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DELTA PILOTS MEDICAL TRUST: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
DELTA PILOTS MEDICAL TRUST (EIN 36-6791917)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-11
IRS object ID
201131339349303968
Schema version
2009v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-11T16:32:38-07:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN366791917EIN

Name Name

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

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameRobert KightName
TitleVP - Comp, Benefits & ServicesTitle
Phone4047152400Phone
Date Signed2011-05-13DateSigned
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11030 Deltal BlvdAddressLine1
Address Line2Dept 216AddressLine2
CityAtlantaCity
StateGAState
ZIP Code30354ZIPCode
FieldValueIRS element (for citing)
Gross Receipts32149240GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.delta.comWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1984YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionDisburse payments on behalf of participants related to medical, dental, mental health and prescription drugs.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
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 Year22544978ProgramServiceRevenuePriorYear
Program Service Revenue CY20424485ProgramServiceRevenueCY
Investment Income Prior Year395444InvestmentIncomePriorYear
Investment Income Current Year53484InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year22940422TotalRevenuePriorYear
Total Revenue Current Year20477969TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year21922096BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY27777380BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1093276OtherExpensePriorYear
Other Expenses Current Year1558350OtherExpensesCurrentYear
Total Expenses Prior Year23015372TotalExpensesPriorYear
Total Expenses Current Year29335730TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-74950RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-8857761RevenuesLessExpensesCY
Total Assets BOY11889787TotalAssetsBOY
Total Assets EOY4353219TotalAssetsEOY
Total Liabilities BOY1935478TotalLiabilitiesBOY
Total Liabilities EOY3256671TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY9954309NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1096548NetAssetsOrFundBalancesEOY
Mission DescriptionDisburse payments on behalf of participants related to medical, dental, mental health and prescription drugs.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense29335730Expense
Grants0Grants
Revenue20477969Revenue
DescriptionHealth Insurance Programs: Medical, mental health, prescription drugs, and dental benefits paid to, or on behalf of participants under the Delta Pilots Medical Plan for the year ended June 30, 2009. The approximate number of participants in the plan as June 30, 2009 is 7,248. (0 members)Description
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense29335730TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy0ConflictOfInterestPolicy
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

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

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationInstitutional TrusteeInstitutionalTrustee
Robert L Kight
Chairman Admin Comm, Member Invest Comm1X000
Paul Jacobson
Chairman Invest Comm1X000
Christopher M Collins
Member Admin Comm1X000
Gregory s Tahvonen
Member Admin Comm1X000
Anthony Charaf
Member Invest Comm1X000
Sandy P Gordon
Member Invest Comm1X000
Gail Grimmet
Member Invest Comm1X000
Kiko Harvey
Member Invest Comm1X000
Nathaniel Pieper
Member Invest Comm1X000
Beverly Hord
Member Admin Subcomm1X000
JP Morgan Chase
Trustee11564400X
FieldValueIRS element (for citing)
Total Reportable Comp From Org15644TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants0GovernmentGrants
All Other Contributions0AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Employers Contribution900099712133171213310$0
Employees Contribution90009913303154133031540$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue20424485TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column164777TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$164,777ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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

Royalties Revenue RoyaltiesRevenue

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

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

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

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities11559978Securities
Other0Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities11671271Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-111293Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-111293TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$111,293ExclusionAmount
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column20477969TotalRevenueColumn
Related Or Exempt Function Income20424485RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$53,484ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total27777380Total
Program Services27777380ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1288684Total
Program Services1288684ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total19000Total
Program Services19000ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total250666Total
Program Services250666ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total29335730Total
Program Services29335730ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3276252BOY
EOY994306EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2155062BOY
EOY3358913EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis0LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec0LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
EOY0EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY6458473BOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY11889787BOY
EOY4353219EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY221635BOY
EOY328912EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1713843BOY
EOY2927759EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1935478BOY
EOY3256671EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY9954309BOY
EOY1096548EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9954309BOY
EOY1096548EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11889787BOY
EOY4353219EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Book Value0BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionBenefits Claims PayableDescription
Amount$2,927,759Amount
FieldValueIRS element (for citing)
Total Of Amounts2927759TotalOfAmounts
Total Revenue20477969TotalRevenue
Total Expenses29335730TotalExpenses
Excess Or Deficit For Year-8857761ExcessOrDeficitForYear
Net Unrealized GL On Investments0NetUnrealizedGLOnInvestments
Donated Services And Facilities0DonatedServicesAndFacilities
Investment Expenses0InvestmentExpenses
Prior Period Adjustments0PriorPeriodAdjustments
Other$0OtherAmount
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS-8857761ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt20477969TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments0NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues0OtherRevenues
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal20477969RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99020477969TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt29335730TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal29335730ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99029335730TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierSchD_P10_S00_L00Identifier
Return ReferenceSchedule D, Part XReturnReference
ExplanationThe Other Liability noted here encompasses the benefit claims payable, which is made up of the IBNR and Insurance Premiums Payable. Effective July, 2009, the Plan recognizes the tax benefit from an uncertain tax position only if it's more likely than not that the tax position will be sustained upon examination by the taxing authority, based on the technical merits of the position. The Plan is exempt from federal and state income taxes under Section 401(a) of the Internal Revenue Code. Tax years that remain subject to examination by major tax jurisdictions date back to the year ending June 30, 2007. All federal and state income tax positions taken or anticipated to be taken in the income tax returns are attributable to the plan sponsor and not to the Plan. As of June 30, 2010, there are no known items which would result in a material accrual related to where the Plan has federal or state attributable tax positions.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0B_L11Form 990, Part VI, Section B, Line 11The Form 990 is completed each year by Delta air Lines, Inc's Corporate Benefits Department. An Analyst enters all information and gathers the necessary files and schedules for support. The return goes through two levels of managerial review; and then the return is reviewed with the Principal Officer prior to signing the return.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19The financial statements of the Delta Pilots Medical Trust are made available to the public upon request.