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OREGON DENTAL SERVICE: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
OREGON DENTAL SERVICE (EIN 93-0438772)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-14
IRS object ID
201113189349303011
Schema version
2010v3.4
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)
Timestamp2011-11-14T11:16:28-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

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 Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN930438772EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1OREGON DENTAL SERVICEBusinessNameLine1
FieldValueIRS element (for citing)
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)
NameDAVE EVANSName
TitleSENIOR VP & CFOTitle
Phone5032286554Phone
Date Signed2011-11-10DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone3142068500Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts351721404GrossReceipts
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 Year319814382ProgramServiceRevenuePriorYear
Program Service Revenue CY326858703ProgramServiceRevenueCY
Investment Income Prior Year-2070540InvestmentIncomePriorYear
Investment Income Current Year847859InvestmentIncomeCurrentYear
Other Revenue Prior Year-1374059OtherRevenuePriorYear
Other Revenue Current Year5375761OtherRevenueCurrentYear
Total Revenue Prior Year316369783TotalRevenuePriorYear
Total Revenue Current Year333082323TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year119922GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY265039GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year296446881BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY295109706BenefitsPaidToMembersCY
Salaries Etc Prior Year39013967SalariesEtcPriorYear
Salaries Etc Current Year40227476SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year-11477735OtherExpensePriorYear
Other Expenses Current Year-12385681OtherExpensesCurrentYear
Total Expenses Prior Year324103035TotalExpensesPriorYear
Total Expenses Current Year323216540TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-7733252RevenuesLessExpensesPriorYear
Revenues Less Expenses CY9865783RevenuesLessExpensesCY
Total Assets BOY131270327TotalAssetsBOY
Total Assets EOY143216216TotalAssetsEOY
Total Liabilities BOY45716835TotalLiabilitiesBOY
Total Liabilities EOY47796941TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY85553492NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY95419275NetAssetsOrFundBalancesEOY
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
Expense295374744Expense
Grants265039Grants
Revenue325877742Revenue
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)
Expense1322316Expense
Revenue980961Revenue
DescriptionPROVISION OF EDUCATION TO THE DENTAL COMMUNITYDescription
FieldValueIRS element (for citing)
Total Program Service Expense296697060TotalProgramServiceExpense
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 With109618022NumberFormsTransmittedWith1096
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 (29 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationOfficerOfficerReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Karen Anderegg
Director1.0X23000
Tracy Andrus
Director1.0X30000
Wayne Barichello
Director1.0X30300
Michael Biermann
Director1.0X31000
George Darke
Director1.0X32300
Robert G Gootee
CEO50.0XX978073788579
David Howerton
Director1.0X33000
Mark Jensen
Director1.0X31300
Jay Lamb
Director1.0X34500
Mike McKeel
Director1.0X29000
Marta Monetti
Director1.0X30000
Pat Nearing
Director1.0X29000
George Passadore
Director1.0X33300
John Stevason
Director1.0X30500
Jon Carnahan
Director1.0X28000
Thomas J Bikales
Secretary50.0X1410939287
William Ten Pas
PRESIDENT50.0X452622385898
David Evans
TREASURER50.0X17993520557
Susan Hansen
Vice President50.019672815878X
Tracie Murphy
SR Vice President50.023281627964X
Robin Richardson
SR Vice President50.022531727807X
Steven Wynne
Sr Vice President50.02879920X
CJ McLeod
SR Vice President50.0612920201827X
Kraig Anderson
Vice President50.019815723706X
James Foley
Vice President50.024786324530X
William Johnson
Vice President50.025882920606X
Christopher Verbiest
Vice President50.017818523010X
Mary Lou True
Vice President50.016637122232X
Jonathan L Jurevic
Senior Vice President25225150000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org425200TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs4609152TotalReportableCompFrmRltdOrgs
Total Other Compensation1641881TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Description Of ServicesDescriptionOfServicesCompensationCompensation
Morrison Street CF LLC
Rent4981700
Shakti Solutions
Offshore/IT Support1867928
IBM Corporation - BE8
Hardware1743241
The Trizetto Group Inc
COMPUTER MAINTENANCE1732520
Sirius Computer Solutions Inc
COMPUTER MAINTENANCE1481903
FieldValueIRS element (for citing)
Number Of Contractors GT100 K41NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
DENTAL SERVICES524114325877742325877742
EDUCATION TO THE DENTAL COMMUNITY611710980961980961
FieldValueIRS element (for citing)
Total Program Service Revenue326858703TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column708771TotalRevenueColumn
Exclusion$708,771ExclusionAmount

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)
Securities18763670Securities
Other14500Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities18593086Securities
Other45995Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities170584Securities
Other-31495Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column139088TotalRevenueColumn
Exclusion$139,088ExclusionAmount

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)523000536980536980
MISC INCOME9000992909029090
INVESTMENT IN SUBSIDIARY90000342559394255939
FieldValueIRS element (for citing)
Total Other Revenue4822009TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column333082323TotalRevenueColumn
Related Or Exempt Function Income331680712RelatedOrExemptFunctionIncome
Exclusion$1,401,611ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total265039Total
Program Services265039ProgramServices

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)
Total295109706Total
Program Services295109706ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total425200Total
Management And General425200ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total31785202Total
Program Services880804ProgramServices
Management And General30904398ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1751038Total
Management And General1751038ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3768465Total
Management And General3768465ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2497571Total
Management And General2497571ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total321641Total
Management And General321641ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total636501Total
Management And General636501ManagementAndGeneral

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)
Total759495Total
Management And General759495ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total8088344Total
Program Services52191ProgramServices
Management And General8036153ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2535940Total
Management And General2535940ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5095655Total
Program Services266880ProgramServices
Management And General4828775ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total436511Total
Management And General436511ManagementAndGeneral

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)
Total4647794Total
Program Services85526ProgramServices
Management And General4562268ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total299415Total
Management And General299415ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneral
EXPENSE ALLOCATION-39752303-39752303
COMMISSIONS AND BROKER FEES21773162177316
CONSULTING583346583346
INVESTMENT EXPENSE5279352793
BOARDS & ASSOCIATIONS322458322458

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1409413Total
Program Services36914ProgramServices
Management And General1372499ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total323216540Total
Program Services296697060ProgramServices
Management And General26519480ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY-10422950BOY
EOY648616EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY12954689BOY
EOY12866817EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1573563BOY
EOY1894593EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis49836979LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec28267741LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY15018069BOY
EOY21569238EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY23278306BOY
EOY20929551EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY80267376BOY
EOY85118886EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY8601274BOY
EOY188515EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY131270327BOY
EOY143216216EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY14165053BOY
EOY18120897EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY31551782BOY
EOY29676044EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY45716835BOY
EOY47796941EOY
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
EOY20747852EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY64775640BOY
EOY74641423EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY85553492BOY
EOY95419275EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY131270327BOY
EOY143216216EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses9865783ReconcilationRevenueExpenses
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

Land Land

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

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6350866OtherCostOrOtherBasis
Depreciation886475Depreciation
Book Value5464391BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis4672485OtherCostOrOtherBasis
Depreciation2280770Depreciation
Book Value2391715BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis32260369OtherCostOrOtherBasis
Depreciation19947395Depreciation
Book Value12312974BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5941068OtherCostOrOtherBasis
Depreciation5153101Depreciation
Book Value787967BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings21569238TotalOfBookValueLandBuildings
Financial DerivativesFinancialDerivatives
Closely Held Equity InterestsCloselyHeldEquityInterests

Other Securities OtherSecurities (3 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
HEALTH SERVICE GROUP73893946C
INVESTMENTS MARKET VALUE206439F
DEFERRED COMP. INVESTMENT11018501F
FieldValueIRS element (for citing)
Total Of Book Value Securities85118886TotalOfBookValueSecurities
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescriptionAmountAmount
ADVANCE DEPOSITS$2,719,622
ESTIMATED POLICY CLAIMS$130,950
PROVISION FOR REFUNDABLE REV$9,383,485
DEFERRED COMP RESERVE$11,018,501
CAPITAL LEASE OBLIGATIONS$3,511,034
UNEARNED PREMIUMS$36,741
CONTINGENCY RESERVE$256,711
IBNR$2,619,000
FieldValueIRS element (for citing)
Total Of Amounts29676044TotalOfAmounts

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, 2010 OR 2009.Explanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAddress Line2AddressUS/AddressLine2
DENTAL FOUNDATION of OREGON
PO Box 2448WILISONVILLEOR97070930818476501(c)(3)72717CHARITY
OHSU FOUNDATION
1121 SE SALMON STPORTLANDOR97205237083114501(c)(3)100500School of Dentistry Capital Campaign - New building fundSuite 100
PORTLAND STATE UNIVERSITY
2125 SW FOURTH AVEPORTLANDOR97201930619733501(c)(3)7500Bldg Renovation
The Oregon Community
1221 SW Yamhill 100PortlandOR97205237315673501(c)(3)50000Charity
Washington Oral Health
126 NW Canal STSeattleWA98107911869855501(c)(3)10000Charity

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 (15 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
14831840000983923376330221863
Thomas J Bikales
1260931500008812475150380
Robert G Gootee
6075503600001052378453440451766652
Susan Hansen
1552223000011506146381240212606
Jonathan L Jurevic
7923314750025518500000302251
Tracie Murphy
183455450004361265041460260780
Robin Richardson
184053350006264266571150253124
William Ten Pas
29879914750063233796386260838520
David Evans
13752635000740920032525200492
James Foley
206599350006264199654565272393
William Johnson
212565400006264206060279435
Steven Wynne
26214320000584900287992
Christopher Verbiest
133152350001003322205805201195
Mary Lou True
12928630000708521782450188603
CJ McLeod
1527681475003126522018278147471369812

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

Form990 Schedule L Part IV Form990ScheduleLPartIV (7 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
JAY C LAMB
DIRECTOR465855DENTAL SERVICE PROVIDERfalse
MICHAEL BIERMANN
DIRECTOR207804DENTAL SERVICE PROVIDERfalse
DAVID HOWERTON
DIRECTOR1498522DENTAL SERVICE PROVIDERfalse
MICHAEL MCKEEL
DIRECTOR199719DENTAL SERVICE PROVIDERfalse
PAT NEARING
DIRECTOR381761DENTAL SERVICE PROVIDERfalse
MARK JENSEN
DIRECTOR122524DENTAL SERVICE PROVIDERfalse
WAYNE BARICHELLO
DIRECTOR327034DENTAL SERVICE PROVIDERfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierExplanationExplanation
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.

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/BusinessNameLine1
DENTAL FOUNDATION OF OREGON
8699 SW SUN PLACEWILSONVILLEOR97070930818476ORAL HEALTHOR501(C)(3)11ANA
OREGON DENTAL ASSOCIATION
PO BOX 3710WILSONVILLEOR97070930243383DENTAL PROFESOR501(c)(6)N/ANA

Form990 Schedule R Part IV Form990ScheduleRPartIV (9 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 CompanyORNAC36932241138074351.00000
ODS Health Plan Inc
601 SW Second AvenuePortlandOR97204930989307InsuranceORHSG IncC42071882441367451.00000
Dentists Benefits Insurance Company
601 SW Second AvenuePortlandOR97204930890424InsuranceORODS Health PlanC46956165085891.00000
Benefithelp Solutions Inc
601 SW Second AvenuePortlandOR97204931135521Admin. ServicesORODS Health PlanC-22543355525701.00000
ODS Community Health Inc
601 SW Second AvenuePortlandOR97204450528457Medicaid InsORODS Health PlanC1382283376331.00000
Dentists Benefit Corporation
601 SW Second AvenuePortlandOR97204930787508Market Liab. Ins.ORHSG IncC-3462713960381.00000
Dentists Management Corporation
601 SW Second AvenuePortlandOR97204930792340Dev & Mkt Mgmt SyORHSG IncC-13305611267631.00000
ODS Plaza Inc
601 SW Second AvenuePortlandOR97204830453200R. Estate Hold CoORODS HEALTH PLANC-6177076092161.00000
Northwest Dentists Insurance Company
601 SW Second AvenuePortlandOR97204911444206Markets Liab. InsORHSG IncC-562652169698950.75000
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 InvolvedAmountInvolved
DENTAL FOUNDATION OF OREGON
B72717
DENTAL FOUNDATION OF OREGON
N73500
HEALTH SERVICES GROUP
M8338289
HEALTH SERVICES GROUP
N26321739
HEALTH SERVICES GROUP
P5092275