2025-11-07T14:45:43-06:00 2024-12-31 135565207 KPMG LLP 401 UNION STREET SUITE 2800 SEATTLE WA 98101 990 2024-01-01 910621480 DELTA DENTAL OF WASHINGTON DELT 2065221300 400 FAIRVIEW AVE N SUITE 800 SEATTLE WA 98109 RYAN BARTLETT VICE PRESIDENT OF FINANCE & CFO 2065221300 2025-11-07 1 0 KATHRYN J OKIMOTO P00746598 2069134000 2025-10-27 2024 2025-03-06 01:10:19Z RYAN BARTLETT 400 FAIRVIEW AVE N SUITE 800 SEATTLE WA 98109 1948638087 0 X WWW.DELTADENTALWA.COM X 1954 WA DDWA WILL REVOLUTIONIZE THE ORAL HEALTH INDUSTRY AND IMPROVE OVERALL HEALTH. 11 6 577 86 0 0 262500 310204 1748856723 1826998080 5672401 6807094 265216 314457 1755056840 1834429835 7388347 2719361 1593593412 1668337385 69047790 72827386 0 0 0 73560735 76214325 1743590284 1820098457 11466556 14331378 283669791 258655741 111377305 91716979 172292486 166938762 X SEE SCHEDULE ODDWA WILL REVOLUTIONIZE THE ORAL HEALTH INDUSTRY AND IMPROVE OVERALL HEALTH. THIS INCLUDES, BUT IS NOT LIMITED TO, THE FOLLOWING: TO SECURE DENTAL SERVICE FOR EMPLOYER GROUPS, INDIVIDUALS AND THEIR FAMILIES; PROVIDE INNOVATIVE PRODUCTS AND SERVICES; TO ENCOURAGE, FOSTER AND FINANCE PROFESSIONAL AND SCIENTIFIC STUDY AND RESEARCH IN THE GENERAL FIELD OF ORAL HEALTH; AND TO EDUCATE THE PUBLIC CONCERNING THE NEED FOR AND ADVANTAGE OF ADEQUATE DENTAL TREATMENT. 0 0 1731886780 1826940478 SEE SCHEDULE ODDWA PROVIDES DENTAL INSURANCE FOR OVER 4,019,000 MEMBERS AND THEIR DEPENDENTS THROUGHOUT THE STATE OF WASHINGTON AND ACROSS THE NATION. WORKING COLLECTIVELY WITH PRODUCERS AND BENEFIT MANAGERS, WE OFFER STANDARD INSURANCE BENEFITS, AS WELL AS HIGHLY CUSTOMIZED PLANS TO MEET THE NEEDS OF INDIVIDUALS AND THEIR FAMILIES. WE HAVE CONTRACTED WITH OVER 4,800 DENTISTS, CREATING A NETWORK OF PROVIDERS SERVING PATIENTS ACROSS THE STATE. AS A MEMBER OF THE DELTA DENTAL PLANS ASSOCIATION, A NATIONAL ASSOCIATION SUPPORTING DELTA INSURERS NATION-WIDE, OUR MEMBERS ARE ABLE TO ACCESS DELTA CONTRACTED PROVIDERS IN EVERY STATE. IN 2024, DDWA PROCESSED OVER 7,796,000 CLAIMS FOR SUBSCRIBERS AND THEIR DEPENDENTS. 2717406 SEE SCHEDULE ODELTA DENTAL OF WASHINGTON PROMOTES THE VALUE OF DENTAL BENEFITS AND IMPORTANCE OF ORAL HEALTH THROUGH MARKETING EFFORTS IN MEDIA ADVERTISING, PUBLIC RELATIONS, EVENT SPONSORSHIPS AND DIRECT OUTREACH TO CUSTOMERS. MARKET RESEARCH FINDINGS SHOW THESE ACTIVITIES IMPROVE OUR ABILITY TO REACH AND ENCOURAGE AUDIENCES TO EMBRACE GOOD ORAL HEALTH AND MAKE WISE USE OF DENTAL BENEFITS. 2187722 2187722 SEE SCHEDULE ODENTAL DISEASE IS THE SINGLE MOST COMMON CHRONIC DISEASE OF EARLY CHILDHOOD - FIVE TIMES MORE COMMON THAN ASTHMA. NEARLY ONE IN FIVE ADULTS, NATIONALLY, HAS UNTREATED DENTAL CAVITIES. THE ARCORA FOUNDATION (THE FOUNDATION), A WHOLLY OWNED SUBSIDIARY OF DDWA, SUPPORTED ALMOST EXCLUSIVELY BY DDWA, FOCUSES MUCH OF THEIR WORK ON COMMUNITIES EXPERIENCING ORAL HEALTH DISPARITIES, AND WORKS CLOSELY WITH PARTNER ORGANIZATIONS TO DEVELOP AND IMPLEMENT INNOVATIVE PROGRAMS THAT IMPROVE ORAL HEALTH. THE ACCESS TO BABY AND CHILD DENTISTRY (ABCD) SYSTEM OF CARE EXPANDS ACCESS TO DENTAL CARE FOR YOUNG MEDICAID INSURED CHILDREN UNDER SIX AND CHILDREN WITH A DEVELOPMENTAL DISABILITIES ADMINISTRATION (DDA) INDICATOR UNDER 13 IN WASHINGTON STATE BY PROVIDING DENTAL SERVICES, BOTH PREVENTATIVE AND RESTORATIVE. IN COUNTIES WITH ABCD, THE UTILIZATION OF DENTAL SERVICES INCREASED FROM 21% TO 51% FROM 1997 TO 2024. THE EARLY INTERVENTION IN MEDICAL SETTINGS PROGRAMS, MOUTHMATTERS, TRAINS PEDIATRIC MEDICAL PROVIDERS IN THE ADVANTAGES AND TECHNIQUES OF EARLY INTERVENTION AND PREVENTION THROUGH ORAL SCREENING AND EDUCATION, APPLYING FLUORIDATION AND REFERRING HIGH RISK PATIENTS FOR DENTAL CARE. 1225308 531639 57602 1. WATER FLUORIDATION IS THE MOST IMPORTANT STEP A COMMUNITY CAN TAKE TO IMPROVE THE ORAL HEALTH OF ALL RESIDENTS. THE FOUNDATION PROMOTES LEGISLATION TO ENCOURAGE FLUORIDATION, PROVIDES ASSISTANCE TO GROUPS WHO ARE COMMITTED TO BRINGING THE BENEFITS OF FLUORIDE TO THEIR COMMUNITIES AND HELPS PREVENT ROLLBACKS IN EXISTING FLUORIDATED COMMUNITIES. SINCE 2001, OVER 646,000 WASHINGTONIANS RECEIVE THE HEALTH BENEFITS ASSOCIATED WITH FLUORIDATED WATER AS A RESULT OF THE FOUNDATION'S WORK.2. ASSISTING THE WORK OF THE FOUNDATION ARE DDWA EMPLOYEES VOLUNTEERING THEIR TIME. DDWA ENABLES ALL EMPLOYEES TO ENGAGE WITH THE PUBLIC REGARDING ORAL HEALTH THROUGH THE USE OF TWO VOLUNTEER DAYS PER YEAR. THE SMILEMOBILE PROGRAM OFFERS VOLUNTEER OPPORTUNITIES IN ASSISTING WITH PATIENT RECRUITMENT AND REGISTRATION WHILE IN A COMMUNITY. THE MOBILE DENTAL VAN STAFFED WITH DENTAL PROFESSIONALS, TRAVELS THE STATE OF WA PROVIDING PREVENTIVE, RESTORATIVE AND EMERGENT DENTAL CARE TO CHILDREN, YOUTH AND PREGNANT/POSTPARTUM PEOPLE WITH A FOCUS ON BLACK, INDIGENOUS, PEOPLE OF COLOR IN UNDERSERVED AREAS OF THE STATE. SINCE 1995, THE PROGRAM HAS EXAMINED OVER 53,000 PATIENTS.3. DDWA MATCHES DONATIONS MADE BY EMPLOYEES TO NON-PROFIT ORGANIZATIONS WITH OFFICIAL IRS 501(C)(3) STATUS, ALTHOUGH THE FOLLOWING ORGANIZATIONS/EVENTS ARE NOT ELIGIBLE FOR MATCHING: CHURCHES, POLITICAL CAMPAIGNS/ORGANIZATIONS, CAPITAL FUNDING, FRATERNAL/LABOR ORGANIZATIONS, TRIPS/TOURS, MASS MAILINGS, ORGANIZATIONS/GROUPS THAT DISCRIMINATE FOR ANY REASON INCLUDING, BUT NOT LIMITED TO, RACE, COLOR, RELIGION, CREED, AGE, SEX, SEXUAL ORIENTATION OR NATIONAL ORIGIN.4. DDWA PROVIDED $287,775 TO UW SCHOOL OF DENTISTRY TO COVER THE WASHINGTON STATE DEPARTMENT OF ORAL HEALTH DENTAL EXAMS FOR ITS GRADUATING CLASS. 1225308 531639 57602 1738017216 0 1 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 74022 0 1 577 1 0 0 0 0 0 0 1 0 X 11 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X RYAN BARTLETT 2065221300 400 FAIRVIEW AVE N SUITE 800 SEATTLE WA 98109 X MITCHKE MARK PRESIDENT & CHIEF EXECUTIVE OFFICER 32.00 8.00 X X 4156863 0 536955 RUTHERFORD EVE M CHAIR - BRD. & DDS FEES 15.00 5.50 X X 1347828 0 0 BROWN COLLEEN B SECRETARY 4.00 1.00 X X 169876 0 0 WHITE MARVIN TREASURER 9.00 3.00 X X 154428 0 0 NELSON CAROL K VICE CHAIR 15.00 5.00 X X 184886 0 0 HAKES KATHERINE M DIRECTOR - BRD. & DDS FEES 14.00 4.00 X 1111386 0 0 BRADSHAW DENNIS DIRECTOR - BRD. & DDS FEES 13.00 4.00 X 346956 0 0 ARMSTRONG SCOTT E DIRECTOR 9.00 3.00 X 169876 0 0 PICKEL CHRISTOPHER DIRECTOR - BRD. & DDS FEES 13.00 4.00 X 554305 0 0 WAGLE DILIP DIRECTOR 7.00 2.00 X 147812 0 0 RIVERA FRED DIRECTOR 9.00 3.00 X 137264 0 0 BARTLETT RYAN VP, CHIEF FINANCIAL OFFICER 36.00 4.00 X 517563 0 96337 BERG BRADLEY SENIOR VP, CHIEF ADMIN OFFICER 24.00 16.00 X 1420115 0 39886 ALIABADI KAREN SENIOR VP, CHIEF HR STRATEGIST 40.00 0.00 X 1185646 0 132742 WHITNEY GARRETT SENIOR VP, CHIEF INFORMATION OFFICER 36.00 4.00 X 798242 0 133205 SNYDER CINDY SENIOR VP, CHIEF OPERATING OFFICER 40.00 0.00 X 890019 0 122984 ROBINSON HERBERT SENIOR VP, CHIEF REVENUE OFFICER 40.00 0.00 X 709716 0 142498 CHEUNG STEPHEN VP, MARKETING 40.00 0.00 X 450275 0 92219 LO ERIC VP, ACTUARIAL & UNDERWRITING 40.00 0.00 X 556769 0 99280 ABDELLATIF VANETTA PRES/CEO ARCORA FDN 39.50 0.50 X 451545 0 83179 ROGERS TIFFANY HEAD OF DISTRIBUTION & STRATEGY 40.00 0.00 X 306952 0 23768 SCHOBER DEBRA SR SALE & STRGY EX LGGRP 40.00 0.00 X 446461 0 30484 SHEPHARD MICHAEL DIRECTOR OF ENTERPRISE SYSTEM 40.00 0.00 X 381766 0 30230 COTA TODD DIRECTOR OF DIGITAL SERVICE 40.00 0.00 X 346217 0 27982 COBURN ERRIN DIRECTOR OF CYBER RISK 40.00 0.00 X 312617 0 39877 FARRELL ANNE V FORMER DIRECTOR (END 12/31/23) 0.00 0.00 X 15000 0 0 17270383 0 1631626 190 1 1 0 8 WEST UNIT 1 CURRAHEEN ROAD CORK EI SOFTWARE DEVELOPMENT 17635297 WYSSTA SERVICES INC PO BOX 86 STEVENS POINT WI 54481 INDIVIDUAL PLAN TPA 11225723 AMAZON SERVICES PO BOX 81226 SEATTLE WA 98108 SOFTWARE DEVELOPMENT AND WEB SERVICES 5437773 REDCARD SYSTEMS LLC 744 OFFICE PARKWAY ST LOUIS MO 63141 PRINTING/MAIL SVCS 3606823 ENCARA INC 4818 STARKEY ROAD SW ROANOKE VA 24018 INDIV PLAN ACQUISITION MKTG 2542349 157 15750 294454 310204 PREMIUM REVENUE 524114 1826940478 1826940478 SMILEMOBILE 621990 57602 57602 1826998080 5861093 5861093 176170 176170 114978083 114116622 91630 861461 -91630 769831 769831 314457 314457 314457 1834429835 1827312537 0 6807094 2719361 2719361 1668337385 1668337385 12916747 3903463 9013284 15000 15000 43684167 18044857 25639310 5004433 2149030 2855403 6921195 3513145 3408050 4285844 1671070 2614774 236672 3005 233667 406226 406226 78543 78543 583316 583316 5731513 3240936 2490577 8642206 2717406 5924800 5771368 3841367 1930001 12416346 66787 12349559 4113489 114747 3998742 1479986 603166 876820 901681 158321 743360 88085 88085 5821255 36167 5785088 471088 471088 TAXES & SERVICE CHARGES 14787728 14550380 237348 COMMISSIONS 11970170 11970170 DUES & SUBSCRIPTIONS 2143343 265122 1878221 RESEARCH & DEVELOPMENT 39540 12990 26550 531770 4798 526972 1820098457 1738017216 82081241 0 4258025 5079228 2659667 1309111 30889935 19881347 7771672 9364726 27593127 13899022 23432033 13694105 195238297 193556993 813366 722076 18606796 15048155 283669791 258655741 80076460 62456171 1141818 1026668 5626788 7539275 24532239 20694865 111377305 91716979 X 172292486 166938762 172292486 166938762 283669791 258655741 X 14331378 6222464 -25907566 X 0 1 X 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 252000 252000 252000 1 FRIENDS OF CHRIS REYKDAL 855 TROSPER ROAD SUITE 108-117 TUMWATER WA 98512 271751460 2400 0 HOUSE DEMOCRATIC CAMPAIGN COMMITTEE PO BOX 9100 SEATTLE WA 98109 916178946 1200 0 WASHINGTON SENATE DEMOCRATIC CAMPAIGN 5628 AIRPORT WAY S STE 108 SEATTLE WA 98108 462614068 1200 0 THE HARRY TRUMAN FUND PO BOX 9100 SEATTLE WA 98109 911769570 15000 0 KENNEDY FUND 401 2ND AVENUE S 303 SEATTLE WA 98104 482745811 15000 0 COMMITTEE TO ELECT STEVE HOBBS 3309 114TH DRIVE NE LAKE STEVENS WA 98258 204733784 1200 0 HECK FOR LT GOVERNOR PO BOX 235 OLYMPIA WA 98507 850575085 2400 0 JACKSON LEGACY FUND 2937 54TH AVE SW SUITE A OLYMPIA WA 98512 812080103 5000 0 NICK BROWN FOR ATTORNEY GENERAL 401 2ND AVE S STE 303 SEATTLE WA 98104 932152124 4800 0 FRIENDS OF DAVINA DUERR 401 2ND AVE S SUITE 303 SEATTLE WA 98104 842633824 1200 0 PEOPLE FOR TIMM ORMSBY PO BOX 2177 SPOKANE WA 992102177 830713482 2400 0 ELECT JASON RITCHIE 27735 214TH AVE SE MAPLE VALLEY WA 98038 933205753 1200 0 FRIENDS OF LISA CALLAN PO BOX 2095 ISSAQUAH WA 98027 824666035 1200 0 ELECT CLYDE SHAVERS PO BOX 24 OAK HARBOR WA 98277 874252502 1200 0 FRIENDS OF DAVE PAUL PO BOX 387 OAK HARBOR WA 98277 824743363 1200 0 HACKNEY FOR THE 11TH PO BOX 12066 SEATTLE WA 98102 844680106 1200 0 CITIZENS FOR STEVE BERGQUIST PO BOX 2050 RENTON WA 98056 454489263 1200 0 FRIENDS OF STROM PETERSON PO BOX 12066 SEATTLE WA 98102 471385570 500 0 FRIENDS OF LILLIAN ORTIZ-SELF PO BOX 581 MUKILTEO WA 98275 463819721 1900 0 FRIENDS OF BETH DOGLIO 120 STATE AVENUE NE 200 OLYMPIA WA 98501 475314796 1200 0 PEOPLE FOR LISA PARSHLEY 1014 4TH AVE E OLYMPIA WA 98506 861574635 1200 0 VOTE DR JOHN GIBBONS 19689 7TH AVE NE 228 POULSBO WA 98370 934514036 1200 0 PEOPLE FOR TARRA SIMMONS PO BOX 774 TRACYTON WA 98393 843381309 1200 0 ELECT ADAM BERNBAUM 301 E VASHON AVE APT 8 PORT ANGELES WA 98362 934561233 1200 0 THARINGER FOR STATE REPRESENTATIVE PO BOX 834 SEQUIM WA 98382 272555702 2400 0 FRIENDS OF LAURIE JINKINS PO BOX 2032 TACOMA WA 98401 272214467 1200 0 COMMITTEE TO ELECT JAKE FEY PO BOX 1372 TACOMA WA 98401 861121642 2400 0 FRIENDS OF MARI LEAVITT PO BOX 65195 TACOMA WA 98466 812668177 1200 0 FRIENDS OF DAN BRONOSKE PO BOX 39408 LAKEWOOD WA 98496 845074803 1200 0 FRIENDS OF SHARLETT MENA PO BOX 7437 TACOMA WA 98417 874010260 1200 0 ELECT JAMILA TAYLOR PO BOX 3996 FEDERAL WAY WA 98063 833917287 500 0 FRIENDS TO ELECT KRISTINE REEVES 1815 SW CAMPUS DRIVE 26332 FEDERAL WAY WA 98093 812277473 1200 0 FRIENDS FOR CINDY RYU PO BOX 33548 SHORELINE WA 98133 202771557 1200 0 ELECT LAUREN DAVIS PO BOX 9100 SEATTLE WA 98109 824710355 1200 0 FRIENDS OF TINA ORWALL PO BOX 12066 SEATTLE WA 98102 010906132 1200 0 PEOPLE FOR MIA PO BOX 297 SEAHURST WA 98062 463326224 1200 0 FRIENDS OF JOE FITZGIBBON PO BOX 66235 BURIEN WA 98166 272265718 1200 0 FRIENDS OF SANTOS 4547 RAINIER AVE S SEATTLE WA 98118 911913482 1200 0 ELECT CHIPALO STREET PO BOX 9100 SEATTLE WA 98109 881942133 1200 0 FRIENDS OF JULIO CORTES PO BOX 412 EVERETT WA 98206 880671350 1200 0 FRIENDS OF MARY FOSSE PO BOX 12066 SEATTLE WA 98102 862563039 500 0 VOTE DEBRA LEKANOFF PO BOX 23125 SEATTLE WA 98102 825166939 1200 0 PEOPLE FOR ALEX RAMEL PO BOX 2819 BELLINGHAM WA 98227 824889130 1200 0 FRIENDS OF TANA SENN PO BOX 771 MERCER ISLAND WA 98040 463757260 1200 0 FRIENDS OF MY-LIHN 11900 NE 1ST STREET STE 300 BELLEVUE WA 98005 824927031 1200 0 VOTE ALICIA RULE PO BOX 444 BLAINE WA 98231 825493030 1200 0 VOTE JOE TIMMONS PO BOX 1995 BELLINGHAM WA 98227 873651462 1200 0 FRIENDS OF NICOLE MACRI PO BOX 9100 SEATTLE WA 98109 811159785 1200 0 FRIENDS FOR ANDREA SUAREZ PO BPX 27113 SEATTLE WA 98165 993005185 1200 0 FRIENDS OF BRANDY DONAGHY PO BOX 12572 MILL CREEK WA 98082 834511285 1400 0 FRIENDS OF APRIL BERG PO BOX 12066 SEATTLE WA 98102 850659766 1200 0 FRIENDS OF ELECT LARRY SPRINGER 10536 NE 122ND STREET KIRKLAND WA 98034 830382872 1200 0 GERRY POLLET FOR STATE REP 7750 17TH AVE NE SEATTLE WA 98115 800147715 1200 0 FRIENDS OF VANDANA SLATTER 11900 NE 1ST STREET BELLEVUE WA 98005 461880322 1200 0 COMMITTEE TO ELECT SHARON WYLIE 6400 NE HIGHWAY 99 SUITE G340 VANCOUVER WA 98665 451965188 1200 0 ELECT MONICA STONIER 7817 NE 69TH ST VANCOUVER WA 98662 271504430 1200 0 FRIENDS OF ANDREW BARKIS PO BOX 8728 LACEY WA 98509 811755579 1200 0 SNAZA FOR STATE PO BOX 2127 YELM WA 98597 992982287 2400 0 SUZANNE SCHMIDT FOR STATE REPRESENTATIVE 9116 E SPRAGUE AVE 470 SPOKANE VALLEY WA 99206 874316868 1200 0 COMMITTEE TO ELECT MIKE VOLZ PO BOX 10163 SPOKANE WA 99209 813891241 1200 0 THE COMMITTEE TO ELECT JENNY GRAHAM PO BOX 48654 SPOKANE WA 99228 824741433 1200 0 STEPHANIE FOR WA PO BOX 5802 PASCO WA 99302 881416754 1200 0 APRIL FOR WASHINGTON 3911 WEST 27TH AVE SUITE 101 PMB 1 KENNEWICK WA 99337 874046423 1200 0 COMMITTEE TO ELECT MARY DYE 2024 1325 BELL PLAIN ROAD POMEROY WA 99347 922468930 1200 0 PEOPLE FOR JOE SCHMICK PO BOX 620 COLFAX WA 99111 450582705 1200 0 CITIZENS TO ELECT MIKE STEELE PO BOX 1072 CHELAN WA 98816 812608262 1200 0 COMMITTEE TO ELECT TOM DENT 601 S PIONEER WAY SUITE F PMB 396 MOSES LAKE WA 98837 464970913 500 0 FRIENDS OF ALEX YBARRA PO BOX 175 QUINCY WA 98848 834576849 1200 0 FRIENDS OF GLORIA MENDOZA PO BOX 596 GRANDVIEW WA 98930 992867052 2400 0 FRIENDS OF DEB MANJARREZ PO BOX 9634 YAKIMA WA 98909 992867605 2400 0 FRIENDS OF CHRIS CORRY PO BOX 1051 YAKIMA VA 98907 825239321 1200 0 FRIENDS OF JEREMIE DUFAULT PO BOX 579 SELAH WA 98942 825183868 2400 0 KEVIN WATERS FOR STATE HOUSE 401 MAPLE WAY STEVENSON WA 98648 874162054 1200 0 STUEBE FOR STATE REP PO BOX 31 WASHOUGAL WA 98671 992494770 2400 0 COMMITTEE TO ELECT STEPHANIE MCCLINTOCK 10013 NE HAZEL DELL AVE PMB 276 VANCOUVER WA 98685 462908931 1200 0 FRIENDS OF PHILIP J 2210 W MAIN ST PMB 133 BATTLE GROUND WA 98604 992406199 1200 0 COMMITTEE TO ELECT PETER ABBARNO PO BOX 94 CENTRALIA WA 98351 473697034 1900 0 COMMITTEE TO RE-ELECT ED ORCUTT PO BOX 1280 KALAMA WA 98625 900038949 1200 0 FRIENDS OF MICHAEL KEATON PO BOX 1122 PUYALLUP WA 98371 474089841 2400 0 FRIENDS OF CYNDY JACOBSEN PO BOX 709 PUYALLUP WA 98371 821646290 1200 0 JIM HENDERSON FOR STATE REPRESENTATIVE PO BOX 2405 GIG HARBOR WA 98335 991858604 1200 0 MICHELLE DOWNEY CALDIER FOR STATE REPRESENTATIVE PO BOX 1710 PORT ORCHARD WA 98366 464305309 1200 0 FRIENDS OF DREW STOKESBARY PO BOX 92 AUBURN WA 98071 465287065 1200 0 VOTE PENNER POBOX 933 ORTING WA 98360 991626580 2400 0 COMMITTEE TO ELECT TRAVIS COUTURE PO BOX 460 ALLYN WA 98524 871198413 1200 0 FRIENDS OF SAM LOW 11002 UCT LOOP RD LAKE STEVENS WA 98258 462096072 2400 0 THE LEADERSHIP COUNCIL PO BOX 12085 OLYMPIA WA 98508 911714860 15000 0 REAGAN FUND PO BOX 904 OLYMPIA WA 98507 911716818 15000 0 HOUSE REPUBLICAN ORGANIZATIONAL COMMITTEE PO BOX 7222 OLYMPIA WA 98507 916177625 1200 0 SENATE REPUBLICAN CAMPAIGN COMMITTEE PO BOX 11025 OLYMPIA WA 98508 910987396 1200 0 CASCADE PAC PO BOX 2693 OLYMPIA WA 98507 851350168 5000 0 ENTERPRISE WASHINGTON JOBS PAC 975 CARPENTER ROAD NE STE 101 LACEY WA 98516 262349466 25000 0 GOPAC INC 1201 WILSON BLVD STE 210 ARLINGTON WA 22209 521237780 10000 0 FRIENDS OF DEREK STANFORD PO BOX 2041 BOTHELL WA 98041 272317624 1200 0 BOB HASEGAWA FOR STATE SENATE 2518 S BRANDON COURT SEATTLE WA 98108 201930625 1200 0 FRIENDS OF JESSICA BATEMAN 120 STATE AVE NE 1462 OLYMPIA WA 98501 473224161 1200 0 COMMITTEE TO ELECT DREW HANSEN PO BOX 9100 SEATTLE WA 98109 453489418 1200 0 MIKE CHAPMAN FOR STATE SENATE 1321 S LAUREL ST PORT ANGELES WA 98362 932335676 1200 0 PEOPLE FOR YASMIN 2522 N PROCTOR ST 520 TACOMA WA 98520 873173541 2400 0 FRIENDS OF TWINA NOBLES PO BOX 65905 UNIVERSITY PLACE WA 98464 473370508 1200 0 CITIZENS FOR JUNE ROBINSON 616 WETMORE AVE EVERETT WA 98201 455346884 600 0 LIZ LOVELETT FOR STATE SENATE 1004 COMMERCIAL AVE 453 ANACORTES WA 98221 834576418 1200 0 FRIENDS OF LISA WELLMAN PO BOX 1725 MERCER ISLAND WA 98040 812563603 1200 0 ANNETTE CLEVELAND FOR STATE SENATE 6400 NE HWY 99 G340 VANCOUVER WA 98665 454514627 1200 0 SENATE COMMITTEE FOR MARK SCHOESLER 1588 E ROSENOFF ROAD RITZVILLE WA 99169 043779321 1200 0 FRIENDS OF RON MUZZALL 316 SE PIONEER WAY 1116 OAK HARBOR WA 98277 843507121 1200 0 COMMITTEE TO ELECT KEITH GOEHNER PO BOX 38 LEAVENWORTH WA 98826 830585405 1200 0 COMMITTEE TO RE-ELECT CURTIS KING PO BOX 10025 YAKIMA WA 98909 208314962 1200 0 PERRY DOZIER FOR SENATE PO BOX 3042 WALLA WALLA WA 99362 301212231 1200 0 COMMITTEE TO ELECT SKYLER RUDE PO BOX 502 WALLA WALLA WA 99362 812502739 1200 0 CAMPAIGN TO ELECT PAUL HARRIS 1916 SE 130TH AVE VANCOUVER WA 98683 272531536 1200 0 JOHN BRAUN FOR STATE SENATE 1955 SALZER VALLEY ROAD CENTRALIA WA 98531 455101339 1200 0 FRIENDS OF CHRIS GILDON 1111 23RD AVENUE CT SW PUYALLUP WA 98371 825179579 1200 0 WAGONER FOR STATE SENATE 410 TALCOTT STREET SEDROWOOLLEY WA 98284 824730963 1200 0 FRIENDS OF RYAN MELLO PO BOX 364 TACOMA WA 98401 274550972 1200 0 PART I-A, LINE 1: DDWA PROVIDES DIRECT CAMPAIGN CONTRIBUTIONS TO CANDIDATES FOR WASHINGTON STATE ELECTED EXECUTIVE OFFICE, LEGISLATIVE OFFICE, AND POLITICAL ORGANIZATIONS IN ORDER TO PROMOTE AN ENVIRONMENT FOR IMPROVED ORAL HEALTH AND OVERALL HEALTH CARE POLICY, AS WELL AS TO SUPPORT OUR OVERALL MISSION OF IMPROVING HEALTH IN OUR STATE. DDWA ALSO PROVIDES LIMITED DIRECT SUPPORT FOR LOCAL LEVEL CANDIDATES OR INITIATIVES THAT PROMOTE A POSITIVE BUSINESS CLIMATE IN WASHINGTON STATE. ALL CONTRIBUTIONS ARE CONDUCTED IN ACCORDANCE WITH FEDERAL AND STATE LAWS AND REPORTING REQUIREMENTS. 351239 351239 6805157 694305 6110852 12809795 7900016 4909779 2313053 1978621 334432 5313883 3326080 1987803 13694105 RIGHT-OF-USE ASSETS 14169120 INTEREST RECEIVABLE 879035 15048155 LEASE LIABILITY 20694865 20694865 1 UW SCHOOL OF DENTISTRY BOX 357137 SEATTLE WA 981957137 943079432 501(C)(3) 287775 0 UNDERWRITE WREB FEES SOCIETY OF TEACHERS OF FAMILY MEDICINE 11400 TOMAHAWK CREEK PARK SUITE 240 LEAWOOD KS 66211 510187107 501(C)(3) 205920 0 FUNDING FOR ORAL HEALTH SUPPORT TACOMA PIERCE COUNTY HEALTH DEPARTMENT 3629 SOUTH D STREET TACOMA WA 98418 911488160 LOCAL GOVERNMENT 159112 0 FUNDING FOR ORAL HEALTH SUPPORT QUILEUTE TRIBAL COUNCIL PO BOX 279 LA PUSH WA 98350 910761286 501(C)(3) 140000 0 FUNDING FOR ORAL HEALTH SUPPORT COMMUNITY CATALYST INC ONE FEDERAL ST FIFTH FLOOR BOSTON MA 02110 043355127 501(C)(3) 135000 0 FUNDING FOR ORAL HEALTH SUPPORT KALISPEL INDIAN COMM OF THE KALISPEL RESERVATION PO BOX 67 USK WA 99180 910875018 501(C)(3) 130000 0 FUNDING FOR ORAL HEALTH SUPPORT COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY 8609 EVERGREEN WAY EVERETT WA 98208 911255170 501(C)(3) 111000 0 FUNDING FOR ORAL HEALTH SUPPORT CHARITABLE PARTNERSHIP FUND PO BOX 13276 PORTLAND OR 97213 931267966 501(C)(3) 110000 0 COMMUNITY FLUORIDATION SUNNYSIDE EDUCATION ASSOCIATION PO BOX 279 SUNNYSIDE WA 98944 237133198 501(C)(3) 75000 0 FUNDING FOR ORAL HEALTH SUPPORT BELLINGHAM PUBLIC SCHOOLS 1985 BARKLEY BLVD BELLINGHAM WA 98226 911551087 501(C)(3) 75000 0 FUNDING FOR ORAL HEALTH SUPPORT BLUE MOUNTAIN ACTION COUNCIL 8 E CHERRY ST WALLA WALLA WA 99362 910793597 501(C)(3) 75000 0 FUNDING FOR ORAL HEALTH SUPPORT COLUMBIA BASIN HEALTH ASSOCIATION 1515 E COLUMBIA ST OTHELLO WA 993441846 910896701 501(C)(3) 75000 0 FUNDING FOR ORAL HEALTH SUPPORT COMUNIDADES SIN FRONTERAS WASHINGTON 124 E 3RD AVE SUITE 205 MOSES LAKE WA 98837 934449241 501(C)(3) 75000 0 FUNDING FOR ORAL HEALTH SUPPORT GLOBAL PERINATAL SERVICES 15203 8TH AVE S BURIEN WA 98148 843421673 501(C)(3) 75000 0 FUNDING FOR ORAL HEALTH SUPPORT COMMUNITY HEALTH WORKERS COALITION 24315 89TH PL W EDMONDS WA 98026 832266657 501(C)(3) 74779 0 FUNDING FOR ORAL HEALTH SUPPORT NATIONAL NETWORK FOR ORAL HEALTH ACCESS 181 E 56TH AVE STE 501 DENVER CO 80216 841186592 501(C)(3) 71800 0 FUNDING FOR ORAL HEALTH SUPPORT COMMUNITY HEALTH ASSOCIATION 611 NORTH IRON BRIDGE WAY SPOKANE WA 99202 911641797 501(C)(3) 71400 0 FUNDING FOR ORAL HEALTH SUPPORT ONE COMMUNITY HEALTH 849 PACIFIC AVENUE HOOD RIVER OR 970311956 930910794 501(C)(3) 70000 0 FUNDING FOR ORAL HEALTH SUPPORT PARA LOS NINOS 425 SW 144TH STREET BURIEN WA 98166 200502368 501(C)(3) 60000 0 FUNDING FOR ORAL HEALTH SUPPORT SOLID GROUND OF WASHINGTON 1501 N 45TH ST SEATTLE WA 98103 237421892 501(C)(3) 60000 0 FUNDING FOR ORAL HEALTH SUPPORT A WATERED GARDEN FAMILY LEARNING CENTER 700 STANDELL STREET PO BOX 218 EVERSON WA 98247 680581727 501(C)(3) 52500 0 FUNDING FOR ORAL HEALTH SUPPORT LATINO EDUCATIONAL TRAINING INSTITUTE 6605 202ND ST SW SUITE 300 LYNWOOD WA 98036 753252857 501(C)(3) 50000 0 FUNDING FOR ORAL HEALTH SUPPORT WASHINGTON ASSOCIATION FOR COMMUNITY HEALTH 101 CAPITOL WAY N SUITE OLYMPIA WA 98501 911323282 501(C)(3) 47360 0 FUNDING FOR ORAL HEALTH SUPPORT NATIONAL INTERPROF INIT ON ORAL HEALTH 55 MADISON STREET STE 675 DENVER CO 80206 862627300 501(C)(3) 41443 0 FUNDING FOR ORAL HEALTH SUPPORT PACIFIC ISLANDER HEALTH BOARD OF WASHINGTON 6519 EAST SIDE DR NE TACOMA WA 98422 862588152 501(C)(3) 40000 0 FUNDING FOR ORAL HEALTH SUPPORT GRACE CLINIC 800 W CANAL DR KENNEWICK WA 99336 770592408 501(C)(3) 33000 0 FUNDING FOR ORAL HEALTH SUPPORT CHILDREN'S ALLIANCE 100 S KING ST STE 100-1026 SEATTLE WA 98104 910982879 501(C)(3) 30000 0 FUNDING FOR ORAL HEALTH SUPPORT UNITED WAY OF KING COUNTY 720 SECOND AVE SEATTLE WA 981041702 910565555 501(C)(3) 28873 0 ANNUAL GIVING CAMPAIGN ARTS FUND PO BOX 19780 SEATTLE WA 98109 910839644 501(C)(3) 25100 0 SPONSORSHIP PACIFIC ISLANDER COMMUNITY ASSOCIATION OF WA 33710 9TH AVE S STE 1 FEDERAL WAY WA 98003 842470123 501(C)(3) 20000 0 FUNDING FOR ORAL HEALTH SUPPORT LATINO EN SPOKANE 1502 N MONROE AVE SPOKANE WA 99207 852725630 501(C)(3) 15927 0 FUNDING FOR ORAL HEALTH SUPPORT ASIA PACIFIC CULTURAL CENTER 4851 S TACOMA WAY TACOMA WA 98409 911854410 501(C)(3) 15000 0 FUNDING FOR ORAL HEALTH SUPPORT FOUNDATION FOR HEALTHY GENERATIONS 2132 3RD AVE 226 SEATTLE WA 98121 916186093 501(C)(3) 14760 0 FUNDING FOR ORAL HEALTH SUPPORT FOOD LIFELINE 815 SOUTH 96TH SEATTLE WA 98108 911090450 501(C)(3) 12564 0 ANNUAL GIVING CAMPAIGN RURAL RESOURCES COMMUNITY ACTION 956 S MAIN ST STE A COLVILLE WA 99114 910793447 501(C)(3) 10554 0 ANNUAL GIVING CAMPAIGN NATIONAL FOUNDATION OF DENTISTRY FOR HANDICAPPED 1800 15TH STREET SUITE 100 DENVER CO 80202 841043478 501(C)(3) 10000 0 FUNDING FOR ORAL HEALTH SUPPORT PARTNERSHIP FOR LEARNING 520 PIKE ST SUITE 1212 SEATTLE WA 98101 911550803 501(C)(3) 10000 0 FUNDING FOR ORAL HEALTH SUPPORT CONFEDERATED TRIBES OF GRAND RONDE 9615 GRAND RONDE ROAD GRAND RONDE OR 97347 930899337 501(C)(3) 10000 0 FUNDING FOR ORAL HEALTH SUPPORT INTERNATIONAL RESCUE COMMITTEE INC 122 EAST 42ND STREET NEW YORK NY 10168 135660870 501(C)(3) 10000 0 FUNDING FOR ORAL HEALTH SUPPORT SWINOMISH INDIAN TRIBAL COMMUNITY 11404 MOORAGE WAY LA CONNER WA 98257 910434170 501(C)(3) 10000 0 FUNDING FOR ORAL HEALTH SUPPORT SECOND HARVEST FOOD BANK 1234 E FRONT AVE SPOKANE WA 992022148 237173826 501(C)(3) 9007 0 ANNUAL GIVING CAMPAIGN NORTH KITSAP FISHLINE 19705 VIKING WAY NW POULSBO WA 98370 911244431 501(C)(3) 5750 0 SPONSORSHIP 43 0 PART I, LINE 2: THE GRANTEE IS REQUIRED TO SIGN A GRANT AGREEMENT STATING THAT THEY WILL USE THE FUNDS ONLY FOR PURPOSES OUTLINED IN THE GRANT AGREEMENT AND APPLICATION. THE GRANTEE IS REQUIRED TO FILE REPORTS ON REGULAR INTERVALS OUTLINING THE USE OF FUNDS. GRANTEE IS ALSO REQUIRED TO RETURN UNUSED FUNDING IF APPLICABLE. X X 1 1 X X X X 1 1 0 0 0 0 0 0 0 MITCHKE MARK PRESIDENT & CHIEF EXECUTIVE OFFICER 1348783 0 2470608 0 337472 0 501239 0 35716 0 4693818 0 322799 0 BERG BRADLEY SENIOR VP, CHIEF ADMIN OFFICER 820232 0 582398 0 17485 0 23000 0 16886 0 1460001 0 0 0 RUTHERFORD EVE M CHAIR - BRD. & DDS FEES 204480 0 0 0 1143348 0 0 0 0 0 1347828 0 0 0 ALIABADI KAREN SENIOR VP, CHIEF HR STRATEGIST 539139 0 271987 0 374520 0 110989 0 21753 0 1318388 0 358632 0 HAKES KATHERINE M DIRECTOR - BRD. & DDS FEES 149516 0 0 0 961870 0 0 0 0 0 1111386 0 0 0 SNYDER CINDY SENIOR VP, CHIEF OPERATING OFFICER 562369 0 266578 0 61072 0 102182 0 20802 0 1013003 0 47537 0 WHITNEY GARRETT SENIOR VP, CHIEF INFORMATION OFFICER 489424 0 240023 0 68795 0 97974 0 35231 0 931447 0 57159 0 ROBINSON HERBERT SENIOR VP, CHIEF REVENUE OFFICER 374310 0 322253 0 13153 0 106801 0 35697 0 852214 0 0 0 LO ERIC VP, ACTUARIAL & UNDERWRITING 326982 0 155959 0 73828 0 66306 0 32974 0 656049 0 60492 0 BARTLETT RYAN VP, CHIEF FINANCIAL OFFICER 347776 0 155871 0 13916 0 63339 0 32998 0 613900 0 0 0 PICKEL CHRISTOPHER DIRECTOR - BRD. & DDS FEES 149650 0 0 0 404655 0 0 0 0 0 554305 0 0 0 CHEUNG STEPHEN VP, MARKETING 294729 0 142056 0 13490 0 59335 0 32884 0 542494 0 0 0 ABDELLATIF VANETTA PRES/CEO ARCORA FDN 344110 0 93670 0 13765 0 59279 0 23900 0 534724 0 0 0 SCHOBER DEBRA SR SALE & STRGY EX LGGRP 158052 0 285783 0 2626 0 13039 0 17445 0 476945 0 0 0 SHEPHARD MICHAEL DIRECTOR OF ENTERPRISE SYSTEM 247691 0 123849 0 10226 0 20224 0 10006 0 411996 0 0 0 COTA TODD DIRECTOR OF DIGITAL SERVICE 219597 0 116098 0 10522 0 17976 0 10006 0 374199 0 0 0 COBURN ERRIN DIRECTOR OF CYBER RISK 211341 0 92085 0 9191 0 17066 0 22811 0 352494 0 0 0 BRADSHAW DENNIS DIRECTOR - BRD. & DDS FEES 139668 0 0 0 207288 0 0 0 0 0 346956 0 0 0 ROGERS TIFFANY HEAD OF DISTRIBUTION & STRATEGY 134897 0 39160 0 132895 0 10151 0 13617 0 330720 0 0 0 NELSON CAROL K VICE CHAIR 184886 0 0 0 0 0 0 0 0 0 184886 0 0 0 BROWN COLLEEN B SECRETARY 169876 0 0 0 0 0 0 0 0 0 169876 0 0 0 ARMSTRONG SCOTT E DIRECTOR 169876 0 0 0 0 0 0 0 0 0 169876 0 0 0 WHITE MARVIN TREASURER 154428 0 0 0 0 0 0 0 0 0 154428 0 0 0 FARRELL ANNE V FORMER DIRECTOR (END 12/31/23) 15000 0 0 0 0 0 0 0 0 0 15000 0 0 0 PART I, LINE 1A ANY FIRST CLASS TRAVEL IS SUBJECT TO THE APPROVAL OF THE CEO, CAO OR CFO. DDWA PROVIDES A WELLNESS PROGRAM WHICH REIMBURSES APPROVED EXPENSES FOR ALL EMPLOYEES WORKING 30 HOURS OR MORE A WEEK, WITH A MAXIMUM PAYABLE OF $480 PER YEAR FOR HEALTH CLUB MEMBERSHIPS, AEROBIC OR GENERAL EXERCISE CLASSES, WEIGHT LOSS PROGRAMS, STRESS MANAGEMENT AND MASSAGE THERAPY. THESE REIMBURSEMENTS ARE TREATED AS TAXABLE INCOME. DDWA GROSSES UP BOARD MEMBER FEES TO COVER B&O TAXES ASSESSED ON DIRECTOR FEES PAID TO THE BOARD. PART I, LINE 3 THE HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS ENGAGES IN AN INDEPENDENT EXTERNAL CONSULTANT TO EVALUATE THE COMPENSATION OF ALL KEY EMPLOYEES, INCLUDING THE PRESIDENT AND CEO, IN COMPARISON TO THE PRACTICE OF SIMILAR EMPLOYERS IN THE MARKETPLACE. THE PROCESS IS CONDUCTED ON AN ANNUAL BASIS. PART I, LINES 4A-B TIFFANY ROGERS ($131,962) RECEIVED SEVERANCE PAYMENTS DURING THE YEAR. THE COMPANY MAKES CONTRIBUTIONS TO A NONQUALIFIED PERFORMANCE BASED COMPENSATION PLAN, AS DETERMINED BY THE BOARD OF DIRECTORS, WHICH IS SUBJECT TO CODE SECTION 457(B). PLAN PARTICIPANTS ARE BOARD-APPROVED EXECUTIVE LEADERSHIP WHO RECEIVE AN ANNUAL CONTRIBUTION BASED ON A PERCENTAGE OF THE PRIOR YEAR EARNINGS LESS THE COMPANY MATCHING CONTRIBUTION TO THE 401(K) PLAN. COMPANY CONTRIBUTIONS ARE DIRECTED BY EACH PARTICIPANT, BUT VESTING OF THE BENEFIT IS SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE AS REQUIRED BY CODE SECTION 409(A). CONTRIBUTIONS MADE IN 2024 WERE AS FOLLOWS: MARK MITCHKE, PRESIDENT & CHIEF EXECUTIVE OFFICER, $478,239; RYAN BARTLETT, VP AND CFO, $40,339; KAREN ALIABADI, SENIOR VP AND CHIEF HUMAN RESOURCE STRATEGIST, $87,989; GARRETT WHITNEY, SENIOR VP AND CHIEF INFORMATION OFFICER, $74,974; CINDY SNYDER, SENIOR VP AND CHIEF OPERATING OFFICER, $79,182; HERBERT ROBINSON, SENIOR VP AND CHIEF REVENUE OFFICER, $83,801; STEPHEN CHEUNG, VICE PRESIDENT OF MARKETING, $36,335; ERIC LO, VP OF ACTUARIAL & UNDERWRITING, $46,020; VANETTA ABDELLATIF, PRESIDENT & CEO ARCORA FOUNDATION, $36,279. THE PLAN HAD TOTAL ASSETS OF $3,122,889 AT DECEMBER 31, 2024. IN ADDITION, THERE IS A 457(B) NONQUALIFIED SERP DEFERRED COMPENSATION PLAN FOR SENIOR MANAGEMENT THAT THE COMPANY DOES NOT MAKE ANY CONTRIBUTIONS TO. EACH OF THE FOLLOWING PARTICIPANTS CONTRIBUTED $23,000 TO THE PLAN DURING 2024: MARK MITCHKE, GARRETT WHITNEY, STEPHEN CHEUNG, BRADLEY BERG, ERIC LO. EACH OF THE FOLLOWING PARTICIPANTS CONTRIBUTED $10,000 TO THE PLAN: RYAN BARTLETT, CINDY SNYDER, HERBERT ROBINSON. THE PLAN HAD TOTAL ASSETS OF $1,874,643 AT DECEMBER 31, 2024. PART I, LINE 6A: THE BOARD OF DDWA ANNUALLY APPROVES A COMPANY-WIDE BONUS MATRIX BASED ON FOUR METRICS. THEY ARE OPERATING PROFIT MARGIN, ADMINISTRATIVE COST, NEW GROUP SALES, AND GROUP PERSISTENCY (RETENTION) OF THE FISCAL YEAR. FORM 990, PART VI, SECTION A, LINE 6 DDWA'S MEMBER DENTISTS ARE ALSO CONSIDERED MEMBERS OF THE COMPANY'S PARENT COMPANY, WASHINGTON DENTAL SERVICE (WDS). MEMBER DENTISTS ELECT THE DENTAL MEMBERS OF THE DDWA BOARD OF DIRECTORS, IN ACCORDANCE WITH THE WDS BYLAWS. FORM 990, PART VI, SECTION A, LINE 7A THE GOVERNANCE & NOMINATING COMMITTEE (GNC) OF THE BOARD OF DIRECTORS SOLICITS ADVICE ON CANDIDATES AND SUBMITS NOMINEES TO THE WDS/DDWA BOARD FOR CONSIDERATION AND APPROVAL TO BE VOTED UPON. THE ENTIRE MEMBERSHIP ELECTS AND RE-ELECTS MEMBER DIRECTORS, WHO COMPRISE A MINORITY OF THE BOARD. THE INCUMBENT INDEPENDENT DIRECTORS NOMINATE AND ELECT OR RE-ELECT INDEPENDENT DIRECTORS. A MEMBER ADVISORY PANEL (MAP) CONSISTS OF TEN TO FIFTEEN MEMBERS THAT ARE SELECTED BY THE WDS BOARD FROM NOMINEES BY THE GNC. THE MAP PROVIDES CONSULTATION TO THE COMPANY, INCLUDING THE GNC AND BOARD, ON A VARIETY OF MATTERS. FORM 990, PART VI, SECTION A, LINE 7B SEE ABOVE FORM 990, PART VI, SECTION A, LINE 7A FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS COMPLETED BY KPMG. THE FORM 990 IS REVIEWED AND APPROVED BY THE DIRECTOR OF FINANCE AND THE CFO. ELECTRONIC COPIES OF THE RETURN ARE PROVIDED FOR REVIEW TO ALL BOARD MEMBERS PRIOR TO SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE INVESTMENT AND AUDIT COMMITTEE OF THE BOARD IS CHARGED WITH MONITORING PROPOSED OR ON-GOING TRANSACTIONS FOR CONFLICTS OF INTEREST AND ADDRESSING ANY POTENTIAL OR ACTUAL CONFLICTS. PURSUANT TO THE CONFLICT OF INTEREST POLICY, AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE, AIMED AT DETERMINING ANY FAMILY AND BUSINESS RELATIONSHIPS AND TRANSACTIONS, OR OTHER TRANSACTIONS THAT MAY POSE A POTENTIAL CONFLICT, IS DISTRIBUTED TO ALL COVERED PERSONS (I.E. BOARD MEMBERS, OFFICERS AND EXECUTIVE LEADERSHIP OR KEY EMPLOYEES). COVERED PERSONS ARE REQUIRED TO DISCLOSE REAL OR POTENTIAL CONFLICTS AT THE TIME WHEN SUCH CONFLICTS ARISE. WHEN SOMEONE BECOMES A COVERED PERSON AND ANNUALLY THEREAFTER, THEY ARE REQUIRED TO EXPLICITLY ACKNOWLEDGE A STATEMENT AFFIRMING THAT HE/SHE: (1) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (2) HAS READ THE POLICY AND UNDERSTANDS SAID POLICY; AND (3) AGREES TO COMPLY WITH ALL REQUIREMENTS OF THE POLICY, INCLUDING COMPLETING THE CONFLICTS OF INTEREST QUESTIONNAIRE IF ANY CONFLICTS EXIST. THE COMPLETED QUESTIONNAIRES THAT NOTE ANY CONFLICTS ARE REVIEWED BY THE BOARD AND ANY PERSONS WITH ACTUAL OR POTENTIAL CONFLICTS ARE INFORMED OF ANY ACTION VIA WRITTEN COMMUNICATION. THE PROCEDURES FOR ADDRESSING ANY CONFLICT OF INTEREST INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: (1) THE CONFLICTING INTEREST IS FULLY DISCLOSED TO THE BOARD; (2) THE INTERESTED PERSON RESPONDS TO FACTUAL QUESTIONS RELATED TO THE SUBSTANCE OF THE TRANSACTION OR ARRANGEMENT BEING CONSIDERED, AFTER WHICH HE/SHE SHALL LEAVE THE MEETING; (3) THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OR DISAPPROVAL OF SUCH TRANSACTION; (4) ALTERNATIVES TO THE PROPOSED TRANSACTION ARE INVESTIGATED AND COMPETITIVE BIDS OR COMPARABLE VALUATIONS ARE OBTAINED IF DEEMED APPROPRIATE; (5) CONFLICTING ISSUES DURING THE COURSE OF A BOARD MEETING WHICH CANNOT BE RESOLVED ARE REFERRED TO THE GOVERNANCE AND NOMINATING COMMITTEE; AND (6) THE TRANSACTION OR ACTION MUST BE APPROVED BY A MAJORITY OF DISINTERESTED PERSONS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE BOARD (THE HRCC), NONE OF WHOM MAY HAVE A CONFLICT OF INTEREST WITH RESPECT TO ANY COMPENSATION ARRANGEMENTS, TO BE ACCOUNTABLE FOR SETTING REASONABLE COMPENSATION PACKAGES FOR THE CEO. THE HRCC DEVELOPED, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA FOR OFFICERS AND KEY EMPLOYEES. THE HRCC ALSO HIRES A QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALIST (INDEPENDENT EXPERT) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFIT PACKAGES OF OFFICERS AND KEY EMPLOYEES. APPROPRIATE COMPARABILITY DATA IS OBTAINED FROM THE INDEPENDENT EXPERT, I.E., TOTAL ECONOMIC BENEFITS PAID BY SIMILAR SITUATED ORGANIZATIONS (BOTH TAXABLE AND TAX-EXEMPT) FOR SIMILAR JOB RESPONSIBILITIES. THE HRCC'S WRITTEN RECORDS INCLUDE THE (1) TERMS OF THE ARRANGEMENTS WITH THE OFFICERS AND KEY EMPLOYEES (INCLUDING THE DATE THE ARRANGEMENT WAS APPROVED); (2) A LIST OF MEMBERS PRESENT DURING THE DISCUSSION ON ANY ARRANGEMENTS; AND (3) A DESCRIPTION OF THE COMPARABLE DATA RELIED UPON BY THE HRCC. KEY DELIBERATIONS OF THE HRCC ARE ALSO DOCUMENTED IN MINUTES WHICH ARE APPROVED AT THE NEXT HRCC MEETING. THE MOST RECENT COMPENSATION REVIEW WAS COMPLETED IN 2024 FOR DIRECTORS AND SMT, AND INCLUDED THE PRESIDENT/CHIEF EXECUTIVE OFFICER, CHAIR, VICE CHAIR, SECRETARY, TREASURER, OTHER C-LEVEL EXECUTIVES AND OTHER VICE PRESIDENT ROLES. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS AND DISCLOSURES ARE FILED QUARTERLY AND ANNUALLY WITH THE WASHINGTON STATE OFFICE OF THE INSURANCE COMMISSIONER (OIC) AS A MATTER OF PUBLIC RECORD. ALL DOCUMENTS SO FILED ARE AVAILABLE TO THE PUBLIC ON THE OIC WEBSITE. AMENDMENTS TO BYLAWS ARE FILED WITH THE WASHINGTON SECRETARY OF STATE'S OFFICE FROM TIME-TO-TIME AS THEY ARE APPROVED BY THE GOVERNING BODY. GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1A THE FOLLOWING DIRECTORS ALSO RECEIVED CLINICAL REIMBURSEMENTS IN ADDITION TO THEIR DIRECTOR'S FEES, THE TOTAL OF WHICH IS REPORTED IN COLUMN D - REPORTABLE COMPENSATION FROM THE ORGANIZATION. RUTHERFORD, EVE M. - $1,347,828 TOTAL DIRECTOR FEE - $204,480 CLINICAL REIMBURSEMENT - $1,143,348 HAKES, KATHERINE - $1,111,386 TOTAL DIRECTOR FEE - $149,516 CLINICAL REIMBURSEMENT - $961,870 PICKEL, CHRISTOPHER - $554,305 TOTAL DIRECTOR FEE - $149,650 CLINICAL REIMBURSEMENT - $404,655 BRADSHAW, DENNIS - $346,956 TOTAL DIRECTOR FEE - $139,668 CLINICAL REIMBURSEMENT - $207,288 FORM 990, PART XI, LINE 9: DISTRIBUTION TO WASHINGTON DENTAL SERVICES -25,907,566. FORM 990, PART XI, LINE 9, CHANGES IN NET ASSETS ON AUGUST 2, 2024 DELTA DENTAL OF WASHINGTON DISTRIBUTED $15,700,000 IN CASH AND CASH EQUIVALENTS TO ITS SOLE MEMBER WASHINGTON DENTAL SERVICE AND $10,207,566 IN 12/31/24 FOR THE SOFTWARE AND COMPUTER ASSETS DISTRIBUTION TO TRIFORZA CORP. ARCORA FOUNDATION 400 FAIRVIEW AVE N SEATTLE WA 98109 910621480 EDUCATION WA 276606 3151202 DDWA WASHINGTON DENTAL SERVICE FUND 400 FAIRVIEW AVE N SUITE 800 SEATTLE WA 98109 911281990 ORAL HEALTH EDUCATION WA 501(C)(3) LINE 10 DDWA 1 WASHINGTON DENTAL SERVICE 400 FAIRVIEW AVE N SUITE 800 SEATTLE WA 98109 270937829 HOLDING CO WA 501(C)(4) N/A 0 SPRINGROCK VENTURES II LP 2001 6TH AVE SUITE 3400 SEATTLE WA 98101 851520667 INVEST ORAL HEALTH DE N/A 0 0 SPRINGROCK VENTURES III LP 2001 6TH AVE SUITE 3400 SEATTLE WA 98101 991828881 INVEST ORAL HEALTH DE N/A 0 0 SPRINGROCK MANAGEMENT COMPANY (SRMC) 2001 6TH AVE SUITE 3400 SEATTLE WA 98101 851502581 MGMT/GP IN SRV II WA N/A C 0 TRIFORZA CORP 400 FAIRVIEW AVENUE N SUITE 800 SEATTLE WA 98109 DENTAL BENEFITS TECH SERVICES WA N/A C 0 8 WEST REVOLUTION TECHNOLOGIES LIMITED BLDG 1 UNIV TECHNOLOGY CENTRE CUR CORK EI T12 AY18 BUSINESS CONSULTING/SOFTWARE DEV COMPANY EI N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 WASHINGTON DENTAL SERVICE R 25907566 FMV WASHINGTON DENTAL SERVICE O 6306168 BOOK SPRINGROCK MANAGEMENT COMPANY O 1170329 BOOK WASHINGTON DENTAL SERVICE Q 73924 BOOK SPRINGROCK MANAGEMENT COMPANY Q 32000 BOOK