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OREGON DENTAL SERVICE: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
OREGON DENTAL SERVICE (EIN 93-0438772)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-10-31
IRS object ID
201243059349300429
Schema version
2011v1.3
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)
Timestamp2012-10-31T11:34:26-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PricewaterhouseCoopers LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1800 Market StreetAddressLine1
CitySt LouisCity
StateMOState
ZIP Code63101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN930438772EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1OREGON DENTAL SERVICEBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% DAVID EVANSInCareOfName
Name ControlOREGNameControl
Phone5032286554Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1601 SW SECOND AVENUEAddressLine1
CityPORTLANDCity
StateORState
ZIP Code972043154ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDavid EvansName
TitleSenior VP & CFOTitle
Phone5052286554Phone
Date Signed2012-10-30DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone3142068500Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts350978800GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1961YearFormation
State Legal DomicileORStateLegalDomicile
Activity Or Mission DescriptionPROVISION OF DENTAL SERVICES TO THE GENERAL PUBLIC TO ASSIST IN ENCOURAGING PREVENTION, EDUCATION, AND GENERAL DENTAL HEALTHActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year326858703ProgramServiceRevenuePriorYear
Program Service Revenue CY337143317ProgramServiceRevenueCY
Investment Income Prior Year847859InvestmentIncomePriorYear
Investment Income Current Year615853InvestmentIncomeCurrentYear
Other Revenue Prior Year5375761OtherRevenuePriorYear
Other Revenue Current Year5330382OtherRevenueCurrentYear
Total Revenue Prior Year333082323TotalRevenuePriorYear
Total Revenue Current Year343089552TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year265039GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY185058GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year295109706BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY306531496BenefitsPaidToMembersCY
Salaries Etc Prior Year40227476SalariesEtcPriorYear
Salaries Etc Current Year40109547SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year-12385681OtherExpensePriorYear
Other Expenses Current Year-14128250OtherExpensesCurrentYear
Total Expenses Prior Year323216540TotalExpensesPriorYear
Total Expenses Current Year332697851TotalExpensesCurrentYear
Revenues Less Expenses Prior Year9865783RevenuesLessExpensesPriorYear
Revenues Less Expenses CY10391701RevenuesLessExpensesCY
Total Assets BOY143216216TotalAssetsBOY
Total Assets EOY146205516TotalAssetsEOY
Total Liabilities BOY47796941TotalLiabilitiesBOY
Total Liabilities EOY40894540TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY95419275NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY105310976NetAssetsOrFundBalancesEOY
Mission DescriptionPROVISION OF DENTAL SERVICES TO THE GENERAL PUBLIC TO ASSIST IN ENCOURAGING PREVENTION, EDUCATION, AND GENERAL DENTAL HEALTHMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense306716554Expense
Grants185058Grants
Revenue336174968Revenue
DescriptionPROVISION OF DENTAL SERVICES TO THE GENERAL PUBLIC TO ASSIST IN ENCOURAGING PREVENTION, EDUCATION, AND GENERAL DENTAL HEALTH.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense943903Expense
Revenue968349Revenue
DescriptionPROVISION OF EDUCATION TO THE DENTAL COMMUNITYDescription
FieldValueIRS element (for citing)
Total Program Service Expense307660457TotalProgramServiceExpense
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109619171NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccounttrueForeignFinancialAccount
Name Of Foreign CountryEINameOfForeignCountry
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledORStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDAVID EVANSNamePerson
Telephone Number5032286554TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1601 SW SECOND AVENUEAddressLine1
CityPORTLANDCity
StateORState
ZIP Code97204ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationOther CompensationOtherCompensationOfficerOfficerReportable Comp From Related OrgsReportableCompFromRelatedOrgsKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Tracy Andrus
Director1.0X31500
Wayne Barichello
Director1.0X31000
Michael Biermann
Director1.0X1300020000
George Darke
Director1.0X34800
Robert G Gootee
CEO50.0X1061653X1081482
David Howerton
Director1.0X35000
Mark Jensen
Director1.0X308004000
Mike McKeel
Director1.0X33000
George Passadore
Director1.0X36300
John Stevason
Director1.0X32000
Jon Carnahan
Director1.0X31000
CJ McLeod
Director1.0X1900013000
Jill Eberwein
Director1.0X16000
JAY LAMB
DIRECTOR1.0X100050000
PATRICK NEARING
DIRECTOR1.0X34800
Thomas J Bikales
Secretary50.025673X174778
William Ten Pas
PRESIDENT50.0534814X474249
David Evans
TREASURER50.032210X236250
Susan Hansen
Vice President50.019411194797X
Tracie Murphy
SR Vice President50.0145014286731X
Robin Richardson
SR Vice President50.0144730287148X
William Johnson
SR Vice President50.017285319964X
Kraig Anderson
Vice President50.025581208277X
James Foley
Vice President50.025083258614X
WILLIAM HOCKETT
DIRECTOR50.011880202730X
ROBERT MILLS
DIRECTOR50.0211035X
CHANDRA WAHRGREN
VICE PRESIDENT50.023299210730X
FieldValueIRS element (for citing)
Total Reportable Comp From Org344400TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs4146785TotalReportableCompFrmRltdOrgs
Total Other Compensation2188433TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Description Of ServicesDescriptionOfServicesCompensationCompensation
The Trizetto Group Inc
COMPUTER MAINTENANCE2810359
Sirius Computer Solutions Inc
COMPUTER MAINTENANCE2125014
IBM CORPORATOIN
COMPUTER MAINTENANCE2564848
SHAKTI SOLUTIONS
OFFSHORE/IT SUPPORT1313651
Solberg-Adams LLC
Telecom Consulting790117
FieldValueIRS element (for citing)
Number Of Contractors GT100 K35NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
DENTAL SERVICES524114336174968336174968
EDUCATION TO THE DENTAL COMMUNITY611710968349968349
FieldValueIRS element (for citing)
Total Program Service Revenue337143317TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column629946TotalRevenueColumn
Exclusion$629,946ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real553752Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real553752Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column553752TotalRevenueColumn
Exclusion$553,752ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities7796714Securities
Other78441Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities7842942Securities
Other46306Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-46228Securities
Other32135Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-14093TotalRevenueColumn
Exclusion-$14,093ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
UNREALIZED GAIN/(LOSS)523000-29303-29303
MISC INCOME9000994316043160
INVESTMENT IN SUBSIDIARY90000347627734762773
FieldValueIRS element (for citing)
Total Other Revenue4776630TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column343089552TotalRevenueColumn
Related Or Exempt Function Income341919947RelatedOrExemptFunctionIncome
Exclusion$1,169,605ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total185058Total
Program Services185058ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total306531496Total
Program Services306531496ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total344400Total
Program Services0ProgramServices
Management And General344400ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total33395259Total
Program Services586492ProgramServices
Management And General32808767ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1364180Total
Management And General1364180ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2257168Total
Management And General2257168ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2748540Total
Management And General2748540ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total102545Total
Management And General102545ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total712992Total
Management And General712992ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total861980Total
Management And General861980ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total8336933Total
Program Services46235ProgramServices
Management And General8290698ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2474684Total
Management And General2474684ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5152868Total
Program Services266880ProgramServices
Management And General4885988ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total512876Total
Management And General512876ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4502969Total
Program Services13239ProgramServices
Management And General4489730ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total485077Total
Management And General485077ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneral
EXPENSE ALLOCATION-42563857-42563857
COMMISSIONS AND BROKER FEES21605162160516
CONSULTING10833271083327
INVESTMENT EXPENSE4915449154

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1999686Total
Program Services31057ProgramServices
Management And General1968629ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total332697851Total
Program Services307660457ProgramServices
Management And General25037394ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY648616BOY
EOY-7605147EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY12866817BOY
EOY11557545EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1894593BOY
EOY2097730EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis51692229LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec31545768LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY21569238BOY
EOY20146461EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY20929551BOY
EOY31095076EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY85118886BOY
EOY88731185EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY188515BOY
EOY182666EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY143216216BOY
EOY146205516EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY18120897BOY
EOY14942933EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY29676044BOY
EOY25951607EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY47796941BOY
EOY40894540EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY30000BOY
EOY30000EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY20747852BOY
EOY20247852EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY74641423BOY
EOY85033124EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY95419275BOY
EOY105310976EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY143216216BOY
EOY146205516EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses10391701ReconcilationRevenueExpenses
Reconcilation Other Changes-500000ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis612191OtherCostOrOtherBasis
Book Value612191BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6350866OtherCostOrOtherBasis
Depreciation1045247Depreciation
Book Value5305619BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis4653841OtherCostOrOtherBasis
Depreciation2495791Depreciation
Book Value2158050BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis34523345OtherCostOrOtherBasis
Depreciation23206619Depreciation
Book Value11316726BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5551986OtherCostOrOtherBasis
Depreciation4798111Depreciation
Book Value753875BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings20146461TotalOfBookValueLandBuildings
Financial DerivativesFinancialDerivatives
Closely Held Equity InterestsCloselyHeldEquityInterests

Other Securities OtherSecurities (3 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
HEALTH SERVICE GROUP78656719C
INVESTMENTS MARKET VALUE177136F
DEFERRED COMP. INVESTMENT9897330F
FieldValueIRS element (for citing)
Total Of Book Value Securities88731185TotalOfBookValueSecurities
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescriptionAmountAmount
ADVANCE DEPOSITS$2,876,493
ESTIMATED POLICY CLAIMS$126,850
PROVISION FOR REFUNDABLE REV$7,316,874
DEFERRED COMP RESERVE$9,897,330
CAPITAL LEASE OBLIGATIONS$2,519,440
UNEARNED PREMIUMS$37,511
CONTINGENCY RESERVE$640,109
IBNR$2,537,000
FieldValueIRS element (for citing)
Total Of Amounts25951607TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierLIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740)Identifier
Return ReferenceSCHEDULE D, PART X, LINE 2ReturnReference
ExplanationTHE COMPANY ADOPTED THE FASB'S GUIDANCE ON ACCOUNTING FOR UNCERTAINTIES IN INCOME TAX ON JANUARY 1, 2009. AS THE COMPANY DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS AT THAT DATE FOR TAX POSITIONS TAKEN IN 2009 AND PRIOR YEARS, NO CUMULATIVE EFFECT ADJUSTMENT WAS RECORDED. THE COMPANY DOES NOT HAVE ANY UNRECOGNIZED INCOME TAX BENEFITS AS OF DECEMBER 31, 2011, 2010 OR 2009.Explanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAddress Line2AddressUS/AddressLine2
DENTAL FOUNDATION of OREGON
PO Box 2448WILSONVILLEOR97070930818476501(c)(3)10000CHARITY
OHSU FOUNDATION
1121 SE SALMON STPORTLANDOR97205237083114501(c)(3)100000School of Dentistry Capital Campaign - New building fundSuite 100
Washington Oral Health
126 NW Canal STSeattleWA98107911869855501(c)(3)10000Charity
Oregon Food Bank
PO Box 55370PortlandOR97209930785786501(c)(3)10000Providing Food to those in Need
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants4TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelXFirstClassOrCharterTravel
Travel For CompanionsXTravelForCompanions
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Club Dues Or FeesXClubDuesOrFees
Personal ServicesXPersonalServices
Written Policy Re T And E ExpensesfalseWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Kraig Anderson
16977730000850025251330233858
Thomas J Bikales
14549920000927925198475200451
Robert G Gootee
7045233672009759105760840452143135
Susan Hansen
163446250006351181711240214208
Tracie Murphy
2080297500037021435541460431745
Robin Richardson
2075837500045651435801150431878
William Ten Pas
349488120000476152855462601009063
David Evans
181853500004397266855525268460
James Foley
2182913000010323205184565283697
William Johnson
264776500005188172850337249
WILLIAM HOCKETT
1349307500603001188021461060300
ROBERT MILLS
211035211035
CHANDRA WAHRGREN
15533050000540023024275234029

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierPart I, Line 1aIdentifier
ExplanationWith respect to the items checked in Question 1a, the organization does not have a written policy regarding reimbursement/payment. Expenses for first-class air and companion travel are incurred from time to time when there is a legitimate business need. Such analysis is made on a case by case basis based on the facts and circumstances in question. It is not, for example, a policy of the organization to purchase first-class air tickets. On occasion, however, scheduling constraints or ticket availability may mean that it is in the best interest of the organization to incur the additional expense. Companion travel for the Board and officers is occasionally reimbursed in connection with leadership retreats at which companions participate in educational and other company-related events. The organization's general policies relating to prior approval of expenses and/or checks and balances as to who can approve such exceptional expenses insure that decisions to take on such expenses are made in a fiscally responsible manner. Tax gross up payments are approved by the CEO or, in the case of benefit to senior management, by the Board. Limited reimbursement for club dues is available as an employee benefit based on an individual's level in the organization.Explanation

Schedule L IRS990ScheduleL

FieldValueIRS element (for citing)
Total Balance Due0TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (7 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
JAY C LAMB
DIRECTOR532314DENTAL SERVICE PROVIDERfalse
MICHAEL BIERMANN
DIRECTOR220312DENTAL SERVICE PROVIDERfalse
DAVID HOWERTON
DIRECTOR1799010DENTAL SERVICE PROVIDERfalse
MICHAEL MCKEEL
DIRECTOR178902DENTAL SERVICE PROVIDERfalse
PAT NEARING
DIRECTOR375505DENTAL SERVICE PROVIDERfalse
MARK JENSEN
DIRECTOR114691DENTAL SERVICE PROVIDERfalse
WAYNE BARICHELLO
DIRECTOR165467DENTAL SERVICE PROVIDERfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Part VI, Section B, Question 12cThe organization's Corporate Compliance Committee is responsible for monitoring potential issues under and enforcing the provisions of the organization's Conflict of Interest Policy. The Corporate Compliance Committee is composed of high level individuals from a variety of departments (including, among others, Legal, Compliance, Human Resources, Privacy/Security and Accounting). The Committee operates under the authority of the Policy Committee of the organization's Board of Directors. The Committee monitors activities under the Conflict of Interest Policy via (i) annual disclosure statements from the Board and management and other self-reporting, (ii) investigations of issues that are brought to the attention of members of the Corporate Compliance Committee in accordance with the Organization's Code of Conduct and Employee Handbook and (iii) submissions of employees sent through the organization's confidential whistleblower reporting mechanism. When the Committee learns of the possibility of such conflicts of interest, the information is brought to the attention of (disinterested) members of senior management and/or members of the Board of Directors. The Committee then works with these individuals to make a determination, in accordance with the principles and procedures set forth in the Conflict of Interest Policy, as to whether a conflict exists and, if so, to decide what steps, including disciplinary action, should be taken. In addition, on an annual basis, and more frequently when circumstances arise, the organization's counsel, on behalf of the Committee, reports to the Policy Committee of the Board of Directors on activities of the Corporate Compliance Committee, including any actions or issues under the Conflict of Interest Policy. Counsel also conducts regular training sessions for the Board of Directors on the Conflict of Interest Policy and works directly with the officers of the corporation as they complete their annual disclosure statements.
Part VI, Section B, Question 15In accordance with the Bylaws of the organization, compensation of the CEO is determined by the Board of Directors and compensation of the organization's officers (as well as its key employees and other highest compensated employees who are officers of an affiliate of the organization) is determined by the CEO under guidelines specified by the Compensation and Governance Committee of the Board of Directors and subject to approval by the Board of Directors. The Compensation and Governance Committee of the Board of Directors, per its charter and the authority delegated to it by the full Board, meets on an annual basis to discuss CEO and officer compensation. The CEO, who is a member of the Committee, recuses himself from all discussions and decisions relating to CEO compensation. Periodically, the Chairman of the Committee and the Chairman of the Board, who is a member of the Committee, work with a third party benefits consultant selected by the Committee to produce a compensation study that provides comparability data from the organization's peer group with respect to CEO and officer compensation. The study is provided to Committee members in advance of its meeting and it serves as a basis for the Committee's determination of CEO compensation and its review and approval of officer compensation. Minutes of the Committee meeting substantiating all deliberations and determinations are maintained. These minutes, together with any other information reported by Committee members, are then presented to the full Board for discussion and approval. Such actions of the full Board are recorded in the minutes of its meeting. Compensation for other key employees and highest compensated employees of the organization who are not officers of the organization or an affiliate is determined by the organization's Human Resources Department and is subject to review and approval by the CEO. Such pay levels are based on independent, third party compensation studies showing pay scales for corporations that are comparable in size and scope to the organization and reflect the employee's skills, experience, tenure and responsibilities with the organization.
Part VI, Section C, Question 19The organization's governing documents, Conflict of Interest Policy and financial statements are not made available to the public.
Part VI, Section A, Question 11A copy of the Form 990 was provided to the Compensation and Governance Committee of the Board of Directors which, per its charter and the authority delegated to it by the full Board, is responsible for all corporate governance issues and for reviewing and approving CEO and officer compensation. The entire Form 990 was made available to the Committee for review. Officers of the organization identified for the Committee critical areas and highlighted significant issues for review and discussion. The Committee Chair led the discussion and allowed Committee members full scope to comment on and question any and all disclosure contained in the Form 990. Minutes of the Committee meeting substantiating all deliberations and determinations were maintained. These minutes, together with any other information reported by Committee members, were then presented to the full Board for discussion and approval and the Form 990 was made available upon request to all Board members for further review. Actions of the full Board are recorded in the minutes of its meeting.
Part XI, Line 5$500,000 of the organization's Subordinated Contingency Reserve, which was a component of Retained Earnings, was reclassed to a current liability account. The reclassification was approved by the Oregon Department of Consumer and Business Services.Reconciliation of Net Assets

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
DENTAL FOUNDATION OF OREGON
8699 SW SUN PLACEWILSONVILLEOR97070930818476ORAL HEALTHOR501(C)(3)11ANAfalse
OREGON DENTAL ASSOCIATION
PO BOX 3710WILSONVILLEOR97070930243383DENTAL PROFESOR501(c)(6)N/ANAfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
Health Services Group Inc
601 SW Second AvenuePortlandOR972043156931083363Holding CompaORNAC19672091192416861.00000
ODS Health Plan Inc
601 SW Second AvenuePortlandOR97204930989307InsuranceORHSG IncC80773652576625311.00000
Dentists Benefits Insurance Company
601 SW Second AvenuePortlandOR97204930890424InsuranceORODS Health PlanC401821167838631.00000
Benefithelp Solutions Inc
601 SW Second AvenuePortlandOR97204931135521Admin. ServicORODS Health PlanC-18528046298911.00000
ODS Community Health Inc
601 SW Second AvenuePortlandOR97204450528457Medicaid InsORODS Health PlanC380708106340311.00000
Dentists Benefit Corporation
601 SW Second AvenuePortlandOR97204930787508Market Liab.ORHSG IncC-2521513123041.00000
Dentists Management Corporation
601 SW Second AvenuePortlandOR97204930792340Dev & Mkt MgmORHSG IncC-9212314656441.00000
ODS Plaza Inc
601 SW Second AvenuePortlandOR97204830453200R. Estate HolORODS HEALTH PLANC-5049174233261.00000
Northwest Dentists Insurance Company
601 SW Second AvenuePortlandOR97204911444206Markets Liab.ORHSG IncC760680181712300.75000
Dental Commerce Corporation
601 SW Second AvenuePortlandOR97204352410053Consumer LendingORHSG INCC-169813174661.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
DENTAL FOUNDATION OF OREGON
B170562CASH GRANT
DENTAL FOUNDATION OF OREGON
N70000ESTIMATED COST
HEALTH SERVICES GROUP
M8590339CLIENT RECORDS
HEALTH SERVICES GROUP
N27738438CLIENT RECORDS
HEALTH SERVICES GROUP
P6235080CLIENT RECORDS