN MINUTES AND HUMAN RESOURCE DEPARTMENT RECONCILES THE PAYMENT AT END OF EACH YEAR. COMPENSATION FOR MANAGEMENT AND STAFF POSITIONS ARE EVALUATED AND DETERMINED BASED ON HAWAII EMPLOYERS COUNCIL SURVEYS AND APPROVED BY THE PRESIDENT AND CEO ANNUALLY. SECTION C. DISCLOSURE PUBLIC DISCLOSURE OF ORGANIZATION GOVERNING DOCUMENTS FORM 990, PART VI, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 5 CHANGES IN FUND BALANCE: CHANGE IN UNREALIZED LOSSES ON INVESTMENTS (1,473,347) LOSS FROM HEALTHENTIC ( 538,128) CHANGE IN ACCRUED POSTRETIREMENT LIABILITIES (3,530,967) --------- TOTAL OTHER CHANGES IN FUND BALANCE (5,542,442) ========= TIME DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII, SECTION A HAWAII DENTAL SERVICE FOUNDATION PAUL CHANG 1.0 HOUR JOHN I. KOTAKE 1.0 HOUR SUSAN LI 1.0 HOUR JODI NAKAYAMA 1.0 HOUR GARRETT B.K. OKA 1.0 HOUR CASEY Z. TAMASHIRO 1.0 HOUR FAYE KURREN 1.0 HOUR CHERYL TAKITANI-SMITH 1.0 HOUR Hawaii Dental Service Foundation 700 Bishop Street Suite 700 Honolulu HI 96813 990246999 SUPPORT COMM. HI 501 (c) (4) NA NA true HAWAII CLIENT SERVICES CORPORATION 700 BISHOP STREET SUITE 710 HONOLULU HI 96813 452740308 ADMIN SERVICES HI HI DENTAL SCVS C CORP 11095 895153 1.00000 true true false false false false false false false true false false false true false true false false HAWAII DENTAL SERVICE FOUNDATION B 1451846 CASH HAWAII CLIENT SERVICES CORPORATION B 1000000 CASH HAWAII CLIENT SERVICES CORPORATION N 93543 CASH