DELTA DENTAL PLAN OF NEW MEXICO INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- DELTA DENTAL PLAN OF NEW MEXICO INC (EIN 85-0224562)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-13
- IRS object ID
- 201743179349301184
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-13T08:56:52-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 Michigan Ave Ste 100 | AddressLine1Txt |
| City | East Lansing | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48823 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 850224562 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL PLAN OF NEW MEXICO INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DELT | BusinessNameControlTxt |
| Phone | 5058557114 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2500 LOUISIANA BLVD NE No 600 | AddressLine1Txt |
| City | ALBUQUERQUE | CityNm |
| State Abbreviation | NM | StateAbbreviationCd |
| ZIP | 87110 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GORAN JURKOVIC | PersonNm |
| Person Title | chief financial officer | PersonTitleTxt |
| Phone | 5058557114 | PhoneNum |
| Signature | 2017-11-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID LOWENTHAL CPA | PreparerPersonNm |
| PTIN | P00378651 | PTIN |
| Phone | 5173326200 | PhoneNum |
| Preparation | 2017-11-07 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.59.56.33 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-08 | IPDt |
| IP Tm | 13:07:25 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | D3994C8C0EED3DC07268D0E06E8E0D044B4248A2 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | EDWARD J LOPEZ JR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2500 LOUISIANA BLVD NE No 600 | AddressLine1Txt |
| City | ALBUQUERQUE | CityNm |
| State Abbreviation | NM | StateAbbreviationCd |
| ZIP | 87110 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $121,021,390 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | HTTP://WWW.DELTADENTALNM.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1971 | FormationYr |
| Legal Domicile State | NM | LegalDomicileStateCd |
| Activity Or Mission | Delta Dental of NEW MEXICO's mission is to advance and promote the improvement of oral health through prepaid dental services, support for research and education, and community outreach directed toward securing access to quality dental care for all. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 44 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $103,061,993 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $109,138,634 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,051,514 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,269,580 | CYInvestmentIncomeAmt |
| PY Other Revenue | $127,507 | PYOtherRevenueAmt |
| CY Other Revenue | $35,579 | CYOtherRevenueAmt |
| PY Total Revenue | $104,241,014 | PYTotalRevenueAmt |
| CY Total Revenue | $110,443,793 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $96,976 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $17,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,083,861 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,249,135 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $97,221,818 | PYOtherExpensesAmt |
| CY Other Expenses | $103,637,306 | CYOtherExpensesAmt |
| PY Total Expenses | $100,402,655 | PYTotalExpensesAmt |
| CY Total Expenses | $106,903,441 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,838,359 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,540,352 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $44,153,721 | TotalAssetsBOYAmt |
| Total Assets EOY | $49,931,405 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,358,542 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,133,597 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $38,795,179 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $42,797,808 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Delta Dental of NEW MEXICO's mission is to advance and promote the improvement of oral health through prepaid dental services, support for research and education, and community outreach directed toward securing access to quality dental care for all. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $105,284,980 | ExpenseAmt |
| Grant | $17,000 | GrantAmt |
| Revenue | $109,174,213 | RevenueAmt |
| Desc | PROMOTING DENTAL CAREDELTA DENTAL PLAN OF NEW MEXICO, INC. IS A LEADING PREPAID DENTAL BENEFITS PROVIDER. THE PURPOSE OF THE ORGANIZATION IS TO ADVANCE AND PROMOTE THE IMPROVEMENT OF ORAL HEALTH. THIS IS DONE BY OFFERING INNOVATIVE, COST-EFFECTIVE PRODUCTS THAT MEET THE NEEDS OF CUSTOMERS. THIS WAS DEMONSTRATED IN 2016 BY PAYING OUT OVER $97 MILLION IN CLAIMS AND BY PROVIDING DENTAL BENEFITS FOR THE PUBLIC AND ADVANCING THE SCIENCE OF DENTISTRY. IN ADDITION, OVER 600,000 CLAIMS WERE PROCESSED FOR OVER 150,000 SUBSCRIBERS.SEE SCHEDULE O FOR CONTINUATIONCOST SAVING STRATEGIESDELTA DENTAL BENEFIT PLANS ARE COMMITTED TO SAVING GROUPS AND SUBSCRIBERS MONEY. THE DELTA DIFFERENCE IS AN INTEGRATION OF ACTIVITIES; SUCH AS COST MANAGEMENT POLICIES, FEE REDUCTION AGREEMENTS WITH DENTISTS, AND AN ANTI-FRAUD HOTLINE, PUT TO WORK ENSURING QUALITY, COST-EFFECTIVE DENTAL BENEFIT DELIVERY. IN 2016, THE DELTA DIFFERENCE SAVED GROUPS AND SUBSCRIBERS APPROXIMATELY $1.8 BILLION. IN ADDITION, THE DELTA DIFFERENCE HELPS KEEP OUR TREND BELOW THE NATIONAL INFLATIONARY TREND IN DENTAL BENEFITS.DELTA DENTAL'S INDUSTRY LEADING TECHNOLOGY PLATFORM, ENTERPRISE TECHNOLOGY SOLUTIONS (ETS), HAS BEEN INTERNATIONALLY RECOGNIZED AS PROVIDING THE BEST IN FAST, FLEXIBLE SERVICE INCLUDING ONLINE, REAL-TIME CLAIMS PROCESSING. DELTA DENTAL'S CONTINUED PRIORITY IS TO REDUCE COSTS AND IMPROVE SERVICE BY INCREASING THE VOLUME OF CLAIMS THAT ARE SUBMITTED ELECTRONICALLY. QUALITY SERVICE IS ALSO MEASURED THROUGH INTERNAL AUDITS. RESULTS INDICATE OVER 99 PERCENT OF CLAIMS ARE PROCESSED WITHIN 10 WORKING DAYS.UNEQUALED ACCESS TO DENTISTSTHE BENEFITS OF DELTA DENTAL ARE NOW AVAILABLE BEYOND THIS NATION'S BORDERS. THROUGH A PARTNERSHIP WITH INTERNATIONAL SOS ASSISTANCE, INC., DELTA DENTAL ENROLLEES CAN NOW RECEIVE EXPERT TREATMENT FOR NON-EMERGENCY AND EMERGENCY DENTAL CARE WHEN THEY ARE OUTSIDE OF THE UNITED STATES.FOR FIVE DECADES, DELTA DENTAL HAS HELPED PROMOTE ORAL HEALTH BY DESIGNING AND ADMINISTERING INNOVATIVE, COST-EFFECTIVE DENTAL BENEFIT PROGRAMS. EXPERTS AT PLAN DESIGN, DELTA DENTAL HAS CREATED DENTAL BENEFIT PROGRAMS THAT MEET CUSTOMER COST-OBJECTIVES WHILE HELPING TO IMPROVE AND MAINTAIN ORAL HEALTH.THE PROGRAMS FEATURE LARGE PANELS OF FULL-TIME PARTICIPATING DENTISTS. IN FACT, 3 OUT OF 4 DENTISTS NATIONWIDE PARTICIPATE WITH DELTA DENTAL. THIS KIND OF REACH HAS ENABLED MILLIONS OF PEOPLE TO RECEIVE COST-EFFECTIVE DENTAL CARE.DELTA DENTALS GROUP MEMBERS ARE AFFORDED ADDED PROTECTION BECAUSE THEY GUARANTEE THAT PARTICIPATING DENTISTS WILL ACCEPT THEIR PAYMENT FOR COVERED SERVICES AND THAT NO CHARGES, OTHER THAN CO-PAYMENTS AND DEDUCTIBLES WILL BE BILLED. THIS LOWERS CLAIM COSTS FOR CUSTOMERS AND REDUCES OUT-OF-POCKET COSTS FOR SUBSCRIBERS.WITH TWO NETWORKS OF FULL-TIME PARTICIPATING DENTISTS IN ONE INTEGRATED CLAIMS SYSTEM, DELTA DENTAL CAN DELIVER TO CUSTOMERS AND GROUP MEMBERS, THE GREATEST ACCESS AT THE BEST COST. | Desc |
| Total Program Service Expenses | $105,284,980 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 4529 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 44 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GORAN JURKOVIC chief financial off | PersonNm |
| Phone | 5173496000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4100 Okemos Road | AddressLine1Txt |
| City | Okemos | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48864 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| EDWARD J LOPEZ JR | |||||||||
| PRESIDENT & CEO | 45.00 | 0.00 | Yes (X) | Yes (X) | $188,944 | $0 | $20 | ||
| WALTER BOLIC | |||||||||
| PRESIDENT & CEO (THRU 7/2016) | 45.00 | 5.00 | Yes (X) | Yes (X) | $250,762 | $0 | $24,799 | ||
| MICHELE M BISHOP DDS | |||||||||
| IMMEDIATE PAST CHAIRPERSON | 5.00 | 0.00 | Yes (X) | Yes (X) | $15,924 | $0 | $0 | ||
| MICHAEL BLOMKER | |||||||||
| SECRETARY/TREASURER | 5.00 | 0.00 | Yes (X) | Yes (X) | $16,242 | $0 | $0 | ||
| JULIA L PETERS | |||||||||
| SECRETARY/TREASURER (THRU 7/2016) | 5.00 | 0.00 | Yes (X) | Yes (X) | $4,500 | $0 | $0 | ||
| STEPHEN B CHREIST | |||||||||
| CHAIRPERSON | 5.00 | 5.00 | Yes (X) | Yes (X) | $35,741 | $23,500 | $0 | ||
| ROBERT L SIMMONS | |||||||||
| VICE CHAIRPERSON | 5.00 | 0.00 | Yes (X) | Yes (X) | $31,408 | $700 | $0 | ||
| MELINDA R HACKER DDS | |||||||||
| DIRECTOR | 5.00 | 0.00 | Yes (X) | $6,000 | $0 | $0 | |||
| JAMES TRUJILLO | |||||||||
| DIRECTOR | 5.00 | 0.00 | Yes (X) | $12,405 | $1,100 | $0 | |||
| RALPH MCELMURRY DDS | |||||||||
| DIRECTOR | 5.00 | 0.00 | Yes (X) | $17,476 | $0 | $0 | |||
| CHRISTINE N NATHE RDH MS | |||||||||
| DIRECTOR | 5.00 | 0.00 | Yes (X) | $3,500 | $0 | $0 | |||
| THOMAS J FLESZAR | |||||||||
| DIRECTOR | 5.00 | 12.00 | Yes (X) | $12,100 | $34,676 | $0 | |||
| GORAN JURKOVIC CPA | |||||||||
| CFO | 1.00 | 49.00 | Yes (X) | $0 | $1,636,919 | $1,412,846 | |||
| JONATHAN S GROAT | |||||||||
| GENERAL COUNSEL | 1.00 | 49.00 | Yes (X) | $0 | $364,795 | $25,974 | |||
| SARA LIMON | |||||||||
| CHIEF OPERATING OFFICER (THRU 9/2016) | 50.00 | 0.00 | Yes (X) | $157,848 | $0 | $16,168 | |||
| MICHAEL GILMORE | |||||||||
| VP, CHIEF INVESTMENT OFFICER | 1.00 | 49.00 | $0 | $324,459 | $92,986 | Yes (X) | |||
| AMY BASEL | |||||||||
| VP OF FINANCE | 1.00 | 49.00 | $0 | $361,985 | $69,760 | Yes (X) | |||
| JESUS C GALVAN | |||||||||
| CHIEF DENTAL OFFICER | 50.00 | 0.00 | $144,210 | $0 | $14,759 | Yes (X) | |||
| JOHN MAYNARD | |||||||||
| CHIEF INFORMATION OFFICER | 50.00 | 0.00 | $109,245 | $0 | $0 | Yes (X) | |||
| MICHAEL WALLACE | |||||||||
| VP - BUSINESS DEV & CORP AFFAIRS | 50.00 | 0.00 | $121,983 | $0 | $12,459 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,128,288 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,748,134 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,669,771 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HUB INTERNATIONAL INSURANCE SERVICE | |||||
| 9990 JEFFERSON NE SUITE 101 | ALBUQUERQUE | NM | 87190 | COMMISSIONS | $325,850 |
| DEWPOINT | |||||
| 300 WASHINGTON SQUARE SUITE 200 | LANSING | MI | 48933 | IT CONSULTING | $252,415 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DENTAL CARE REVENUE | Desc |
| Business | 524114 | BusinessCd |
| Total Revenue Column | $109,138,634 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $109,138,634 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $109,138,634 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $795,877 | TotalRevenueColumnAmt |
| Exclusion | $795,877 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $11,051,300 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $10,577,597 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $473,703 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $473,703 | TotalRevenueColumnAmt |
| Exclusion | $473,703 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DISCOUNT CARD INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $35,579 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $35,579 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $35,579 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $110,443,793 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $109,174,213 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,269,580 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,000 | TotalAmt |
| Program Services | $17,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $838,968 | TotalAmt |
| Program Services | $467,023 | ProgramServicesAmt |
| Management And General | $371,945 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,810,463 | TotalAmt |
| Program Services | $1,679,654 | ProgramServicesAmt |
| Management And General | $130,809 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $145,099 | TotalAmt |
| Program Services | $135,246 | ProgramServicesAmt |
| Management And General | $9,853 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $276,160 | TotalAmt |
| Program Services | $247,038 | ProgramServicesAmt |
| Management And General | $29,122 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $178,445 | TotalAmt |
| Program Services | $152,873 | ProgramServicesAmt |
| Management And General | $25,572 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $197,097 | TotalAmt |
| Management And General | $197,097 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,777 | TotalAmt |
| Management And General | $105,777 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,074 | TotalAmt |
| Management And General | $65,074 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,988,630 | TotalAmt |
| Program Services | $97,748,852 | ProgramServicesAmt |
| Management And General | $239,778 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,364 | TotalAmt |
| Program Services | $172,364 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $431,867 | TotalAmt |
| Program Services | $382,316 | ProgramServicesAmt |
| Management And General | $49,551 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $330,520 | TotalAmt |
| Program Services | $262,757 | ProgramServicesAmt |
| Management And General | $67,763 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $211,780 | TotalAmt |
| Program Services | $133,262 | ProgramServicesAmt |
| Management And General | $78,518 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,545 | TotalAmt |
| Program Services | $147,641 | ProgramServicesAmt |
| Management And General | $57,904 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,461 | TotalAmt |
| Program Services | $11,215 | ProgramServicesAmt |
| Management And General | $1,246 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,471 | TotalAmt |
| Program Services | $38,315 | ProgramServicesAmt |
| Management And General | $19,156 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,850 | TotalAmt |
| Management And General | $37,850 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| COMMISSIONS | $1,712,534 | $1,712,534 | |
| PROCESSING FEES | $1,083,513 | $1,083,513 | |
| PREMIUM TAXES | $735,672 | $735,672 | |
| Membership Dues & Assoc | $214,751 | $143,789 | $70,962 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,400 | TotalAmt |
| Program Services | $13,916 | ProgramServicesAmt |
| Management And General | $60,484 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,903,441 | TotalAmt |
| Program Services | $105,284,980 | ProgramServicesAmt |
| Management And General | $1,618,461 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,025,407 | BOYAmt |
| EOY | $2,437,207 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,181,060 | BOYAmt |
| EOY | $2,034,048 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,138,764 | BOYAmt |
| EOY | $5,883,222 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,633 | BOYAmt |
| EOY | $56,062 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,305,963 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,117,240 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $218,902 | BOYAmt |
| EOY | $188,723 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,951,526 | BOYAmt |
| EOY | $33,474,899 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,852,276 | BOYAmt |
| EOY | $4,740,015 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,697,153 | BOYAmt |
| EOY | $1,117,229 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,153,721 | BOYAmt |
| EOY | $49,931,405 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,017,792 | BOYAmt |
| EOY | $1,700,419 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $539,070 | BOYAmt |
| EOY | $1,364,821 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,801,680 | BOYAmt |
| EOY | $4,068,357 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,358,542 | BOYAmt |
| EOY | $7,133,597 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,795,179 | BOYAmt |
| EOY | $42,797,808 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,795,179 | BOYAmt |
| EOY | $42,797,808 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,153,721 | BOYAmt |
| EOY | $49,931,405 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,540,352 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $481,450 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$19,173 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,179 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,179 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $149,500 | OtherCostOrOtherBasisAmt |
| Depreciation | $134,688 | DepreciationAmt |
| Book Value | $14,812 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,108,992 | OtherCostOrOtherBasisAmt |
| Depreciation | $956,308 | DepreciationAmt |
| Book Value | $152,684 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,292 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,065 | DepreciationAmt |
| Book Value | $21,227 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $188,723 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $4,440,015 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SURPLUS NOTE RECEIVABLE | Desc |
| Book Value | $300,000 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $4,740,015 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| CLAIMS RESERVES | $3,679,210 |
| DUE TO AFFILIATE | $389,147 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,068,357 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $110,424,620 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$19,173 | OtherRevenueAmt |
| Revenue Not Reported | -$19,173 | RevenueNotReportedAmt |
| Revenue Subtotal | $110,443,793 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $110,443,793 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $106,903,441 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $106,903,441 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $106,903,441 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part XI, Line 2d - Other Adjustments: | FormAndLineReferenceDesc |
| Explanation | LOSS ON RENAISSANCE HOLDING COMPANY INVESTMENT -19,173. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| SPECIAL OLYMPICS NEW MEXICO INC | |||||||
| 6600 PALOMAS NE | ALBUQUERQUE | NM | 87109 | 850268084 | 501(c)(3) | $10,000 | CHARITABLE DONATION |
| presbyterian healthcare foundation | |||||||
| po box 26666 | alBUQUERQUE | NM | 87125 | 856016041 | 501(c)(3) | $7,000 | charitable donation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | Contributions are made at the organization's discretion to organizations that support Delta Dental Plan of NEW MEXICO's mission. In order for funds to be disbursed, voucher records must pass through the approval process, similar to any other expenditure made by Delta Dental Plan of NEW MEXICO. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EDWARD J LOPEZ JR | ||||||||||||||
| PRESIDENT & CEO | $159,358 | $0 | $23,000 | $0 | $6,586 | $0 | $0 | $0 | $20 | $0 | $188,964 | $0 | $0 | $0 |
| WALTER BOLIC | ||||||||||||||
| PRESIDENT & CEO (THRU 7/2016) | $156,122 | $0 | $80,000 | $0 | $14,640 | $0 | $24,782 | $0 | $17 | $0 | $275,561 | $0 | $0 | $0 |
| GORAN JURKOVIC CPA | ||||||||||||||
| CFO | $0 | $844,887 | $0 | $776,485 | $0 | $15,547 | $0 | $1,390,840 | $0 | $22,006 | $0 | $3,049,765 | $0 | $0 |
| JONATHAN S GROAT | ||||||||||||||
| GENERAL COUNSEL | $0 | $260,163 | $0 | $99,401 | $0 | $5,231 | $0 | $18,619 | $0 | $7,355 | $0 | $390,769 | $0 | $0 |
| SARA LIMON | ||||||||||||||
| CHIEF OPERATING OFFICER (THRU 9/2016 | $122,453 | $0 | $35,014 | $0 | $381 | $0 | $16,146 | $0 | $22 | $0 | $174,016 | $0 | $0 | $0 |
| MICHAEL GILMORE | ||||||||||||||
| VP, CHIEF INVESTMENT OFFICER | $0 | $230,791 | $0 | $90,750 | $0 | $2,918 | $0 | $70,980 | $0 | $22,006 | $0 | $417,445 | $0 | $0 |
| AMY BASEL | ||||||||||||||
| VP OF FINANCE | $0 | $256,679 | $0 | $100,808 | $0 | $4,498 | $0 | $47,754 | $0 | $22,006 | $0 | $431,745 | $0 | $0 |
| JESUS C GALVAN | ||||||||||||||
| CHIEF DENTAL OFFICER | $126,770 | $0 | $10,000 | $0 | $7,440 | $0 | $14,759 | $0 | $0 | $0 | $158,969 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 4b | THE RELATED ORGANIZATION, DELTA DENTAL PLAN OF MICHIGAN, HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). IN ORDER TO BE ELIGIBLE FOR THE SERP, AN EMPLOYEE MUST BE A SENIOR VICE PRESIDENT OR HIGHER. AN OUTSIDE INDEPENDENT ACTUARY CALCULATES THE VALUE ON AN ANNUAL BASIS. IN 2016, GORAN JURKOVIC, CFO, PARTICIPATED IN THE SERP BUT DID NOT RECEIVE A DISTRIBUTION. |
| Part I, Line 7 | AS INDICATED IN SCHEDULE J, PART II, TOP MANAGEMENT OFFICIALS RECEIVED A BONUS BASED ON PERFORMANCE AND THE FINANCIAL RESULTS OF THE ORGANIZATION. THIS BONUS WAS APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | DELTA DENTAL PLAN OF NEW MEXICO, INC. HAS A SOLE MEMBER, RENAISSANCE HEALTH SERVICE CORPORATION. |
| Form 990, Part VI, Section A, line 7a | BOARD MEMBERS ARE ELECTED BY THE PRESENT BOARD AND ARE APPROVED BY RENAISSANCE HEALTH SERVICE CORPORATION, THE SOLE CORPORATE MEMBER OF DELTA DENTAL PLAN OF NEW MEXICO, INC. |
| Form 990, Part VI, Section A, line 7b | AS STATED, THE PRESENT BOARD IS ELECTED BY THE CURRENT BOARD MEMBERS, BUT MUST BE APPROVED BY RHSC. |
| Form 990, Part VI, Section B, line 11b | THE INFORMATION PRESENTED ON THE FORM 990 IS GATHERED BY THE SENIOR TAX ADMINISTRATOR FOR THE ORGANIZATION. THE CFO REVIEWS THE INFORMATION. ONCE APPROVED THE INFORMATION IS GIVEN TO OUTSIDE TAX PREPARERS WHO PREPARE AND REVIEW THE FORM 990. ONCE COMPLETE, A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD TO REVIEW PRIOR TO FILING FORM 990 WITH THE IRS. |
| Form 990, Part VI, Section B, line 12c | The ENTERPRISE'S Vice President and General Counsel is charged with reviewing and monitoring any potential conflict of interest transactions. All members of the board of directors, officers, and key employees are required to review and execute a conflict of interest policy. This policy requires that any conflicts of interest be disclosed on an annual basis, or at any other time that the person executing the policy becomes aware of a situation or transaction that actually or potentially creates a conflict of interest. All conflict of interest disclosure forms are initially reviewed by the Vice President and General Counsel. If a prohibited transaction were identified, the matter would be brought to the Chairperson of the Board for further review and appropriate action. In the event of a conflict of interest involving a member of the Board of Directors, such as a conflict in which a member had an interest, the member is required to disclose the potential conflict and abstain from any vote on the matter. Whether further precautions are required (e.g., prohibiting the interested party from engaging in discussions) would depend upon the specific nature and background of the conflict. |
| Form 990, Part VI, Section B, line 15 | Outside compensation consultants are used to determine market data for the executive positions and for other officers and key employees. THE POSITIONS COVERED ARE THE CEO AND CFO. THE ORGANIZATION CONTRACTS WITH TOWERS WATSON TO DO A COMPENSATION AND REASONABLENESS ANALYSIS EVERY TWO YEARS. The final determination of compensation is done by the Executive Committee of the Board of Directors, which is made up of independent persons, and is based on the comparability data provided by the compensation consultants. The deliberations and decisions regarding the compensation are contemporaneously documented in the committee minutes and approved by the board. THE COMPENSATION WAS LAST REVIEWED UNDER THIS PROCESS DURING 2016. THE REPORT BASED ON THIS REVIEW WAS THEN ISSUED BY THE CONSULTANTS IN 2017. |
| Form 990, Part VI, Section C, line 19 | DELTA DENTAL PLAN OF NEW MEXICO, INC. (DDNM) FILES ON A QUARTERLY AND ANNUAL BASIS COMPREHENSIVE FINANCIAL DOCUMENTS WITH THE NEW MEXICO OFFICE OF INSURANCE SUPERINTENDENT (OSI). OSI AND THE NEW MEXICO SECRETARY OF STATE HAVE ON FILE ALL GOVERNING DOCUMENTS. THE DDNM'S 990 FORM IS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VII | Certain employees are officers of multiple companies within the larger organization. The average hours worked reflects approximate time spent in each of those individual companies. While the hours are allocated to individual companies, much of the officers' time is spent working on issues that impact the entire organization, not just one company. Compensation is reported in full to agree to the employee's W-2 as required by IRS instructions. Any allocation of compensation is included on Schedule R. |
| Form 990, Part IX, line 11g | CONTRACT LABOR: Program service expenses 463,124. Management and general expenses 239,778. Fundraising expenses 0. Total expenses 702,902. PURCHASED DENTAL SERVICES: Program service expenses 97,285,728. Management and general expenses 0. Fundraising expenses 0. Total expenses 97,285,728. |
| Form 990, Part XI, line 9: | LOSS ON INVESTMENT IN RENAISSANCE HOLDING COMPANY -19,173. |
| FORM 990, PART XIi, LINE 2C: | IN REGARDS TO THE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT, THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| RENAISSANCE HEALTH SERVICE CORPORATION | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 381675667 | PROMOTING DENTAL CARE | MI | 501(c)(4) | N/A | N/A | 0 | |
| DELTA DENTAL PLAN OF MICHIGAN INC | |||||||||||
| 4100 OKEMOS ROAD | OKEMOS | MI | 48864 | 381791480 | PROVIDE DENTAL SERVICE PLANS | MI | 501(c)(4) | N/A | Yes (1) | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL PLAN OF INDIANA INC | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 351545647 | PROVIDE DENTAL SERVICE PLANS | IN | 501(c)(4) | N/A | Yes (1) | delta dental plan of michigan inc | |
| DELTA DENTAL PLAN OF OHIO INC | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 310685339 | PROVIDE DENTAL SERVICE PLANS | OH | 501(c)(4) | N/A | Yes (1) | delta dental plan of michigan inc | |
| DELTA DENTAL OF TENNESSEE INC | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 620812197 | PROVIDE DENTAL SERVICE PLANS | TN | 501(c)(4) | N/A | Yes (1) | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL OF KENTUCKY INC | |||||||||||
| pO BOX 30416 | LANSING | MI | 489097916 | 610659432 | PROVIDE DENTAL SERVICE PLANS | KY | 501(c)(4) | N/A | Yes (1) | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL FUND | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 382337000 | SUPPORT DENTAL EDUCATION AND RESEARCH PROGRAMS | MI | 501(c)(3) | Line 12b, II | Yes (1) | delta dental plan of michigan inc | |
| DELTA DENTAL OF NORTH CAROLINA | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 561018068 | PROVIDE DENTAL SERVICE PLANS | NC | 501(c)(4) | N/A | Yes (1) | Renaissance Health Service Corporation | |
| DELTA DENTAL OF ARKANSAS | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 710561140 | PROVIDE DENTAL SERVICE PLANS | AR | 501(c)(4) | N/A | Yes (1) | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL OF ARKANSAS FOUNDATION | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 261569324 | Emphasize DENTAL HEALTH IN COMMUNITIES | AR | 501(c)(3) | PF | Yes (1) | DELTA DENTAL OF ARKANSAS | |
| RENAISSANCE FAMILY FOUNDATION INC | |||||||||||
| 4100 OKEMOS ROAD | OKEMOS | MI | 48864 | 461376165 | Emphasize DENTAL HEALTH IN COMMUNITIES | IN | 501(c)(3) | PF | Yes (1) | RENAISSANCE HOLDING COMPANY | |
| SMILE 180 FOUNDATION | |||||||||||
| 240 VENTURE CIRCLE | NASHVILLE | TN | 37228 | 471654054 | Emphasize DENTAL HEALTH IN COMMUNITIES | TN | 501(c)(3) | Line 12a, I | Yes (1) | DELTA DENTAL OF TENNESSEE INC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RENAISSANCE HOLDING COMPANY | ||||||||||||
| PO BOX 30381 | LANSING | MI | 48909 | 412177193 | HOLDING COMPANY | MI | RENAISSANCE HEALTH SERVICE CORPORATION | C | $55,716 | $4,949,382 | 0.04000 | Yes (1) |
| Renaissance Life & Health Insurance Company OF AMERICA | ||||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 470397286 | INSURANCE | IN | RENAISSANCE HOLDING COMPANY | C | Yes (1) | |||
| RENAISSANCE HEALTH INSURANCE COMPANY OF NEW YORK | ||||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 134098096 | INSURANCE | NY | RENAISSANCE HOLDING COMPANY | C | Yes (1) | |||
| FOre Holding Corporation | ||||||||||||
| 240 VENTURE CIRCLE | NASHVILLE | TN | 37228 | 204116122 | HOLDING COMPANY | TN | DELTA DENTAL OF TENNESSEE | C | Yes (1) | |||
| DENTAL CHOICE INC | ||||||||||||
| 10100 LINN STATION RD 700 | LOUISVILLE | KY | 402233861 | 611105118 | PROVIDE DENTAL SERVICE PLANS | KY | DELTA DENTAL OF KENTUCKY | C | Yes (1) | |||
| DENTAL CHOICE AGENCY INC | ||||||||||||
| 10100 LINN STATION RD 700 | LOUISVILLE | KY | 402233861 | 611336003 | PRIMARY GENERAL AGENCY FOR DDKY AND DENTAL CHOICE | KY | DELTA DENTAL OF KENTUCKY | C | Yes (1) | |||
| OMEGA ADMINISTRATORS INC | ||||||||||||
| 1513 COUNTRY CLUB ROAD | SHERWOOD | AR | 72120 | 043740469 | PROVIDING THIRD-PARTY ADMINISTRATIVE SERVICES | AR | DELTA DENTAL OF ARKANSAS | C | Yes (1) | |||
| GLM HOLDING COMPANY | ||||||||||||
| 4100 OKEMOS ROAD | OKEMOS | MI | 48864 | 472557772 | INVESTMENT IN SUBSIDIARIES | MI | DELTA DENTAL OF MICHIGAN | C | Yes (1) | |||
| DEWPOINT INC | ||||||||||||
| 300 S WASHINGTON SQUARE | LANSING | MI | 48933 | 383300595 | IT CONSULTING | MI | GLM HOLDING COMPANY | C | Yes (1) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| DELTA DENTAL PLAN OF MICHIGAN inc | ||
| M | $1,274,281 | actual cost |
| delta dental of north carolina | ||
| D | $300,000 | Actual cost |
| delta dental of north carolina | ||
| A | $23,667 | Actual cost |
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