DELTA DENTAL OF RHODE ISLAND: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL OF RHODE ISLAND (EIN 05-0296998)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-10
IRS object ID
201713149349300311
Schema version
2016v3.1
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

FieldValueIRS element (for citing)
Return2017-11-10T07:04:02-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1GRANT THORNTON LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line175 State StreetAddressLine1Txt
CityBostonCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02109ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN050296998EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Delta Dental of Rhode IslandBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% GEORGE BEDARDInCareOfNm
Business Name ControlDELTBusinessNameControlTxt
Phone4017526000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110 Charles StreetAddressLine1Txt
CityProvidenceCityNm
State AbbreviationRIStateAbbreviationCd
ZIP02904ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRICHARD A FRITZPersonNm
Person TitleVP Finance & CFOPersonTitleTxt
Phone4017526000PhoneNum
Signature2017-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonROBERT J BUTLER JR mdirectorPreparerPersonNm
PTINP00037953PTIN
Phone6177237900PhoneNum
Preparation2017-11-15PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address38.69.39.117IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id04586620173145000001FederalOriginalSubmissionId
Federal Original Submission Id2017-11-10FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdAC49DF7B4F2ECAA147D716DF4F48DB487416CA3BAtSubmissionCreationDeviceId
At Submission Filing Device Id9D49953C1E783D387C9BA17CAD36DC199840A584AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2018-03-14 21:41:22ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJoseph NaglePrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line110 Charles StreetAddressLine1Txt
CityProvidenceCityNm
State AbbreviationRIStateAbbreviationCd
ZIP02904ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$223,550,482GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website Addresswww.deltadentalri.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1959FormationYr
Legal Domicile StateRILegalDomicileStateCd
Activity Or MissionTo provide cost effective group dental insurance to the Rhode Island business communities.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee59TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$196,524,961PYProgramServiceRevenueAmt
CY Program Service Revenue$200,306,895CYProgramServiceRevenueAmt
PY Investment Income$3,147,829PYInvestmentIncomeAmt
CY Investment Income$2,169,630CYInvestmentIncomeAmt
PY Other Revenue$169,621PYOtherRevenueAmt
CY Other Revenue$174,071CYOtherRevenueAmt
PY Total Revenue$199,842,411PYTotalRevenueAmt
CY Total Revenue$202,650,596CYTotalRevenueAmt
PY Grants And Similar Paid$545,271PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$557,920CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$177,440,293PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$179,613,864CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,724,651PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$11,862,556CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$9,070,969PYOtherExpensesAmt
CY Other Expenses$8,102,295CYOtherExpensesAmt
PY Total Expenses$198,781,184PYTotalExpensesAmt
CY Total Expenses$200,136,635CYTotalExpensesAmt
PY Revenues Less Expenses$1,061,227PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,513,961CYRevenuesLessExpensesAmt
Total Assets BOY$107,812,958TotalAssetsBOYAmt
Total Assets EOY$114,660,592TotalAssetsEOYAmt
Total Liabilities BOY$18,698,122TotalLiabilitiesBOYAmt
Total Liabilities EOY$21,821,982TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$89,114,836NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$92,838,610NetAssetsOrFundBalancesEOYAmt
MissionOur mission is to deliver impeccable service, quality and innovation that exceeds expectations. As experts in oral health care, we are committed to accessible, affordable care that drives improved health outcomes.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$180,171,784ExpenseAmt
Grant$557,920GrantAmt
Revenue$200,184,887RevenueAmt
DescDENTAL BENEFITS FOR 602,183 MEMBERS UNDER 288,236 CONTRACTS. THE COMPANY OFFERS A BROAD RANGE OF PREPAID DENTAL CARE COVERAGE OPTIONS AND ADMINISTRATIVE SERVICES TO ORGANIZATIONS PROVIDING SUCH BENEFITS TO THEIR EMPLOYEES ON A CONTRIBUTORY OR A NONCONTRIBUTORY BASIS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$8,050,575ExpenseAmt
Revenue$141,694RevenueAmt
DescOPERATIONS EXPENSE INCURRED TO ADMINISTER THE PAYMENT OF DENTAL BENEFITS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$188,222,359TotalProgramServiceExpensesAmt
Described In Section501c3falseDescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntYes (true)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document15IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee59EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonGEORGE BEDARDPersonNm
Phone4017526240PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110 CHARLES STREETAddressLine1Txt
CityProvidenceCityNm
State AbbreviationRIStateAbbreviationCd
ZIP02904ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Julie G Duffy
Director1.01.0Yes (X)$6,500$0$0
Francis J Flynn
Director1.01.0Yes (X)$6,500$0$0
William G Foulkes
Director1.01.0Yes (X)$8,000$0$0
Jonathan W Hall
Director1.01.0Yes (X)$3,500$0$0
Almon C Hall
Director1.01.0Yes (X)$8,500$0$0
Edward O Handy III
Director1.01.0Yes (X)$8,200$0$0
Steven J Issa
Chair1.01.0Yes (X)$11,000$0$0Yes (X)
Joseph J MarcAurele
Director1.01.0Yes (X)$8,000$0$0
Linda R McGoldrick
Director1.01.0Yes (X)$7,500$0$0
James F McManus DDS
Director1.01.0Yes (X)$7,500$0$0
Marc A Paulhus
Director1.01.0Yes (X)$3,000$0$0
Cynthia S Reed
Director1.01.0Yes (X)$9,500$0$0
James V Rosati
Director1.01.0Yes (X)$3,000$0$0
John T Ruggieri
Vice Chair1.01.0Yes (X)$8,000$0$0Yes (X)
Vanessa Toledo-Vickers
Director1.01.0Yes (X)$7,500$0$0
Fred K Butler
Vice Chair (Thru 04/16)1.01.0Yes (X)$6,000$0$0Yes (X)
William A Mekrut
Chair (Thru 04/16)1.01.0Yes (X)$10,500$0$0Yes (X)
Edwin J Santos
Director (Thru 04/16)1.01.0Yes (X)$6,200$0$0
JOSEPH NAGLE
President & CEO40.01.0$1,438,636$0$138,260Yes (X)
RICHARD FRITZ
VP Finance, CFO & Treasurer40.01.0$359,305$0$57,053Yes (X)
KERRIE BENNETT
VP Marketing & Secretary40.01.0$246,577$0$40,884Yes (X)
GEORGE BEDARD
Controller & Asst Treasurer40.01.0$139,318$0$36,104Yes (X)
MELISSA GENNARI
Director Compliance & Asst Sec40.01.0$139,371$0$16,375Yes (X)
THOMAS CHASE
VP Technology & CIO40.01.0$0$388,888$56,796Yes (X)
JOSEPH PERRONI
VP Sales-Dental & Altus Dental40.01.0$351,889$0$54,782Yes (X)
BLAINE CARROLL
VP Strategic Initiatives40.01.0$276,954$0$55,262Yes (X)
ANGELO PEZZULO
VP Sales40.01.0$205,497$0$39,806Yes (X)
ELLEN HENDRIX
AVP Underwriting40.01.0$158,323$0$40,156Yes (X)
TIMOTHY FITZGIBBONS
Sr. Director Actuarial40.01.0$159,987$0$36,761Yes (X)
DUANE EASTER
Director of Corp Reporting40.01.0$134,583$0$36,721Yes (X)
SHAUNA FONTAINE
Director of Sales40.01.0$130,162$0$29,740Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,869,502TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$388,888TotReportableCompRltdOrgAmt
Total Other Compensation$638,700TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K16IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
NETCENERY LLC
231 ELM STREETWARWICKRI02888IT CONSULTING$762,481
DUFFY SHANLEY INC
10 CHARLES STREETPROVIDENCERI02904MARKETING SERVICES$427,305
CATHEDRAL CORPORATION
GRIFFIN TECHNOLOGYPARK ROMENY13441PRINTING AND MAIL$349,437
EDGEWATER TECHNOLOGY INC
PO BOX 845183BOSTONMA02284IT PRODUCT DEVELOP.$248,592
The Hilb Group of New England LLC
931 Jefferson Blvd Suite 3001WARWICKRI02886Insurance Broker$354,930
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K22CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPREMIUMSDesc
Business524114BusinessCd
Total Revenue Column$200,306,895TotalRevenueColumnAmt
Related Or Exempt Func Income$200,306,895RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$200,306,895TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,860,173TotalRevenueColumnAmt
Exclusion$1,860,173ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$21,209,343SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$20,899,886SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$309,457SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$309,457TotalRevenueColumnAmt
Exclusion$309,457ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
INCOME FROM SUBSIDIARIES900099$154,385$154,385
OTHER INCOME900099$19,686$19,686
FieldValueIRS element (for citing)
Other Revenue Total$174,071OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$202,650,596TotalRevenueColumnAmt
Related Or Exempt Func Income$200,326,581RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,324,015ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$557,920TotalAmt
Program Services$557,920ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$179,613,864TotalAmt
Program Services$179,613,864ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$3,031,552TotalAmt
Program Services$738,887ProgramServicesAmt
Management And General$2,292,665ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,395,071TotalAmt
Program Services$4,119,323ProgramServicesAmt
Management And General$3,275,748ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$389,716TotalAmt
Program Services$217,086ProgramServicesAmt
Management And General$172,630ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$340,551TotalAmt
Program Services$189,699ProgramServicesAmt
Management And General$150,852ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$705,666TotalAmt
Program Services$348,193ProgramServicesAmt
Management And General$357,473ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$155,960TotalAmt
Management And General$155,960ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$277,149TotalAmt
Management And General$277,149ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$60,000TotalAmt
Program Services$60,000ProgramServicesAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$722,292TotalAmt
Management And General$722,292ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,072,929TotalAmt
Program Services$285,398ProgramServicesAmt
Management And General$787,531ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$506,165TotalAmt
Management And General$506,165ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$872,698TotalAmt
Program Services$621,382ProgramServicesAmt
Management And General$251,316ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$810,615TotalAmt
Program Services$406,355ProgramServicesAmt
Management And General$404,260ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$111,114TotalAmt
Program Services$3,694ProgramServicesAmt
Management And General$107,420ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$6,085TotalAmt
Management And General$6,085ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$934,025TotalAmt
Management And General$934,025ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$162,511TotalAmt
Management And General$162,511ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
EQUIPMENT RENTAL & MAINT$1,049,102$1,049,102
BOARD & ASSOCIATION FEES$379,937$9,346$370,591
FACILITIES EXPENSES$184,166$184,166
LICENSES & FEES$21,660$965$20,695

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$775,887TotalAmt
Program Services$1,145ProgramServicesAmt
Management And General$774,742ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$200,136,635TotalAmt
Program Services$188,222,359ProgramServicesAmt
Management And General$11,914,276ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$250BOYAmt
EOY$250EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY-$1,358,237BOYAmt
EOY$7,733,838EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$11,805,775BOYAmt
EOY$10,456,635EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,714,640BOYAmt
EOY$2,344,899EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$11,587,778LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$10,657,978LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,566,512BOYAmt
EOY$929,800EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$80,960,681BOYAmt
EOY$81,864,937EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$10,344,305BOYAmt
EOY$10,694,024EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,779,032BOYAmt
EOY$636,209EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$107,812,958BOYAmt
EOY$114,660,592EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$11,594,232BOYAmt
EOY$14,845,989EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,103,890BOYAmt
EOY$6,975,993EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$18,698,122BOYAmt
EOY$21,821,982EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$89,114,836BOYAmt
EOY$92,838,610EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$89,114,836BOYAmt
EOY$92,838,610EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$107,812,958BOYAmt
EOY$114,660,592EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,513,961ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$680,449NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$529,364OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp
BuildingsBuildingsGrp

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,689,561OtherCostOrOtherBasisAmt
Depreciation$2,599,768DepreciationAmt
Book Value$89,793BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,934,895OtherCostOrOtherBasisAmt
Depreciation$5,209,413DepreciationAmt
Book Value$725,482BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,963,322OtherCostOrOtherBasisAmt
Depreciation$2,848,797DepreciationAmt
Book Value$114,525BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$929,800TotalBookValueLandBuildingsAmt
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
SUBSIDIARIES$7,965,026C
INVESTMENT-OTHER$2,728,998F
FieldValueIRS element (for citing)
Total Book Value Securities$10,694,024TotalBookValueSecuritiesAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
CLAIMS INCURRED BUT UNPAID$4,267,000
ADVANCED SUBSCRIBER PREMIUMS$1,754,524
ACCRUED CLAIMS ADJUSTMENT EXPENSE$394,381
ADVANCED DEPOSITS$560,088
FieldValueIRS element (for citing)
Total Liability$6,975,993TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceASC 470FormAndLineReferenceDesc
ExplanationSCHEDULE D, PART X Delta Dental of Rhode Island is a not-for-profit corporation pursuant to Section 501(c)(4) of the Internal Revenue Code (IRC) and is generally exempt from federal income taxes on related income under Section 501(a) of the IRC and, accordingly, no provision for income taxes relative to Delta Dental of Rhode Island has been made in the accompanying consolidated financial statements. The Company evaluates its uncertain tax positions with a two-step process in accordance with GAAP. First, the Company determines whether it is more likely than not that an uncertain tax position will be sustained upon examination based on the technical merits of the position. Second, an uncertain tax position that meets the more likely than not threshold is measured to determine the amount of benefit to recognize in the financial statements. The position is measured at the largest amount of benefit that is greater than 50% likely of being realized upon ultimate settlement. Uncertain tax positions that previously failed to meet the more likely than not recognition threshold are recognized in the first subsequent reporting period in which the threshold is met. Previously recognized uncertain tax positions that no longer meet the more likely than not recognition threshold are derecognized in the first subsequent reporting period in which the threshold is no longer met. Should interest or penalties be assessed, such expenses would be reflected in selling, general and administrative expenses. As of December 31, 2016 and 2015, the Company had no uncertain tax positions.ExplanationTxt

Schedule I IRS990ScheduleI

Recipient Table RecipientTable (29 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
RI FOUNDATION
ONE UNION STATIONProvidenceRI02914222604963501 (C) (3)$52,500Program Support
UNITED WAY OF RI
50 VALLEY STREETProvidenceRI02909050276059501 (C) (3)$39,205Program Support
RI COMMUNITY FOOD BANK
200 NIANTIC AVEProvidenceRI02907050395601501 (C) (3)$37,050Program Support
LA SALLE ACADEMY
612 ACADEMY AVEProvidenceRI02908050258897501 (C) (3)$27,700Program Support
CVS CHARITY CLASSIC INC
ONE CVS DRIVE WOONSOCKETWoonsocketRI02895050508742501 (C) (3)$26,500Program Support
SAN MIGUEL SCHOOL
525 BRANCH AVENUEProvidenceRI02904223232973501 (C) (3)$21,950Program Support
SOCIAL ENTERPRISE GREENHOUSE
460 HARRIS AVE 303ProvidenceRI02909260163730501 (C) (3)$20,000Program Support
SALVE REGINA UNIVERSITY
100 OCHRE POINT AVENewportRI02840050259080501 (C) (3)$16,750Program Support
CROSSROADS RHODE ISLAND
160 BROAD STREETProvidenceRI02903050259094501 (C) (3)$16,150Program Support
JOHNSON & WALES UNIVERSITY
8 ABBOT PARK PLACEProvidenceRI02903050306206501 (C) (3)$15,000Program Support
FIRST WORKS
275 WESTMINSTER STREETProvidenceRI02903222597014501 (C) (3)$10,000Program Support
CITY YEAR INC
287 COLUMBUS AVEBostonMA02116222882549501 (C) (3)$10,000Program Support
LEARNING COMMUNITY
21 LINCOLN AVECentral FallRI02863470942849501 (C) (3)$10,000Program Support
VENTURE FOR AMERICA
40 WEST 29TH STREET SUITE 301New YorkNY10001272987904501 (C) (3)$10,000Program Support
MIRIAM HOSPITAL FOUNDATION
167 POINT STREETProvidenceRI02903050377502501 (C) (3)$9,500Program Support
RI HOSPITAL FOUNDATION
167 POINT STREETProvidenceRI02903050468736501 (C) (3)$9,500Program Support
PROVIDENCE COLLEGE
1 CUNNING SQUAREProvidenceRI02908050258932501 (C) (3)$8,720Program Support
AAACAA EASTERN CONFERENCE
1415 KELLUM PLGarden CityNY11530133224101501 (C) (3)$8,550Program Support
FRIARS FOREVER FUND
1 CUNNING SQUAREProvidenceRI02908050258932501 (C) (3)$7,830Program Support
JEFFREY OSBORNE CELEBRITY CLASSIC
P O BOX 27815ProvidenceRI02907050510492501 (C) (3)$7,500Program Support
JUNIOR ACHIEVEMENT
57 GREENE STREETWarwickRI02886050263443501 (C) (3)$7,500Program Support
MCAULEY MINISTRIES
622 ELMWOOD AVEProvidenceRI02907050440470501 (C) (3)$7,474Program Support
COMMUNITY PREPARATORY SCHOOL
135 PRAIRIE AVEProvidenceRI02905222485332501 (C) (3)$7,080Program Support
BRYANT UNIVERSITY
1150 DOUGLAS TURNPIKESmithfieldRI02908050258810501 (C) (3)$6,750Program Support
HASBRO CHILDREN'S HOSPITAL
139 POINT STREETProvidenceRI02903050377502501 (C) (3)$6,750Program Support
MARCH OF DIMES FOUNDATION
1275 MAMARONECK AVEWhite PlainsNY10605131846366501 (C) (3)$6,100Program Support
OCEAN STATE JOB LOT CHARITABLE
375 COMMERCE PARK RDN KingstonRI02852200959438501 (C) (3)$6,000Program Support
AMOS HOUSE
415 FRIENDSHIP STREETProvidenceRI02907050387218501 (C) (3)$5,450Program Support
TOMORROW FUND
593 EDDY STREETProvidenceRI02903050450569501 (C) (3)$5,300Program Support
FieldValueIRS element (for citing)
Total501c3 Org29Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part I, Line 2FormAndLineReferenceDesc
ExplanationThe Company does not issue specific grants, however, as part of THE corporate responsibility program, DELTA DENTAL OF RHODE ISLAND supports local charitable organizations.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JOSEPH NAGLE
President & CEO$609,084$0$206,220$0$623,332$0$119,031$0$19,229$0$1,576,896$0$448,109$0
RICHARD FRITZ
VP Finance, CFO & Treasurer$299,070$0$57,333$0$2,902$0$37,074$0$19,979$0$416,358$0$0$0
KERRIE BENNETT
VP Marketing & Secretary$208,842$0$37,281$0$454$0$29,953$0$10,931$0$287,461$0$0$0
GEORGE BEDARD
Controller & Asst Treasurer$131,527$0$6,017$0$1,774$0$16,954$0$19,150$0$175,422$0$0$0
MELISSA GENNARI
Director Compliance & Asst Sec$125,748$0$13,064$0$559$0$14,850$0$1,525$0$155,746$0$0$0
THOMAS CHASE
VP Technology & CIO$0$324,921$0$62,275$0$1,692$0$37,167$0$19,629$0$445,684$0$0
JOSEPH PERRONI
VP Sales-Dental & Altus Dental$269,122$0$75,387$0$7,380$0$36,153$0$18,629$0$406,671$0$0$0
BLAINE CARROLL
VP Strategic Initiatives$229,325$0$45,453$0$2,176$0$33,816$0$21,446$0$332,216$0$0$0
ANGELO PEZZULO
VP Sales$150,317$0$47,827$0$7,353$0$20,176$0$19,630$0$245,303$0$0$0
ELLEN HENDRIX
AVP Underwriting$144,433$0$13,194$0$696$0$19,446$0$20,710$0$198,479$0$0$0
TIMOTHY FITZGIBBONS
Sr. Director Actuarial$153,994$0$5,255$0$738$0$18,131$0$18,630$0$196,748$0$0$0
DUANE EASTER
Director of Corp Reporting$121,599$0$12,610$0$374$0$15,541$0$21,180$0$171,304$0$0$0
SHAUNA FONTAINE
Director of Sales$105,195$0$19,799$0$5,168$0$11,134$0$18,606$0$159,902$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Gross-Up PaymentsSchedule J, Part I, Line 1a THE CEO'S EMPLOYMENT AGREEMENT CONTAINS PROVISIONS FOR HIM TO RECEIVE PAYMENTS SO THAT HE CAN PERSONALLY PROCURE CERTAIN FRINGE BENEFITS SUCH AS LIFE INSURANCE AND LONG TERM DISABILITY POLICIES, AND PENSION AND RETIREMENT BENEFITS THAT ARE OTHERWISE AVAILABLE TO ALL OTHER EMPLOYEES. THIS ADDITIONAL INCOME IS GROSSED UP TO ACCOUNT FOR THE TAX IMPACT OF THESE PAYMENTS AND THE GROSS-UP IS INCLUDED IN REPORTABLE COMPENSATION ON SCHEDULE J PART II COLUMN (B)(III).
Health or Social Club DuesSchedule J, Part I, Line 1a The CEO is a member of a local business club. Reimbursement for use of this is exclusively for offsite employee meetings as well as business related meetings with individuals outside the company. The company maintains strict policies regarding substantiation and documentation for all business related expenses incurred. This benefit is NOT reported as taxable compensation. Travel For Companions Schedule J, Part I, Line 1a The CEO's wife accompanies him for various business meetings. This benefit is reported as taxable compensation included on Schedule J Part II column B(iii).
Supplemental nonqualified retirement planSchedule J, Part I, Line 4b The CEO participates in a 457(F) deferred compensation plan and has met a vesting criteria during 2016. Therefore a payment of $538,724 was made to the CEO in 2016 and reported on Schedule J Part II column B(iii). $448,109 of the payment was previously reported as deferred compensation on prior returns, as such it is disclosed on Schedule J Part II Column F. In addition, contributions of $66,031 made to the plan during 2016 have been reported on Schedule J Part II Column (C).

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonMcManus PrattPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionMcManus - Board MemberRelationshipDescriptionTxt
Transaction$482,358TransactionAmt
TransactionPayment to Dental PracticeTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceBusiness Transactions Involving Interested PersonsFormAndLineReferenceDesc
ExplanationSchedule L Part IV The organization engages in transactions with dental practices of whom the board member identified in Schedule L Part IV has a controlling interest. The transactions are entered into in the ordinary course of business and at fair market value. Transactions with this entity are subject to the same procedures and review as all dental practices.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
MEMBERS OF THE ORGANIZATIONFORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS 75 CORPORATE MEMBERS.
MEMBERS THAT MAY ELECT THE GOVERNING BODYForm 990, Part VI, section a, LINE 7a The corporate members meet annually to approve any by-law changes and to elect individuals to the 15 member board of directors which is the organization's governing body. All 15 members of the board of directors also serve as representatives of the corporate members.
DECISIONS OF THE GOVERNING BODY SUBJECT TO APPROVAL BY MEMBERSForm 990, Part VI, section a, LINE 7b The members of the corporation, at the annual meeting, shall elect directors of the corporation that have been proposed by the board of directors and shall approve amendments or alterations of the by-laws proposed by the board of directors.
FORM 990 REVIEW PROCESSForm 990, Part VI, Section B, Line 11 THE ANNUAL FORM 990 IS PREPARED BY GRANT THORNTON LLP, THE COMPANY'S TAX ADVISOR AND INDEPENDENT AUDITOR, USING INFORMATION PROVIDED BY DELTA DENTAL OF RHODE ISLAND. AFTER PREPARATION AND REVIEW OF THE RETURN BY GRANT THORNTON, THE DRAFT is REVIEWED BY Delta Dental's FINANCE DEPARTMENT AND MANAGEMENT, INCLUDING THE CONTROLLER, CFO, AND CEO AS NECESSARY. THE COMPLETE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
CONFLICT OF INTEREST POLICYForm 990, Part VI, section b, LINE 12c All W-2 employees, interns, temps, dental consultants, and board members complete an annual conflict of interest questionnaire. The review process for complete questionnaires containing disclosures is as follows: For W-2 employees, interns, and temps, disclosures are reviewed by the director of compliance and CFO. Disclosed potential conflicts are discussed and may be elevated in the review process to the CEO and external legal counsel for advice. Any required actions are immediately implemented in accordance with the company's documented conflict of interest policies. For the CEO and CFO, disclosures are reviewed by external legal counsel. Legal counsel advises of any required actions which are immediately implemented in accordance with the company's documented standards of conduct and business ethics and conflict of interest policies. For dental consultants, disclosures are reviewed by the director of compliance, the VP-CFO, and the VP-CIO. All conflicts are discussed and may be elevated to external legal counsel for advice. Any required actions are immediately implemented in accordance with the company's documented conflict of interest policies. For board members, disclosures are reviewed by external legal counsel. Legal counsel prepares a written memorandum for presentation to board members with the results of the review. All conflicts are discussed and any required actions are immediately implemented in accordance with the company's documented conflict of interest policies. In the case of a conflict, immediate and appropriate action is taken in accordance with the company's policies. Persons with a conflict are recused from discussions and do not vote on resolutions that pertain directly to their conflict.
COMPENSATION POLICYForm 990, Part VI, SECTION B, LINE 15 The board of directors elects independent members to serve on its compensation committee which is responsible for setting the CEO's compensation and approving pay ranges for the various job tracks within the company as well as approving any fringe benefits. The company and the committee annually contract with independent compensation consultants to help determine appropriate pay ranges and fringe benefits such as health and other insurances and retirement and other benefits. Comparable data is used to determine whether compensation is consistent with similar organizations. Recommendations for the CEO's compensation are made by the compensation committee to the board of directors for review and approval. The review and approval process is contemporaneously documented in the minutes of both the compensation committee and the board of directors.
PUBLIC DISCLOSUREForm 990, Part VI, SECTION C, LINE 19 The company's governing documents, such as bylaws and corporate charter, are available upon request from the company and can also be obtained from the secretary of state's office within the state of Rhode Island. The company's conflict of interest policy, as well as the company's audited financial statements, are also available upon request at the company's headquarters. Additionally, all statutory filings completed by the company are available through the insurance division within the Rhode Island department of business regulation. The company's Form 990 is also posted on www.guidestar.org.
OTHER CHANGES IN NET ASSETSFORM 990, PART XI, LINE 9 LINE 9 INCLUDES AN ADJUSTMENT OF $572,320 FOR OVERACCRUED EXPENSES RELATED TO A JOINT VENTURE WITH OTHER DELTA DENTAL PLANS AND AN ADJUSTMENT OF ($42,956) FOR A BOND IMPAIRMENT WRITE DOWN. TOTAL OTHER CHANGES IN NET ASSETS EQUAL $529,360.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Altus Realty CompanyBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line110 Charles StreetAddressLine1Txt
CityProvidenceCityNm
State AbbreviationRIStateAbbreviationCd
ZIP029042208ZIPCd
FieldValueIRS element (for citing)
EIN030396397EIN
Primary ActivitiesHolding Co.PrimaryActivitiesTxt
Legal Domicile StateRILegalDomicileStateCd
Exempt Code Section501(c)(2)ExemptCodeSectionTxt
Public Charity StatusN/APublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1DDRIBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (true)ControlledOrganizationInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
The Altus Group Inc
10 Charles StreetProvidenceRI029042208050502610InsuranceRIDDRIC Corp$66,722,379$43,499,9751.00000Yes (true)
Altus Dental Inc
10 Charles StreetProvidenceRI029042208050502612InsuranceRIAltus GroupC Corp$0$01.00000Yes (true)
Altus Ventures Inc
10 Charles StreetProvidenceRI029042208465627174Venture CapRIAltus GroupC Corp$0$01.00000Yes (true)
Altus Dental Insurance Co Inc
10 Charles StreetProvidenceRI029042208050513223InsuranceRIAltus GroupC Corp$0$01.00000Yes (true)
Altus Systems Inc
10 Charles StreetProvidenceRI029042208050502611InsuranceRIAltus GroupC Corp$0$01.00000Yes (true)
First Circle Inc
10 Charles StreetProvidenceRI02904814567207SOFTWARERIAltus GroupC Corp$0$01.00000Yes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (true)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (8 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Altus Dental Insurance Co Inc
A(iv)$266,600FMV
Altus Dental Inc
A(i)$93,783FMV
Altus Realty Company
A(i)$60,723FMV
Altus Realty Company
D$2,756,267FMV
Altus Realty Company
K$810,615FMV
Altus Systems Inc
L$5,553,970FMV
Altus Dental Insurance Co Inc
M$1,308,764FMV
Altus Dental Insurance Co Inc
O$848,273FMV

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