DELTA DENTAL PLAN OF NEW MEXICO INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- DELTA DENTAL PLAN OF NEW MEXICO INC (EIN 85-0224562)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-13
- IRS object ID
- 201903179349305990
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-11-13T14:09:59-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 MICHIGAN AVE STE 100 | AddressLine1Txt |
| City | EAST LANSING | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48823 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 850224562 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL PLAN OF NEW MEXICO INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DELT | BusinessNameControlTxt |
| Phone | 5058557114 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2500 LOUISIANA BLVD NE NO 600 | AddressLine1Txt |
| City | ALBUQUERQUE | CityNm |
| State Abbreviation | NM | StateAbbreviationCd |
| ZIP | 87110 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AMY BASEL | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 5058557114 | PhoneNum |
| Signature | 2019-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID LOWENTHAL CPA | PreparerPersonNm |
| PTIN | P00378651 | PTIN |
| Phone | 5173326200 | PhoneNum |
| Preparation | 2019-11-07 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 68.62.32.134 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-11 | IPDt |
| IP Tm | 08:19:25 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | AFBDF4DF54CCD05CFBA4AEDC275F7F3808ECB98B | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LOUIS VOLK III | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2500 LOUISIANA BLVD NE NO 600 | AddressLine1Txt |
| City | ALBUQUERQUE | CityNm |
| State Abbreviation | NM | StateAbbreviationCd |
| ZIP | 87110 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $126,130,184 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | HTTP://WWW.DELTADENTALNM.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1971 | FormationYr |
| Legal Domicile State | NM | LegalDomicileStateCd |
| Activity Or Mission | DELTA DENTAL OF NEW MEXICO'S MISSION IS TO ADVANCE AND PROMOTE THE IMPROVEMENT OF ORAL HEALTH THROUGH DENTAL SERVICES, SUPPORT FOR RESEARCH AND EDUCATION, AND COMMUNITY OUTREACH DIRECTED TOWARD SECURING ACCESS TO QUALITY DENTAL CARE FOR ALL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 44 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $110,955,061 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $114,428,173 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,283,111 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,440,950 | CYInvestmentIncomeAmt |
| PY Other Revenue | $25,655 | PYOtherRevenueAmt |
| CY Other Revenue | $25,539 | CYOtherRevenueAmt |
| PY Total Revenue | $112,263,827 | PYTotalRevenueAmt |
| CY Total Revenue | $115,894,662 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $113,727 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $374,993 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,006,550 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,734,940 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $105,351,067 | PYOtherExpensesAmt |
| CY Other Expenses | $108,305,923 | CYOtherExpensesAmt |
| PY Total Expenses | $108,471,344 | PYTotalExpensesAmt |
| CY Total Expenses | $112,415,856 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,792,483 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,478,806 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $54,172,245 | TotalAssetsBOYAmt |
| Total Assets EOY | $56,147,641 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,058,416 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,596,367 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $48,113,829 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $49,551,274 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | DELTA DENTAL OF NEW MEXICO'S MISSION IS TO ADVANCE AND PROMOTE THE IMPROVEMENT OF ORAL HEALTH THROUGH DENTAL SERVICES, SUPPORT FOR RESEARCH AND EDUCATION, AND COMMUNITY OUTREACH DIRECTED TOWARD SECURING ACCESS TO QUALITY DENTAL CARE FOR ALL. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $110,144,029 | ExpenseAmt |
| Grant | $374,993 | GrantAmt |
| Revenue | $114,453,712 | RevenueAmt |
| Desc | PROMOTING DENTAL CAREDELTA DENTAL PLAN OF NEW MEXICO, INC. IS A LEADING DENTAL BENEFITS PROVIDER. THE PURPOSE OF THE ORGANIZATION IS TO ADVANCE AND PROMOTE THE IMPROVEMENT OF ORAL HEALTH. THIS IS DONE BY OFFERING INNOVATIVE, COST-EFFECTIVE PRODUCTS THAT MEET THE NEEDS OF CUSTOMERS. THIS WAS DEMONSTRATED IN 2018 BY PAYING OUT OVER $100 MILLION IN CLAIMS AND BY PROVIDING DENTAL BENEFITS FOR THE PUBLIC AND ADVANCING THE SCIENCE OF DENTISTRY. IN ADDITION, OVER 630,000 CLAIMS WERE PROCESSED FOR OVER 328,000 MEMBERS.SEE SCHEDULE O FOR CONTINUATIONCOST SAVING STRATEGIESDELTA DENTAL BENEFIT PLANS ARE COMMITTED TO SAVING GROUPS AND MEMBERS MONEY. THE DELTA DIFFERENCE IS AN INTEGRATION OF ACTIVITIES SUCH AS COST MANAGEMENT POLICIES, FEE REDUCTION AGREEMENTS WITH DENTISTS, AND ANTI-FRAUD PROGRAMS, ALL OF WHICH ENSURE QUALITY, COST-EFFECTIVE DENTAL BENEFIT DELIVERY. DELTA DENTAL'S INDUSTRY LEADING TECHNOLOGY PLATFORM, ENTERPRISE TECHNOLOGY SYSTEM, ETS, PROVIDES FAST, FLEXIBLE SERVICE, INCLUDING ONLINE, REAL-TIME CLAIMS PROCESSING. THE NEXT GENERATION OF ETS, ROOSEVELT, WILL MAINTAIN ALL OF THE ETS FUNCTIONALITY, WHILE ADDING NEW TOOLS AND FEATURES TO IMPROVE MARKET COMPETITIVENESS. THE COMPANY'S PRIORITY IS TO REDUCE COSTS AND IMPROVE SERVICE BY INCREASING THE VOLUME OF CLAIMS THAT ARE SUBMITTED ELECTRONICALLY.QUALITY SERVICE IS ALSO MEASURED THROUGH INTERNAL AUDITS. RESULTS INDICATE OVER 99 PERCENT OF CLAIMS ARE PROCESSED ACCURATELY WITHIN 10 WORKING DAYS.FOR OVER FIVE DECADES, DELTA DENTAL HAS HELPED PROMOTE ORAL HEALTH BY DESIGNING AND ADMINISTERING INNOVATIVE, COST-EFFECTIVE DENTAL BENEFIT PROGRAMS. EXPERTS AT PLAN DESIGN, DELTA DENTAL HAS CREATED DENTAL BENEFIT PROGRAMS THAT MEET CUSTOMER COST-OBJECTIVES WHILE HELPING TO IMPROVE AND MAINTAIN ORAL HEALTH.DELTA DENTAL'S GROUP MEMBERS ARE AFFORDED ADDED PROTECTION BECAUSE PARTICIPATING DENTISTS ACCEPT DELTA DENTAL'S PAYMENT FOR COVERED SERVICES AND NO CHARGE, OTHER THAN CO-PAYMENTS AND DEDUCTIBLES ARE BILLED BACK TO THE MEMBER. THIS LOWERS CLAIM COSTS FOR CUSTOMERS AND REDUCES OUT-OF-POCKET EXPENSES FOR MEMBERS. WITH TWO NETWORKS OF FULL-TIME PARTICIPATING DENTISTS IN ONE INTERGRATED CLAIMS SYSTEM, DELTA DENTAL CAN DELIVER TO CUSTOMERS AND GROUP MEMBERS BROAD ACCESS TO CARE. | Desc |
| Total Program Service Expenses | $110,144,029 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 4880 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 44 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AMY BASEL CFO | PersonNm |
| Phone | 5173496000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4100 OKEMOS ROAD | AddressLine1Txt |
| City | OKEMOS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48864 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| EDWARD J LOPEZ JR | |||||||||
| PRESIDENT & CEO THRU 12/18 | 50.00 | 0.00 | Yes (X) | Yes (X) | $336,382 | $0 | $39,137 | ||
| STEPHEN B CHREIST | |||||||||
| IMMEDIATE PAST CHAIRPERSON | 5.00 | 5.00 | Yes (X) | Yes (X) | $12,700 | $28,960 | $0 | ||
| ROBERT L SIMMONS | |||||||||
| CHAIRPERSON | 5.00 | 0.00 | Yes (X) | Yes (X) | $21,458 | $0 | $0 | ||
| JAMES TRUJILLO | |||||||||
| VICE CHAIRPERSON | 5.00 | 0.00 | Yes (X) | Yes (X) | $12,794 | $0 | $0 | ||
| THOMAS J FLESZAR DDS MS | |||||||||
| INTERIM PRESIDENT & CEO | 5.00 | 12.00 | Yes (X) | $7,500 | $94,750 | $0 | |||
| MICHAEL BLOMKER | |||||||||
| SECRETARY/TREASURER THRU 10/18 | 5.00 | 0.00 | Yes (X) | $8,200 | $0 | $0 | |||
| RALPH MCELMURRY DDS | |||||||||
| DIRECTOR | 5.00 | 0.00 | Yes (X) | $8,799 | $0 | $0 | |||
| CHRISTINE N NATHE RDH MS | |||||||||
| DIRECTOR | 5.00 | 0.00 | Yes (X) | $9,019 | $0 | $0 | |||
| LOUIS VOLK III | |||||||||
| DIRECTOR | 5.00 | 0.00 | Yes (X) | $7,500 | $0 | $0 | |||
| DAVID JAMES MARTINEZ DDS | |||||||||
| DIRECTOR | 5.00 | 0.00 | Yes (X) | $7,500 | $0 | $0 | |||
| GORAN JURKOVIC CPA | |||||||||
| CFO THRU 4/18 | 1.00 | 49.00 | Yes (X) | $0 | $2,411,710 | $1,927,286 | |||
| AMY BASEL | |||||||||
| CFO | 1.00 | 49.00 | Yes (X) | $0 | $814,278 | $1,570,964 | |||
| SUE ELLEN JENKINS | |||||||||
| VP- LEGAL COUNSEL | 1.00 | 49.00 | Yes (X) | $0 | $319,432 | $40,233 | |||
| CYNTHIA LUCERO-ALI | |||||||||
| DIRECTOR, OPERATIONS | 50.00 | 0.00 | $102,971 | $0 | $23,227 | Yes (X) | |||
| JOLOU TRUJILLO-OTTINO | |||||||||
| VP SALES AND MARKETING | 50.00 | 0.00 | $157,142 | $0 | $36,200 | Yes (X) | |||
| JONATHAN S GROAT | |||||||||
| FORMER VP GENERAL COUNSEL | 0.00 | 0.00 | $0 | $227,358 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $691,965 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,896,488 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $3,637,047 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HUB INTERNATIONAL INSURANCE SERVICE | |||||
| 9990 JEFFERSON NE SUITE 101 | ALBUQUERQUE | NM | 87190 | COMMISSIONS | $345,614 |
| DEWPOINT | |||||
| 300 WASHINGTON SQUARE | LANSING | MI | 48933 | IT CONSULTING | $287,860 |
| MONTGOMERY & ANDREWS PA | |||||
| PO BOX 2307 | SANTA FE | NM | 87504 | LEGAL SERVICES | $196,378 |
| AON RISK INSURANCE SERVICES WEST | |||||
| 6501 AMERICAS PARKWAY NE | ALBUQUERQUE | NM | 87110 | COMMISSIONS | $102,469 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DENTAL CARE REVENUE | Desc |
| Business | 524114 | BusinessCd |
| Total Revenue Column | $114,428,173 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $114,428,173 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $114,428,173 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,357,509 | TotalRevenueColumnAmt |
| Exclusion | $1,357,509 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $10,318,963 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $10,235,522 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $83,441 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $83,441 | TotalRevenueColumnAmt |
| Exclusion | $83,441 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DISCOUNT CARD INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $25,539 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $25,539 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $25,539 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $115,894,662 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $114,453,712 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,440,950 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $374,993 | TotalAmt |
| Program Services | $374,993 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $504,121 | TotalAmt |
| Program Services | $327,679 | ProgramServicesAmt |
| Management And General | $176,442 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,568,122 | TotalAmt |
| Program Services | $1,794,269 | ProgramServicesAmt |
| Management And General | $773,853 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,334 | TotalAmt |
| Program Services | $143,168 | ProgramServicesAmt |
| Management And General | $3,166 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $348,714 | TotalAmt |
| Program Services | $318,260 | ProgramServicesAmt |
| Management And General | $30,454 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,649 | TotalAmt |
| Program Services | $146,892 | ProgramServicesAmt |
| Management And General | $20,757 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,438 | TotalAmt |
| Management And General | $146,438 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,752 | TotalAmt |
| Management And General | $57,752 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,607 | TotalAmt |
| Management And General | $72,607 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,720,598 | TotalAmt |
| Program Services | $101,460,283 | ProgramServicesAmt |
| Management And General | $260,315 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,828 | TotalAmt |
| Program Services | $166,612 | ProgramServicesAmt |
| Management And General | $216 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $559,614 | TotalAmt |
| Program Services | $482,468 | ProgramServicesAmt |
| Management And General | $77,146 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $317,722 | TotalAmt |
| Program Services | $255,675 | ProgramServicesAmt |
| Management And General | $62,047 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $211,145 | TotalAmt |
| Program Services | $137,244 | ProgramServicesAmt |
| Management And General | $73,901 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $301,710 | TotalAmt |
| Program Services | $212,558 | ProgramServicesAmt |
| Management And General | $89,152 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,005 | TotalAmt |
| Program Services | $47,363 | ProgramServicesAmt |
| Management And General | $5,642 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,630 | TotalAmt |
| Program Services | $40,027 | ProgramServicesAmt |
| Management And General | $19,603 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,117 | TotalAmt |
| Management And General | $41,117 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| COMMISSIONS | $1,858,389 | $1,858,389 | |
| PROCESSING FEES | $1,356,858 | $1,356,858 | |
| PREMIUM TAXES | $840,568 | $840,568 | |
| MEMBERSHIP DUES & ASSOC | $296,738 | $37,526 | $259,212 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,204 | TotalAmt |
| Program Services | $143,197 | ProgramServicesAmt |
| Management And General | $102,007 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,415,856 | TotalAmt |
| Program Services | $110,144,029 | ProgramServicesAmt |
| Management And General | $2,271,827 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,077,442 | BOYAmt |
| EOY | $2,500,802 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,774,165 | BOYAmt |
| EOY | $2,747,502 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,193,092 | BOYAmt |
| EOY | $4,811,179 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $170,728 | BOYAmt |
| EOY | $113,305 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,443,335 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,216,701 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,749 | BOYAmt |
| EOY | $226,634 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,270,885 | BOYAmt |
| EOY | $39,362,696 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,410,808 | BOYAmt |
| EOY | $5,059,878 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,129,376 | BOYAmt |
| EOY | $1,325,645 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,172,245 | BOYAmt |
| EOY | $56,147,641 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,590,740 | BOYAmt |
| EOY | $1,933,806 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $792,383 | BOYAmt |
| EOY | $1,259,779 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,675,293 | BOYAmt |
| EOY | $3,402,782 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,058,416 | BOYAmt |
| EOY | $6,596,367 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,113,829 | BOYAmt |
| EOY | $49,551,274 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,113,829 | BOYAmt |
| EOY | $49,551,274 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,172,245 | BOYAmt |
| EOY | $56,147,641 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,478,806 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,906,482 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$134,879 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $149,500 | OtherCostOrOtherBasisAmt |
| Depreciation | $138,822 | DepreciationAmt |
| Book Value | $10,678 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,246,210 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,046,264 | DepreciationAmt |
| Book Value | $199,946 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $47,625 | OtherCostOrOtherBasisAmt |
| Depreciation | $31,615 | DepreciationAmt |
| Book Value | $16,010 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $226,634 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $4,959,878 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SURPLUS NOTE RECEIVABLE | Desc |
| Book Value | $100,000 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $5,059,878 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| CLAIMS RESERVES | $2,916,000 |
| DUE TO AFFILIATE | $486,782 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,402,782 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $115,848,027 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $115,848,027 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $46,635 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $46,635 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $115,894,662 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $112,369,221 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $112,369,221 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $46,635 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $46,635 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $112,415,856 | TotalExpensesPerForm990Amt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc |
|---|---|---|---|---|---|---|---|---|---|---|
| SPECIAL OLYMPICS NEW MEXICO INC | ||||||||||
| 6600 PALOMAS NE | ALBUQUERQUE | NM | 87109 | 850268084 | 501(C)(3) | $20,000 | CHARITABLE DONATION | |||
| AMERICAN HEART ASSOCIATION | ||||||||||
| 727 GREENVILLE AVE | DALLAS | TX | 75231 | 135613797 | 501(C)(3) | $70,000 | CHARITABLE DONATION | |||
| NEW MEXICO DENTAL FOUNDATION | ||||||||||
| 9201 MONTGOMERY BLVD NE | ALBUQUERQUE | NM | 87111 | 743146433 | 501(C)(3) | $20,000 | CHARITABLE DONATION | |||
| ALBUQUERQUE HEALTH CARE FOR THE HOMELESS | ||||||||||
| PO BOX 25445 | ALBUQUERQUE | NM | 87125 | 850368993 | 501(C)(3) | $25,000 | CHARITABLE DONATION | |||
| UNIVERSITY OF NEW MEXICO FOUNDATION INC | ||||||||||
| TWO WOODWARD CENTER | ALBUQUERQUE | NM | 87102 | 850275408 | 501(C)(3) | $72,500 | CHARITABLE DONATION | |||
| CENTRAL NEW MEXICO COMMUNITY COLLEGE FOUNDATION | ||||||||||
| 525 BUENA VISTA SE | ALBUQUERQUE | NM | 87106 | 850338623 | 501(C)(3) | $25,000 | STUDENT SUPPORT | |||
| NATIONAL HISPANIC CULTURAL CENTER FOUNDATION | ||||||||||
| 1701 4TH STREET SW | ALBUQUERQUE | NM | 87102 | 850335056 | 501(C)(3) | $32,500 | CHARITABLE DONATION | |||
| NEW MEXICO STATE UNIVERSITY FOUNDATION | ||||||||||
| PO BOX 3590 | LAS CRUCES | NM | 88003 | 850170157 | 501(C)(3) | $40,000 | CHARITABLE DONATION & DENTAL HYGIENE PROGRAM | |||
| RMA KIDNEY FOUNDATION | ||||||||||
| PO BOX 92373 | ALBUQUERQUE | NM | 87199 | 475504391 | 501(C)(3) | $10,000 | CHARITABLE DONATION | |||
| ALBUQUERQUE PUBLIC SCHOOLS | ||||||||||
| 6400 UPTOWN BLVD NE | ALBUQUERQUE | NM | 87110 | GOVT | FOOD PROVIDED TO 6000 SCHOOL CHILDREN TO TAKE HOME ON THE WEEKEND, WHEN THEY MAY NOT HAVE ENOUGH TO EAT. | $47,120 | FMV | FOOD | ||
| CITY OF ALBUQUERQUE | ||||||||||
| 1 CIVIC PLAZA | ALBUQUERQUE | NM | 87123 | GOVT | CHARITABLE DONATION - TO ENCOURAGE DRINKING WATER OVER SUGARY BEVERAGES. | $12,873 | FMV | 10 WATER REFILLING FOUNTATIONS | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 11 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | CONTRIBUTIONS ARE MADE AT THE ORGANIZATION'S DISCRETION TO ORGANIZATIONS THAT SUPPORT DELTA DENTAL PLAN OF NEW MEXICO'S MISSION. IN ORDER FOR FUNDS TO BE DISBURSED, VOUCHER RECORDS MUST PASS THROUGH THE APPROVAL PROCESS, SIMILAR TO ANY OTHER EXPENDITURE MADE BY DELTA DENTAL PLAN OF NEW MEXICO. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EDWARD J LOPEZ JR | ||||||||||||||
| PRESIDENT & CEO THRU 12/18 | $246,018 | $0 | $80,000 | $0 | $10,364 | $0 | $20,721 | $0 | $18,416 | $0 | $375,519 | $0 | $0 | $0 |
| GORAN JURKOVIC CPA | ||||||||||||||
| CFO THRU 4/18 | $0 | $1,045,371 | $0 | $1,343,351 | $0 | $22,988 | $0 | $1,903,103 | $0 | $24,183 | $0 | $4,338,996 | $0 | $0 |
| AMY BASEL | ||||||||||||||
| CFO | $0 | $377,235 | $0 | $424,821 | $0 | $12,222 | $0 | $1,546,781 | $0 | $24,183 | $0 | $2,385,242 | $0 | $0 |
| SUE ELLEN JENKINS | ||||||||||||||
| VP- LEGAL COUNSEL | $0 | $258,640 | $0 | $60,000 | $0 | $792 | $0 | $28,736 | $0 | $11,497 | $0 | $359,665 | $0 | $0 |
| JOLOU TRUJILLO-OTTINO | ||||||||||||||
| VP SALES AND MARKETING | $129,395 | $0 | $26,107 | $0 | $1,640 | $0 | $15,985 | $0 | $20,215 | $0 | $193,342 | $0 | $0 | $0 |
| JONATHAN S GROAT | ||||||||||||||
| FORMER VP GENERAL COUNSEL | $0 | $0 | $0 | $0 | $0 | $227,358 | $0 | $0 | $0 | $0 | $0 | $227,358 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | TRAVEL FOR COMPANIONS RELATED TO TRAVEL FOR A SPOUSE. THIS AMOUNT WAS TREATED AS TAXABLE TO THE BOARD MEMBER OR EMPLOYEE. |
| PART I, LINES 4A-B | A RELATED ORGANIZATION, DELTA DENTAL PLAN OF MICHIGAN, HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). IN ORDER TO BE ELIGIBLE FOR THE SERP, AN EMPLOYEE MUST BE A SENIOR VICE PRESIDENT OR HIGHER AND ADDED TO THE PLAN BY THE BOARD OF DIRECTORS. THE SERP BENEFITS ARE REVIEWED AS PART OF THE TOTAL COMPENSATION BY AN INDEPENDENT CONSULTANT; TOWERS WATSON. IN 2018, GORAN JURKOVIC AND AMY BASEL ACCRUED BENEFITS AS PARTICIPANTS IN THE SERP PLAN, BUT DID NOT RECEIVE A DISTRIBUTION. IN 2018, JON GROAT RECEIVED A SEVERANCE PAYMENT OF $227,358 FROM A RELATED ORGANIZATION. |
| PART I, LINE 7 | AS INDICATED IN SCHEDULE J, PART II, TOP MANAGEMENT OFFICIALS RECEIVED A BONUS BASED ON PERFORMANCE AND THE FINANCIAL RESULTS OF THE ORGANIZATION. THIS BONUS WAS APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID J MARTINEZ DDS | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | DAVID MARTINEZ IS A DIRECTOR ON THE DDNM BOARD OF DIRECTORS | RelationshipDescriptionTxt |
| Transaction | $695,846 | TransactionAmt |
| Transaction | PAYMENTS FOR DENTAL SERVICES. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | DELTA DENTAL PLAN OF NEW MEXICO, INC. HAS A SOLE MEMBER, RENAISSANCE HEALTH SERVICE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | BOARD MEMBERS ARE ELECTED BY THE PRESENT BOARD AND ARE APPROVED BY RENAISSANCE HEALTH SERVICE CORPORATION, THE SOLE CORPORATE MEMBER OF DELTA DENTAL PLAN OF NEW MEXICO, INC. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE MEMBER HAS THE RIGHTS THAT ARE PRESCRIBED BY LAW, FOR MEMBERS OF NON-PROFIT CORPORATIONS, INCLUDING THE APPROVAL OF SIGNIFICANT EXPENDITURES AND CEO APPOINTMENT. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE INFORMATION PRESENTED ON THE FORM 990 IS GATHERED BY THE SENIOR TAX ADMINISTRATOR FOR THE ORGANIZATION. THE CFO REVIEWS THE INFORMATION. ONCE APPROVED THE INFORMATION IS GIVEN TO OUTSIDE TAX PREPARERS WHO PREPARE AND REVIEW THE FORM 990. ONCE COMPLETE, AN ELECTRONIC COPY OF THE FORM 990 IS PLACED IN A SECURE PORTAL FOR THE BOARD TO REVIEW, PRIOR TO FILING THE 990 WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ENTERPRISE'S VICE PRESIDENT, GENERAL COUNSEL AND COMPLIANCE OFFICER IS CHARGED WITH REVIEWING AND MONITORING ANY POTENTIAL CONFLICT OF INTEREST TRANSACTIONS. ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO REVIEW AND EXECUTE A CONFLICT OF INTEREST POLICY. THIS POLICY REQUIRES THAT ANY CONFLICTS OF INTEREST BE DISCLOSED ON AN ANNUAL BASIS, OR AT ANY OTHER TIME THAT THE PERSON EXECUTING THE POLICY BECOMES AWARE OF A SITUATION OR TRANSACTION THAT ACTUALLY OR POTENTIALLY CREATES A CONFLICT OF INTEREST. ALL CONFLICT OF INTEREST DISCLOSURE FORMS ARE INITIALLY REVIEWED BY THE VICE PRESIDENT, GENERAL COUNSEL AND COMPLIANCE OFFICER. IF A PROHIBITED TRANSACTION IS IDENTIFIED, THE MATTER IS ESCALATED TO THE CEO AND TO THE AUDIT, FINANCE AND RISK MANAGEMENT COMMITTEE OF THE BOARD OF DIRECTORS FOR FURTHER REVIEW AND APPROPRIATE ACTION. IN THE EVENT OF A CONFLICT OF INTEREST INVOLVING A MEMBER OF THE BOARD OF DIRECTORS, SUCH AS A VOTE, IN WHICH A MEMBER HAS AN INTEREST, THE MEMBER IS REQUIRED TO DISCLOSE THE POTENTIAL CONFLICT AND ABSTAIN FROM ANY VOTE ON THE MATTER. WHETHER FURTHER PRECAUTIONS ARE REQUIRED (E.G., PROHIBITING THE INTERESTED PARTY FROM ENGAGING IN DISCUSSIONS) WOULD DEPEND UPON THE SPECIFIC NATURE AND BACKGROUND OF THE CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | CEO COMPENSATION IS SET BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. MARKET DATA PROVIDED BY OUTSIDE CONSULTANTS, TOWERS WATSON, IS USED TO VALIDATE THE REASONABLENESS OF THE TOTAL COMPENSATION PACKAGE. COMPENSATION FOR CERTAIN OFFICERS, INCLUDING THE CFO AND GENREAL COUNSEL IS DETERMINED AND PAID THROUGH A RELATED ORGANIZATION, DELTA DENTAL PLAN OF MICHIGAN, INC. |
| FORM 990, PART VI, SECTION C, LINE 19 | DELTA DENTAL PLAN OF NEW MEXICO, INC. (DDNM) FILES ON A QUARTERLY AND ANNUAL BASIS COMPREHENSIVE FINANCIAL DOCUMENTS WITH THE NEW MEXICO OFFICE OF INSURANCE SUPERINTENDENT (OSI). OSI AND THE NEW MEXICO SECRETARY OF STATE HAVE ON FILE ALL GOVERNING DOCUMENTS. THE DDNM'S 990 FORM IS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VII | CERTAIN EMPLOYEES ARE OFFICERS OF MULTIPLE COMPANIES WITHIN THE LARGER ORGANIZATION. THE AVERAGE HOURS WORKED REFLECTS APPROXIMATE TIME SPENT IN EACH OF THOSE INDIVIDUAL COMPANIES. WHILE THE HOURS ARE ALLOCATED TO INDIVIDUAL COMPANIES, MUCH OF THE OFFICERS' TIME IS SPENT WORKING ON ISSUES THAT IMPACT THE ENTIRE ORGANIZATION, NOT JUST ONE COMPANY. COMPENSATION IS REPORTED IN FULL TO AGREE TO THE EMPLOYEE'S W-2 AS REQUIRED BY IRS INSTRUCTIONS. ANY ALLOCATION OF COMPENSATION IS INCLUDED ON SCHEDULE R. |
| FORM 990, PART IX, LINE 11G | CONTRACT LABOR: PROGRAM SERVICE EXPENSES 545,426. MANAGEMENT AND GENERAL EXPENSES 260,315. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 805,741. PURCHASED DENTAL SERVICES: PROGRAM SERVICE EXPENSES 100,914,857. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 100,914,857. |
| FORM 990, PART XI, LINE 9: | LOSS ON INVESTMENT IN RENAISSANCE HOLDING COMPANY -134,879. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| RENAISSANCE HEALTH SERVICE CORPORATION | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 381675667 | PROMOTING DENTAL CARE | MI | 501(C)(4) | N/A | N/A | 0 | |
| DELTA DENTAL PLAN OF MICHIGAN INC | |||||||||||
| 4100 OKEMOS ROAD | OKEMOS | MI | 48864 | 381791480 | PROVIDE DENTAL SERVICE PLANS | MI | 501(C)(4) | N/A | 0 | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL PLAN OF INDIANA INC | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 351545647 | PROVIDE DENTAL SERVICE PLANS | IN | 501(C)(4) | N/A | 0 | DELTA DENTAL PLAN OF MICHIGAN INC | |
| DELTA DENTAL PLAN OF OHIO INC | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 310685339 | PROVIDE DENTAL SERVICE PLANS | OH | 501(C)(4) | N/A | 0 | DELTA DENTAL PLAN OF MICHIGAN INC | |
| DELTA DENTAL OF TENNESSEE INC | |||||||||||
| 240 VENTURE CIRCLE | NASHVILLE | TN | 37228 | 620812197 | PROVIDE DENTAL SERVICE PLANS | TN | 501(C)(4) | N/A | 0 | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL OF KENTUCKY INC | |||||||||||
| 10100 LINN STATION ROAD NO 700 | LOUISVILLE | KY | 40223 | 610659432 | PROVIDE DENTAL SERVICE PLANS | KY | 501(C)(4) | N/A | 0 | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL FUND | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 382337000 | SUPPORT DENTAL EDUCATION AND RESEARCH PROGRAMS | MI | 501(C)(3) | LINE 12B, II | 0 | DELTA DENTAL PLAN OF MICHIGAN INC | |
| DELTA DENTAL OF NORTH CAROLINA | |||||||||||
| 4242 SIX FORKS ROAD | RALEIGH | NC | 27609 | 561018068 | PROVIDE DENTAL SERVICE PLANS | NC | 501(C)(4) | N/A | 0 | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL PLAN OF ARKANSAS INC | |||||||||||
| 1513 COUNTRY CLUB RD | SHERWOOD | AR | 72120 | 710561140 | PROVIDE DENTAL SERVICE PLANS | AR | 501(C)(4) | N/A | 0 | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL OF ARKANSAS FOUNDATION INC | |||||||||||
| 1513 COUNTRY CLUB RD | SHERWOOD | AR | 72120 | 261569324 | EMPHASIZE DENTAL HEALTH IN COMMUNITIES | AR | 501(C)(3) | PF | 0 | DELTA DENTAL OF ARKANSAS | |
| RENAISSANCE FAMILY FOUNDATION INC | |||||||||||
| 4100 OKEMOS ROAD | OKEMOS | MI | 48864 | 461376165 | EMPHASIZE DENTAL HEALTH IN COMMUNITIES | IN | 501(C)(3) | PF | 0 | RENAISSANCE HOLDING COMPANY | |
| SMILE 180 FOUNDATION | |||||||||||
| 240 VENTURE CIRCLE | NASHVILLE | TN | 37228 | 471654054 | EMPHASIZE DENTAL HEALTH IN COMMUNITIES | TN | 501(C)(3) | LINE 12A, I | 0 | DELTA DENTAL OF TENNESSEE INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHESME LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 124 N BRIDGE ST | AddressLine1Txt |
| City | DEWITT | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48820 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200061957 | EIN |
| Primary Activities | CAPITAL MANAGEMENT | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RENAISSANCE HOLDING COMPANY | |||||||||||||
| PO BOX 30381 | LANSING | MI | 48909 | 412177193 | HOLDING COMPANY | MI | DELTA DENTAL OF MICHIGAN | C | $47,184 | $2,115,452 | 0.04000 | 0 | |
| RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | |||||||||||||
| PO BOX 30381 | LANSING | MI | 48909 | 470397286 | INSURANCE | IN | RENAISSANCE HOLDING COMPANY | C | $303,417 | $4,153,580 | 0.04000 | 0 | |
| RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF NEW YORK | |||||||||||||
| PO BOX 30381 | LANSING | MI | 48909 | 134098096 | INSURANCE | NY | RENAISSANCE HOLDING COMPANY | C | $21,487 | $439,893 | 0.04000 | 0 | |
| FORE HOLDING CORPORATION | |||||||||||||
| 240 VENTURE CIRCLE | NASHVILLE | TN | 37228 | 204116122 | HOLDING COMPANY | TN | C | 0 | N/A | ||||
| DENTAL CHOICE INC | |||||||||||||
| 10100 LINN STATION RD 700 | LOUISVILLE | KY | 402233861 | 611105118 | PROVIDE DENTAL SERVICE PLANS | KY | C | 0 | N/A | ||||
| DENTAL CHOICE AGENCY INC | |||||||||||||
| 10100 LINN STATION RD 700 | LOUISVILLE | KY | 402233861 | 611336003 | PRIMARY GENERAL AGENCY FOR DDKY AND DENTAL CHOICE | KY | C | 0 | N/A | ||||
| OMEGA ADMINISTRATORS INC | |||||||||||||
| 1513 COUNTRY CLUB ROAD | SHERWOOD | AR | 72120 | 043740469 | PROVIDING THIRD-PARTY ADMINISTRATIVE SERVICES | AR | C | 0 | N/A | ||||
| THE 4100 GROUP | |||||||||||||
| 4100 OKEMOS ROAD | OKEMOS | MI | 48864 | 472557772 | INVESTMENT IN SUBSIDIARIES | MI | C | 0 | N/A | ||||
| DEWPOINT INC | |||||||||||||
| 300 S WASHINGTON SQUARE | LANSING | MI | 48933 | 383300595 | IT CONSULTING | MI | C | 0 | N/A | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| DELTA DENTAL PLAN OF MICHIGAN INC | ||
| M | $1,592,293 | ACTUAL COST |
| DELTA DENTAL OF NORTH CAROLINA | ||
| D | $100,000 | ACTUAL COST |
| DELTA DENTAL OF NORTH CAROLINA | ||
| A | $31,556 | ACTUAL COST |
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