2017-11-10T07:04:02-06:00 2016-12-31 GRANT THORNTON LLP 75 State Street Boston MA 02109 990 2016-01-01 050296998 Delta Dental of Rhode Island % GEORGE BEDARD DELT 4017526000 10 Charles Street Providence RI 02904 RICHARD A FRITZ VP Finance & CFO 4017526000 2017-11-15 true ROBERT J BUTLER JR mdirector P00037953 6177237900 2017-11-15 38.69.39.117 04586620173145000001 2017-11-10 P AC49DF7B4F2ECAA147D716DF4F48DB487416CA3B 9D49953C1E783D387C9BA17CAD36DC199840A584 2016 2018-03-14 21:41:22Z Joseph Nagle 10 Charles Street Providence RI 02904 223550482 false X www.deltadentalri.com X 1959 RI To provide cost effective group dental insurance to the Rhode Island business communities. 15 14 59 0 0 0 0 0 196524961 200306895 3147829 2169630 169621 174071 199842411 202650596 545271 557920 177440293 179613864 11724651 11862556 0 0 0 9070969 8102295 198781184 200136635 1061227 2513961 107812958 114660592 18698122 21821982 89114836 92838610 Our 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. false false 180171784 557920 200184887 DENTAL 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. 8050575 141694 OPERATIONS EXPENSE INCURRED TO ADMINISTER THE PAYMENT OF DENTAL BENEFITS. 188222359 false false false false false false false false false true true false false true true false true false false false false false false false false false true false true false false false false false false false true false false false false false true true true false true 15 0 true 59 true false false false false false false X 15 14 false false false false true true true true true false false true true true true true true true true false X GEORGE BEDARD 4017526240 10 CHARLES STREET Providence RI 02904 Julie G Duffy Director 1.0 1.0 X 6500 0 0 Francis J Flynn Director 1.0 1.0 X 6500 0 0 William G Foulkes Director 1.0 1.0 X 8000 0 0 Jonathan W Hall Director 1.0 1.0 X 3500 0 0 Almon C Hall Director 1.0 1.0 X 8500 0 0 Edward O Handy III Director 1.0 1.0 X 8200 0 0 Steven J Issa Chair 1.0 1.0 X X 11000 0 0 Joseph J MarcAurele Director 1.0 1.0 X 8000 0 0 Linda R McGoldrick Director 1.0 1.0 X 7500 0 0 James F McManus DDS Director 1.0 1.0 X 7500 0 0 Marc A Paulhus Director 1.0 1.0 X 3000 0 0 Cynthia S Reed Director 1.0 1.0 X 9500 0 0 James V Rosati Director 1.0 1.0 X 3000 0 0 John T Ruggieri Vice Chair 1.0 1.0 X X 8000 0 0 Vanessa Toledo-Vickers Director 1.0 1.0 X 7500 0 0 Fred K Butler Vice Chair (Thru 04/16) 1.0 1.0 X X 6000 0 0 William A Mekrut Chair (Thru 04/16) 1.0 1.0 X X 10500 0 0 Edwin J Santos Director (Thru 04/16) 1.0 1.0 X 6200 0 0 JOSEPH NAGLE President & CEO 40.0 1.0 X 1438636 0 138260 RICHARD FRITZ VP Finance, CFO & Treasurer 40.0 1.0 X 359305 0 57053 KERRIE BENNETT VP Marketing & Secretary 40.0 1.0 X 246577 0 40884 GEORGE BEDARD Controller & Asst Treasurer 40.0 1.0 X 139318 0 36104 MELISSA GENNARI Director Compliance & Asst Sec 40.0 1.0 X 139371 0 16375 THOMAS CHASE VP Technology & CIO 40.0 1.0 X 0 388888 56796 JOSEPH PERRONI VP Sales-Dental & Altus Dental 40.0 1.0 X 351889 0 54782 BLAINE CARROLL VP Strategic Initiatives 40.0 1.0 X 276954 0 55262 ANGELO PEZZULO VP Sales 40.0 1.0 X 205497 0 39806 ELLEN HENDRIX AVP Underwriting 40.0 1.0 X 158323 0 40156 TIMOTHY FITZGIBBONS Sr. Director Actuarial 40.0 1.0 X 159987 0 36761 DUANE EASTER Director of Corp Reporting 40.0 1.0 X 134583 0 36721 SHAUNA FONTAINE Director of Sales 40.0 1.0 X 130162 0 29740 3869502 388888 638700 16 false true false NETCENERY LLC 231 ELM STREET WARWICK RI 02888 IT CONSULTING 762481 DUFFY SHANLEY INC 10 CHARLES STREET PROVIDENCE RI 02904 MARKETING SERVICES 427305 CATHEDRAL CORPORATION GRIFFIN TECHNOLOGY PARK ROME NY 13441 PRINTING AND MAIL 349437 EDGEWATER TECHNOLOGY INC PO BOX 845183 BOSTON MA 02284 IT PRODUCT DEVELOP. 248592 The Hilb Group of New England LLC 931 Jefferson Blvd Suite 3001 WARWICK RI 02886 Insurance Broker 354930 22 0 PREMIUMS 524114 200306895 200306895 200306895 1860173 1860173 0 0 0 0 0 21209343 20899886 309457 309457 309457 0 0 0 0 0 0 0 0 0 INCOME FROM SUBSIDIARIES 900099 154385 154385 OTHER INCOME 900099 19686 19686 174071 202650596 200326581 0 2324015 557920 557920 0 0 179613864 179613864 3031552 738887 2292665 0 7395071 4119323 3275748 389716 217086 172630 340551 189699 150852 705666 348193 357473 0 155960 155960 277149 277149 60000 60000 0 722292 722292 1072929 285398 787531 506165 506165 872698 621382 251316 0 0 810615 406355 404260 111114 3694 107420 0 6085 6085 0 0 934025 934025 162511 162511 EQUIPMENT RENTAL & MAINT 1049102 1049102 BOARD & ASSOCIATION FEES 379937 9346 370591 FACILITIES EXPENSES 184166 184166 LICENSES & FEES 21660 965 20695 775887 1145 774742 200136635 188222359 11914276 0 250 250 -1358237 7733838 0 0 11805775 10456635 0 0 0 0 0 0 0 0 2714640 2344899 11587778 10657978 1566512 929800 80960681 81864937 10344305 10694024 0 0 0 0 1779032 636209 107812958 114660592 11594232 14845989 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7103890 6975993 18698122 21821982 X 0 0 0 0 89114836 92838610 89114836 92838610 107812958 114660592 X 2513961 680449 529364 X false true X true false 2689561 2599768 89793 5934895 5209413 725482 2963322 2848797 114525 929800 SUBSIDIARIES 7965026 C INVESTMENT-OTHER 2728998 F 10694024 0 CLAIMS INCURRED BUT UNPAID 4267000 ADVANCED SUBSCRIBER PREMIUMS 1754524 ACCRUED CLAIMS ADJUSTMENT EXPENSE 394381 ADVANCED DEPOSITS 560088 6975993 X ASC 470 SCHEDULE 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. RI FOUNDATION ONE UNION STATION Providence RI 02914 222604963 501 (C) (3) 52500 Program Support UNITED WAY OF RI 50 VALLEY STREET Providence RI 02909 050276059 501 (C) (3) 39205 Program Support RI COMMUNITY FOOD BANK 200 NIANTIC AVE Providence RI 02907 050395601 501 (C) (3) 37050 Program Support LA SALLE ACADEMY 612 ACADEMY AVE Providence RI 02908 050258897 501 (C) (3) 27700 Program Support CVS CHARITY CLASSIC INC ONE CVS DRIVE WOONSOCKET Woonsocket RI 02895 050508742 501 (C) (3) 26500 Program Support SAN MIGUEL SCHOOL 525 BRANCH AVENUE Providence RI 02904 223232973 501 (C) (3) 21950 Program Support SOCIAL ENTERPRISE GREENHOUSE 460 HARRIS AVE 303 Providence RI 02909 260163730 501 (C) (3) 20000 Program Support SALVE REGINA UNIVERSITY 100 OCHRE POINT AVE Newport RI 02840 050259080 501 (C) (3) 16750 Program Support CROSSROADS RHODE ISLAND 160 BROAD STREET Providence RI 02903 050259094 501 (C) (3) 16150 Program Support JOHNSON & WALES UNIVERSITY 8 ABBOT PARK PLACE Providence RI 02903 050306206 501 (C) (3) 15000 Program Support FIRST WORKS 275 WESTMINSTER STREET Providence RI 02903 222597014 501 (C) (3) 10000 Program Support CITY YEAR INC 287 COLUMBUS AVE Boston MA 02116 222882549 501 (C) (3) 10000 Program Support LEARNING COMMUNITY 21 LINCOLN AVE Central Fall RI 02863 470942849 501 (C) (3) 10000 Program Support VENTURE FOR AMERICA 40 WEST 29TH STREET SUITE 301 New York NY 10001 272987904 501 (C) (3) 10000 Program Support MIRIAM HOSPITAL FOUNDATION 167 POINT STREET Providence RI 02903 050377502 501 (C) (3) 9500 Program Support RI HOSPITAL FOUNDATION 167 POINT STREET Providence RI 02903 050468736 501 (C) (3) 9500 Program Support PROVIDENCE COLLEGE 1 CUNNING SQUARE Providence RI 02908 050258932 501 (C) (3) 8720 Program Support AAACAA EASTERN CONFERENCE 1415 KELLUM PL Garden City NY 11530 133224101 501 (C) (3) 8550 Program Support FRIARS FOREVER FUND 1 CUNNING SQUARE Providence RI 02908 050258932 501 (C) (3) 7830 Program Support JEFFREY OSBORNE CELEBRITY CLASSIC P O BOX 27815 Providence RI 02907 050510492 501 (C) (3) 7500 Program Support JUNIOR ACHIEVEMENT 57 GREENE STREET Warwick RI 02886 050263443 501 (C) (3) 7500 Program Support MCAULEY MINISTRIES 622 ELMWOOD AVE Providence RI 02907 050440470 501 (C) (3) 7474 Program Support COMMUNITY PREPARATORY SCHOOL 135 PRAIRIE AVE Providence RI 02905 222485332 501 (C) (3) 7080 Program Support BRYANT UNIVERSITY 1150 DOUGLAS TURNPIKE Smithfield RI 02908 050258810 501 (C) (3) 6750 Program Support HASBRO CHILDREN'S HOSPITAL 139 POINT STREET Providence RI 02903 050377502 501 (C) (3) 6750 Program Support MARCH OF DIMES FOUNDATION 1275 MAMARONECK AVE White Plains NY 10605 131846366 501 (C) (3) 6100 Program Support OCEAN STATE JOB LOT CHARITABLE 375 COMMERCE PARK RD N Kingston RI 02852 200959438 501 (C) (3) 6000 Program Support AMOS HOUSE 415 FRIENDSHIP STREET Providence RI 02907 050387218 501 (C) (3) 5450 Program Support TOMORROW FUND 593 EDDY STREET Providence RI 02903 050450569 501 (C) (3) 5300 Program Support 29 0 Schedule I, Part I, Line 2 The Company does not issue specific grants, however, as part of THE corporate responsibility program, DELTA DENTAL OF RHODE ISLAND supports local charitable organizations. X X X true true X X X X X false true false false false false false false false JOSEPH NAGLE President & CEO 609084 0 206220 0 623332 0 119031 0 19229 0 1576896 0 448109 0 RICHARD FRITZ VP Finance, CFO & Treasurer 299070 0 57333 0 2902 0 37074 0 19979 0 416358 0 0 0 KERRIE BENNETT VP Marketing & Secretary 208842 0 37281 0 454 0 29953 0 10931 0 287461 0 0 0 GEORGE BEDARD Controller & Asst Treasurer 131527 0 6017 0 1774 0 16954 0 19150 0 175422 0 0 0 MELISSA GENNARI Director Compliance & Asst Sec 125748 0 13064 0 559 0 14850 0 1525 0 155746 0 0 0 THOMAS CHASE VP Technology & CIO 0 324921 0 62275 0 1692 0 37167 0 19629 0 445684 0 0 JOSEPH PERRONI VP Sales-Dental & Altus Dental 269122 0 75387 0 7380 0 36153 0 18629 0 406671 0 0 0 BLAINE CARROLL VP Strategic Initiatives 229325 0 45453 0 2176 0 33816 0 21446 0 332216 0 0 0 ANGELO PEZZULO VP Sales 150317 0 47827 0 7353 0 20176 0 19630 0 245303 0 0 0 ELLEN HENDRIX AVP Underwriting 144433 0 13194 0 696 0 19446 0 20710 0 198479 0 0 0 TIMOTHY FITZGIBBONS Sr. Director Actuarial 153994 0 5255 0 738 0 18131 0 18630 0 196748 0 0 0 DUANE EASTER Director of Corp Reporting 121599 0 12610 0 374 0 15541 0 21180 0 171304 0 0 0 SHAUNA FONTAINE Director of Sales 105195 0 19799 0 5168 0 11134 0 18606 0 159902 0 0 0 Gross-Up Payments Schedule 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 Dues Schedule 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 plan Schedule 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). McManus Pratt McManus - Board Member 482358 Payment to Dental Practice false Business Transactions Involving Interested Persons Schedule 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. MEMBERS OF THE ORGANIZATION FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS 75 CORPORATE MEMBERS. MEMBERS THAT MAY ELECT THE GOVERNING BODY Form 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 MEMBERS Form 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 PROCESS Form 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 POLICY Form 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 POLICY Form 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 DISCLOSURE Form 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 ASSETS FORM 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. Altus Realty Company 10 Charles Street Providence RI 029042208 030396397 Holding Co. RI 501(c)(2) N/A DDRI true The Altus Group Inc 10 Charles Street Providence RI 029042208 050502610 Insurance RI DDRI C Corp 66722379 43499975 1.00000 true Altus Dental Inc 10 Charles Street Providence RI 029042208 050502612 Insurance RI Altus Group C Corp 0 0 1.00000 true Altus Ventures Inc 10 Charles Street Providence RI 029042208 465627174 Venture Cap RI Altus Group C Corp 0 0 1.00000 true Altus Dental Insurance Co Inc 10 Charles Street Providence RI 029042208 050513223 Insurance RI Altus Group C Corp 0 0 1.00000 true Altus Systems Inc 10 Charles Street Providence RI 029042208 050502611 Insurance RI Altus Group C Corp 0 0 1.00000 true First Circle Inc 10 Charles Street Providence RI 02904 814567207 SOFTWARE RI Altus Group C Corp 0 0 1.00000 true true false false true false false false false false false true true true true true false false false false Altus Dental Insurance Co Inc A(iv) 266600 FMV Altus Dental Inc A(i) 93783 FMV Altus Realty Company A(i) 60723 FMV Altus Realty Company D 2756267 FMV Altus Realty Company K 810615 FMV Altus Systems Inc L 5553970 FMV Altus Dental Insurance Co Inc M 1308764 FMV Altus Dental Insurance Co Inc O 848273 FMV