DELTA DENTAL OF WASHINGTON: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL OF WASHINGTON (EIN 91-0621480)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-08-04
IRS object ID
201602179349301265
Schema version
2015v2.1
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)
Return2016-08-04T12:37:29-05:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11918 Eighth Avenue Suite 2900AddressLine1Txt
CitySeattleCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98101ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN910621480EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Delta Dental of WashingtonBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% BRADLEY BERGInCareOfNm
Business Name ControlDELTBusinessNameControlTxt
Phone2065221300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line19706 4th Ave NEAddressLine1Txt
CitySeattleCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98115ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBRADLEY A BERGPersonNm
Person TitleCFO & COOPersonTitleTxt
Signature2016-08-03SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSUE ROBISONPreparerPersonNm
PTINP00560072PTIN
Phone2069134000PhoneNum
Preparation2016-08-03PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2016-12-15 16:53:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBradley A BergPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line19706 4th Ave NEAddressLine1Txt
CitySeattleCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98115ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,175,911,531GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website Addresswww.deltadentalwa.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1954FormationYr
Legal Domicile StateWALegalDomicileStateCd
Activity Or MissionSEE SCHEDULE OActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee411TotalEmployeeCnt
Total Volunteers59TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$51,320PYContributionsGrantsAmt
CY Contributions Grants$121,448CYContributionsGrantsAmt
PY Program Service Revenue$1,075,513,470PYProgramServiceRevenueAmt
CY Program Service Revenue$1,140,842,247CYProgramServiceRevenueAmt
PY Investment Income$18,236,329PYInvestmentIncomeAmt
CY Investment Income$5,698,486CYInvestmentIncomeAmt
PY Other Revenue$663,309PYOtherRevenueAmt
CY Other Revenue$882,837CYOtherRevenueAmt
PY Total Revenue$1,094,464,428PYTotalRevenueAmt
CY Total Revenue$1,147,545,018CYTotalRevenueAmt
PY Grants And Similar Paid$4,423,574PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$6,123,545CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$978,586,624PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$1,033,807,840CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$40,132,663PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$43,531,908CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$50,963,849PYOtherExpensesAmt
CY Other Expenses$52,975,817CYOtherExpensesAmt
PY Total Expenses$1,074,106,710PYTotalExpensesAmt
CY Total Expenses$1,136,439,110CYTotalExpensesAmt
PY Revenues Less Expenses$20,357,718PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$11,105,908CYRevenuesLessExpensesAmt
Total Assets BOY$237,972,879TotalAssetsBOYAmt
Total Assets EOY$233,609,242TotalAssetsEOYAmt
Total Liabilities BOY$51,398,676TotalLiabilitiesBOYAmt
Total Liabilities EOY$59,767,140TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$186,574,203NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$173,842,102NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangeYes (true)SignificantChangeInd
Expense$1,068,371,404ExpenseAmt
Revenue$1,140,741,658RevenueAmt
DescSEE SCHEDULE ODesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,011,395ExpenseAmt
DescSEE SCHEDULE ODesc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$1,294,421ExpenseAmt
Grant$1,294,421GrantAmt
DescSEE SCHEDULE ODesc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$5,339,271ExpenseAmt
Grant$4,829,124GrantAmt
Revenue$100,589RevenueAmt
DescOTHER INCOMEDesc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$5,339,271TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$4,829,124TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$100,589TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$1,078,016,491TotalProgramServiceExpensesAmt
Described In Section501c3falseDescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyYes (true)PoliticalCampaignActyInd
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 SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
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 EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
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 Document49824IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee411EmployeeCnt
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 Members11GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
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 VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldWAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBRADLEY BERGPersonNm
Phone2065221300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line19706 4TH AVE NEAddressLine1Txt
CitySEATTLECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98115ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
BECK GEORGE DOUGLAS
CHAIR11.04.0Yes (X)Yes (X)$96,732$0$0
BROWN COLLEEN
DIRECTOR4.03.0Yes (X)$64,468$0$0
DWYER JAMES D
PRESIDENT & CEO36.04.0Yes (X)Yes (X)$1,321,493$0$140,633
FARRELL ANNE V
DIRECTOR7.03.0Yes (X)$67,570$0$0
HARWELL JANIS L
SECRETARY8.03.0Yes (X)Yes (X)$58,379$0$0
LABBERTON WELLS K
DIRECTOR7.03.0Yes (X)$282,007$0$0
LOHKAMP JOANNA LYN
DIRECTOR8.03.0Yes (X)$60,689$0$0
PHIPPS GERALD S
VICE CHAIR10.04.0Yes (X)Yes (X)$77,762$0$0
RUTHERFORD EVE
DIRECTOR7.03.0Yes (X)$482,307$0$0
SEELY JEFFREY THOMAS
DIRECTOR10.04.0Yes (X)$64,484$0$0
TUNE JAMES F
TREASURER7.03.0Yes (X)Yes (X)$58,387$0$0
BERG BRADLEY A
COO & CFO36.04.0$657,532$0$112,525Yes (X)
MERLO KRISTIN N
CHIEF MKTG, INFO & SALES OFF40.00.0$627,847$0$48,817Yes (X)
GATES THOMAS A
VP, PLANNING & CORP DEVEL40.00.0$468,335$0$88,725Yes (X)
SMITH LAURA J
WDS FDN, PRESIDENT & CEO40.00.0$426,676$0$27,612Yes (X)
LO ERIC C
VP, ACTUARIAL & UNDERWRITING40.00.0$348,943$0$38,947Yes (X)
ALIABADI KAREN
CHIEF HR STRATEGIST40.00.0$266,574$0$85,494Yes (X)
BURSETT JOHN T
SR VP, UNDERWRITING/ACTUARIAL32.00.0$265,665$0$39,947Yes (X)
LAY LINDA T
DIRECTOR, SALES ACCT. MGMT40.00.0$247,448$0$23,764Yes (X)
SNYDER CINDY K
VP, INNOVATIVE SERVICES40.00.0$291,053$0$111,523Yes (X)
WHITNEY GARRETT
DIR., IT ARCHITECTURE/INFRA40.00.0$222,255$0$29,015Yes (X)
DOSCH KYLE P
DENTAL DIRECTOR40.00.0$217,613$0$23,473Yes (X)
ORENSTEIN JANE
DIRECTOR, REG. & COMPLIANCE40.00.0$216,661$0$32,592Yes (X)
CURHAN SUSAN
SENIOR SALES EXECUTIVE40.00.0$210,640$0$36,809Yes (X)
LILEY DARRYL
DIRECTOR, IT OPERATIONS40.00.0$205,344$0$25,506Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$7,306,864TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$865,382TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K96IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/ForeignAddress/AddressLine1TxtCityContractorAddress/ForeignAddress/CityNmProvince Or StateContractorAddress/ForeignAddress/ProvinceOrStateNmCountryContractorAddress/ForeignAddress/CountryCdServicesServicesDescCompensationCompensationAmtAddress Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCd
DECARE SYSTEMS
UNIT 1 CURRAHEEN ROADCORK0EISOFTWARE DEVELOPMENT$5,142,398
EMDEON BUSINESS SERVICES
PRINTING/MAILING$3,624,343PO BOX 572490MURRAYUT84157
ENCARA INC
IND. PLAN TPA$2,213,3434818 STARKET ROAD SWROANOKEVA24018
GREENRUBINO INC
ADVERTISING AGENCY$2,168,1441938 FAIRVIEW AVE E 200SEATTLEWA98102
AON CONSULTING INC
BROKER$1,372,544PO BOX 905494CHARLOTTENC28290
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K83CntrctRcvdGreaterThan100KCnt
Related Organizations$8,750RelatedOrganizationsAmt
All Other Contributions$112,698AllOtherContributionsAmt
Total Contributions$121,448TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PROGRAM REVENUE524114$1,140,741,658$1,140,741,658
SMILEMOBILE (MOBILE DENTIST OFFICE)621990$100,589$100,589
FieldValueIRS element (for citing)
Total Program Service Revenue$1,140,842,247TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,207,792TotalRevenueColumnAmt
Exclusion$5,207,792ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$149,001TotalRevenueColumnAmt
Exclusion$149,001ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

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

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$479,396RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$479,396RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$479,396TotalRevenueColumnAmt
Exclusion$479,396ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$28,605,267SecuritiesAmt
Other$102,939OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$28,366,513SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$238,754SecuritiesAmt
Other$102,939OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$341,693TotalRevenueColumnAmt
Exclusion$341,693ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

Net Income From Gaming NetIncomeFromGamingGrp

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Business900099BusinessCd
Total Revenue Column$403,441TotalRevenueColumnAmt
Related Or Exempt Func Income$403,441RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$403,441OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,147,545,018TotalRevenueColumnAmt
Related Or Exempt Func Income$1,141,245,688RelatedOrExemptFuncIncomeAmt
Exclusion$6,177,882ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$6,123,545TotalAmt
Program Services$6,123,545ProgramServicesAmt

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$1,033,807,840TotalAmt
Program Services$1,033,807,840ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$6,358,369TotalAmt
Program Services$2,755,297ProgramServicesAmt
Management And General$3,603,072ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$26,399,808TotalAmt
Program Services$9,362,581ProgramServicesAmt
Management And General$17,037,227ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,632,380TotalAmt
Program Services$525,208ProgramServicesAmt
Management And General$1,107,172ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$6,731,470TotalAmt
Program Services$2,476,963ProgramServicesAmt
Management And General$4,254,507ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,409,881TotalAmt
Program Services$1,018,274ProgramServicesAmt
Management And General$1,391,607ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$14,106TotalAmt
Program Services$25,079ProgramServicesAmt
Management And General-$10,973ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$332,070TotalAmt
Management And General$332,070ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$72,113TotalAmt
Program Services$72,113ProgramServicesAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$471,398TotalAmt
Management And General$471,398ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$6,856,503TotalAmt
Program Services$3,117,591ProgramServicesAmt
Management And General$3,738,912ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$5,239,910TotalAmt
Program Services$3,011,395ProgramServicesAmt
Management And General$2,228,515ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,697,055TotalAmt
Program Services$3,393,751ProgramServicesAmt
Management And General$2,303,304ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$5,156,715TotalAmt
Program Services$38,962ProgramServicesAmt
Management And General$5,117,753ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,011,257TotalAmt
Program Services$856,261ProgramServicesAmt
Management And General$1,154,996ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,505,840TotalAmt
Program Services$545,934ProgramServicesAmt
Management And General$959,906ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$759,447TotalAmt
Program Services$133,702ProgramServicesAmt
Management And General$625,745ManagementAndGeneralAmt

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$4,474,434TotalAmt
Program Services$58,020ProgramServicesAmt
Management And General$4,416,414ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$279,891TotalAmt
Management And General$279,891ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
COMMISSIONS$9,310,507$9,310,507
TAXES & SERVICE CHARGES$9,431,715$1,263,229$8,168,486
RESEARCH & DEVELOPMENT$250,300$250,300
DUES & SUBSCRIPTIONS$852,417$72,469$779,948

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$260,139TotalAmt
Program Services$47,770ProgramServicesAmt
Management And General$212,369ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,136,439,110TotalAmt
Program Services$1,078,016,491ProgramServicesAmt
Management And General$58,422,619ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,100,790BOYAmt
EOY$215,485EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,027,927BOYAmt
EOY$2,627,084EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$21,069,920BOYAmt
EOY$28,082,760EOYAmt

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$2,974,435BOYAmt
EOY$3,916,372EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$67,937,854LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$48,244,152LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$16,820,018BOYAmt
EOY$19,693,702EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$188,980,209BOYAmt
EOY$176,925,744EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$275,732BOYAmt
EOY$1,263,358EOYAmt

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$723,848BOYAmt
EOY$884,737EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$237,972,879BOYAmt
EOY$233,609,242EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$44,126,705BOYAmt
EOY$52,572,751EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$873,466BOYAmt
EOY$125,000EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$6,398,505BOYAmt
EOY$7,069,389EOYAmt

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$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$51,398,676BOYAmt
EOY$59,767,140EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$186,574,203BOYAmt
EOY$173,842,102EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

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

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$186,574,203BOYAmt
EOY$173,842,102EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$237,972,879BOYAmt
EOY$233,609,242EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$11,105,908ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$6,937,007NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments-$1,002PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$16,900,000OtherChangesInNetAssetsAmt
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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Political Expenditures$122,850PoliticalExpendituresAmt
Internal Funds Contributed$122,850InternalFundsContributedAmt
Total Exempt Function Expend$122,850TotalExemptFunctionExpendAmt
Form1120 POL FiledYes (true)Form1120POLFiledInd

Section527 Political Org Section527PoliticalOrgGrp (6 entries)

Business Name Line2OrganizationBusinessName/BusinessNameLine2TxtAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPaid Internal FundsPaidInternalFundsAmt
COMMITTEE TO ELECT
BARBARA BAILEYPO BOX 374OAK HARBORWA98277020556800$950
FRIENDS TO ELECT
RANDI BECKERPO BOX 83GRAHAMWA98338770708976$950
COMMITTEE TO ELECT
DON BENTONPO BOX 5076VANCOUVERWA98686510645142$950
FRIENDS OF ANDY
BILLIGPO BOX 145SPOKANEWA99210271127517$950
COMMITTEE TO ELECT
BRIAN BLAKEPO BOX 1541LONGVIEWWA98632870699800$950
FRIENDS OF BRADY
WALKINSHAW3518 FREMONT AVE NW 545SEATTLEWA98103464272797$950
FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceForm Sch C Part I-A Line 1FormAndLineReferenceDesc
ExplanationDDWA PROVIDES DIRECT CAMPAIGN CONTRIBUTIONS TO CANDIDATES FOR WASHINGTON STATE ELECTED EXECUTIVE OFFICE, LEGISLATIVE OFFICE, AND POLITICAL ORGANIZATIONS IN ORDER TO PROMOTE AN ENVIRONMENT FOR IMPROVED ORAL HEALTH AND OVERALL HEALTH CARE POLICY, AS WELL AS TO SUPPORT OUR OVERALL MISSION OF IMPROVING ORAL HEALTH IN OUR STATE. DDWA ALSO PROVIDES LIMITED, DIRECT SUPPORT FOR LOCAL LEVEL CANDIDATES OR INITIATIVES THAT PROMOTE A POSITIVE BUSINESS CLIMATE IN WASHINGTON STATE. ALL CONTRIBUTIONS ARE CONDUCTED IN ACCORDANCE WITH FEDERAL AND STATE LAWS AND REPORTING REQUIREMENTS.ExplanationTxt

Schedule D IRS990ScheduleD

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

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,211,191OtherCostOrOtherBasisAmt
Book Value$1,211,191BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,163,206OtherCostOrOtherBasisAmt
Depreciation$8,599,153DepreciationAmt
Book Value$2,564,053BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,715,345OtherCostOrOtherBasisAmt
Depreciation$816,542DepreciationAmt
Book Value$898,803BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,133,820OtherCostOrOtherBasisAmt
Depreciation$9,774,378DepreciationAmt
Book Value$2,359,442BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$41,714,292OtherCostOrOtherBasisAmt
Depreciation$29,054,079DepreciationAmt
Book Value$12,660,213BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$19,693,702TotalBookValueLandBuildingsAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (15 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
WASHINGTON EARLY LEARNING FUND
1218 THIRD AVENUESEATTLEWA98101912041837501(C)(3)$45,000YEARLY THRIVE BY FIVE FUNDING
PENINSULA COMMUNITY HEALTH SERVICES - ADMINISTRATI
400 WARREN AVENUE SUITE 300BREMERTONWA98337943079770501(C)(3)$275,000NEW SIX CHAIR CLINIC IN PORT ORCHARD
OLYMPIC EDUCATIONAL SERVICE DISTRICT (OESD) 114
105 NATIONAL AVE NBREMERTONWA98312910919927501(C)(3)$21,055OLYMPIC KITSAP EARLY LEARNING COALITION AND ABCD PARTNERSHIP
CHILDREN'S DENTAL HEALTH PROJECT
1020 19TH STREET NW STE 400WASHINGTONDC20036061561317501(C)(3)$25,000NATIONAL SEALANT WORK GROUP
EDUCATIONAL SERVICE DISTRICT 123
3918 W COURT STPASCOWA99301910948131501(C)(3)$30,000SOUTHEAST EARLY LEARNING COALITION AND ABCD PARTNERSHIP - YEAR TWO
VOLUNTEERS IN MEDICINE OF THE OLYMPICS CLINIC
819 GEORGIANA STPORT ANGELESWA98362010590704501(C)(3)$7,371FUND EQUIPMENT FOR NON-PROFIT CLINIC
AMERICAN ACADEMY OF PEDIATRICS
141 NORTHWEST POINT BLVEELK GROVE VILLAGEIL60007362275597501(C)(3)$50,000NATIONAL FLUORIDATION CAMPAIGN
WASHINGTON EARLY LEARNING FUND
1218 THIRD AVENUESEATTLEWA98101912041837501(C)(3)$20,000STATE HOME VISITING MATCH FUND TO EXPAND HOME VISITING PROGRAMS'S FOR WASHINGTON'S YOUNGEST CHILDREN
JAMESTOWN SKLALLAM TRIBE
1033 OLD BLYN HIGHWAYSEQUIMWA98382910963298GOVERNMENT$290,282EXPAND ACCESS TO DENTAL CARE FOR LOW INCOME ADULTS IN CLALLAM AND JEFFERSON COUNTIES
COMMUNITY HEALTH ASSOCIATION OF SPOKANE
3919 N MAPLESPOKANEWA99205911641797501(c)(3)$125,000EXPAND ACCESS TO DENTAL CARE FOR LOW INCOME ADULTS IN CHILDREN IN CHENEY (NEW DENTAL CLINIC)
NE WASHINGTON HEALTH PROGRAMS - ADMINISTRATION
509 EAST MAIN AVENUECHEWELAHWA99109911053847501(C)(3)$176,937EXPAND ACCESS TO DENTAL CARE FOR LOW INCOME PRIMARILY ADULTS (CLINIC EXPANSION IN LAKE SPOKANE)
CHILDREN'S DENTAL HEALTH PROJECT
1020 19TH STREET NW STE 400WASHINGTONDC20036061561317501(C)(3)$16,994DEVELOP FLUORIDATION TOOLKIT
CHARITABLE PARTNERSHIP FUND
PO BOX 13276PORTLANDOR97213931267966501(C)(3)$26,250DEVELOPMENT COSTS OF FLUORIDEEXPOSED.ORG WEBSITE
DENTAQUEST FOUNDATION
465 MEDFORD STREETBOSTONMA02129043265080501(C)(3)$200,000NATIONAL INTERPROFESSIONAL INITIATIVE ON ORAL HEALTH FUNDING
WASHINGTON ASSOCIATION OF COMMUNITY MIGRANT HEALTH
2120 STATE AVENUE NE SUITE 220OLYMPIAWA98506911323282501(C)(3)$56,782COMMUNITY HEALTH CENTER LEARNING SESSIONS
FieldValueIRS element (for citing)
Total501c3 Org15Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PART I, LINE 2FormAndLineReferenceDesc
ExplanationTHE GRANTEE IS REQUIRED TO SIGN A GRANT AGREEMENT STATING THAT THEY WILL USE THE FUNDS ONLY FOR PURPOSES OUTLINED IN THE GRANT AGREEMENT AND APPLICATION. THE GRANTEE IS REQUIRED TO FILE REPORTS ON REGULAR INTERVALS OUTLINING USE OF FUNDS. GRANTEE IS ALSO REQUIRED TO RETURN UNUSED FUNDING IF APPLICABLE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelYes (X)FirstClassOrCharterTravelInd
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
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 (17 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
DWYER JAMES D
PRESIDENT & CEO$639,415$0$670,000$0$12,078$0$118,000$0$22,633$0$1,462,126$0$0$0
LABBERTON WELLS K
DIRECTOR$71,806$0$0$0$210,201$0$0$0$0$0$282,007$0$0$0
RUTHERFORD EVE
DIRECTOR$66,723$0$0$0$415,584$0$0$0$0$0$482,307$0$0$0
BERG BRADLEY A
COO & CFO$408,593$0$238,469$0$10,470$0$85,262$0$27,263$0$770,057$0$0$0
MERLO KRISTIN N
CHIEF MKTG, INFO & SALES OFF$390,099$0$229,937$0$7,811$0$18,000$0$30,817$0$676,664$0$0$0
GATES THOMAS A
VP, PLANNING & CORP DEVEL$291,075$0$169,678$0$7,582$0$57,960$0$30,765$0$557,060$0$0$0
SMITH LAURA J
WDS FDN, PRESIDENT & CEO$272,931$0$143,877$0$9,868$0$18,000$0$9,612$0$454,288$0$0$0
LO ERIC C
VP, ACTUARIAL & UNDERWRITING$227,879$0$114,625$0$6,439$0$23,791$0$15,156$0$387,890$0$0$0
ALIABADI KAREN
CHIEF HR STRATEGIST$260,000$0$0$0$6,574$0$66,947$0$18,547$0$352,068$0$0$0
BURSETT JOHN T
SR VP, UNDERWRITING/ACTUARIAL$218,079$0$51,086$0-$3,500$0$23,915$0$16,032$0$305,612$0$0$0
LAY LINDA T
DIRECTOR, SALES ACCT. MGMT$172,119$0$74,380$0$949$0$13,770$0$9,994$0$271,212$0$0$0
SNYDER CINDY K
VP, INNOVATIVE SERVICES$226,317$0$58,762$0$5,974$0$89,371$0$22,152$0$402,576$0$0$0
WHITNEY GARRETT
DIR., IT ARCHITECTURE/INFRA$190,914$0$35,214$0-$3,873$0$12,414$0$16,601$0$251,270$0$0$0
DOSCH KYLE P
DENTAL DIRECTOR$177,000$0$40,689$0-$76$0$14,160$0$9,313$0$241,086$0$0$0
ORENSTEIN JANE
DIRECTOR, REG. & COMPLIANCE$172,212$0$43,932$0$517$0$13,777$0$18,815$0$249,253$0$0$0
CURHAN SUSAN
SENIOR SALES EXECUTIVE$170,089$0$44,208$0-$3,657$0$13,607$0$23,202$0$247,449$0$0$0
LILEY DARRYL
DIRECTOR, IT OPERATIONS$165,233$0$40,802$0-$691$0$1,966$0$23,540$0$230,850$0$0$0

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1ADDWA OCCASIONALLY PAYS FOR SPOUSAL TRAVEL FOR THE CEO, WHICH IS TREATED AS TAXABLE INCOME. ANY FIRST CLASS TRAVEL IS SUBJECT TO THE APPROVAL OF THE CEO. DDWA PROVIDES A WELLNESS PROGRAM WHICH REIMBURSES 50% OF APPROVED EXPENSES FOR ALL EMPLOYEES WORKING 30 HOURS OR MORE A WEEK, WITH A MAXIMUM PAYABLE OF $40/ MONTH, OR $480 PER YEAR, AND 25% OF APPROVED EXPENSES FOR PART-TIME EMPLOYEES WORKING 20 TO 30 HOURS A WEEK WITH A MAXIMUM PAYMENT OF $20/ MONTH, OR $240 PER YEAR FOR HEALTH CLUB MEMBERSHIPS, AEROBIC OR GENERAL EXERCISE CLASSES, WEIGHT LOSS PROGRAMS, STRESS MANAGEMENT AND MASSAGE THERAPY. THESE REIMBURSEMENTS ARE TREATED AS TAXABLE INCOME. ADDITIONALLY, HEALTH OR LUNCHEON CLUB DUES ARE PAID IN FULL FOR SENIOR MANAGEMENT WHICH IS INCLUDED IN TAXABLE INCOME. DDWA GROSSES UP AN EXECUTIVE AUTO STIPEND PAID TO CERTAIN EMPLOYEES. DDWA GROSSES UP BOARD MEMBER FEES TO COVER B&O TAXES ASSESSED ON DIRECTOR FEES PAID TO THE BOARD.
SCHEDULE J, PART I, LINE 3THE HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD OF DIRECTORS ENGAGES AN EXTERNAL CONSULTANT TO EVALUATE ALL KEY EMPLOYEES, INCLUDING PRESIDENT AND CEO, CFO/COO, VP UNDERWRITING/ACTUARIAL, CMO/CIO/CSO, VP PLANNING, AND CORPORATE DEVELOPMENT, CHIEF HUMAN RESOURCE STRATEGIST, AND VP INNOVATIVE SERVICES & PROVIDER RELATIONS COMPENSATION IN COMPARISON TO THE PRACTICE OF SIMILAR EMPLOYERS IN THE MARKETPLACE. THE PROCESS IS CONDUCTED ON AN ANNUAL BASIS.
SCHEDULE J, PART I, LINE 4BTHE COMPANY MAKES CONTRIBUTIONS TO A NON-QUALIFIED, SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), AS DETERMINED BY THE BOARD OF DIRECTORS, WHICH IS SUBJECT TO CODE SECTION 457(B). PLAN PARTICIPANTS ARE "KEY EMPLOYEES" WHO RECEIVE AN ANNUAL CONTRIBUTION BASED ON THEIR AGE, EARNINGS AND PROJECTED 401(K) INVESTMENT RETURNS. THE INVESTMENT OF THE COMPANY CONTRIBUTIONS IS DIRECTED BY EACH PARTICIPANT, BUT VESTING OF THE BENEFIT IS SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE AS REQUIRED BY CODE SECTION 409(A). CONTRIBUTIONS MADE IN 2015 WERE AS FOLLOWS: BRADLEY BERG, CHIEF OPERATING AND FINANCIAL OFFICER, $67,262; THOMAS GATES, VP PLANNING AND CORPORATE DEVELOPMENT, $39,960; ERIC LO, VP UNDERWRITING/ACTUARIAL, $5,791; CINDY SNYDER, VP INNOVATION SERVICES AND PROVIDER RELATIONS, $73,371; KAREN ALIABADI, CHIEF HR STRATEGIST, $48,947. THE 457(B) PLAN HAD TOTAL ASSETS OF $511,770 AT DECEMBER 31, 2015. THE COMPANY ALSO MAKES A CONTRIBUTION TO A 457(F) NON-QUALIFIED SERP, A DEFINED CONTRIBUTION PLAN FOR THE PRESIDENT AND CEO DUE TO AGE RESTRICTIONS ASSOCIATED WITH THE 457(B) PLAN. THE COMPANY CONTRIBUTED $100,000 TO THE PLAN FOR 2015. THE 457(F) PLAN HAD TOTAL ASSETS OF $252,537 AT DECEMBER 31, 2015. IN ADDITION, THERE IS ANOTHER 457(B) NONQUALIFIED SERP DEFERRED COMPENSATION PLAN FOR SENIOR MANAGEMENT THAT THE COMPANY DOES NOT MAKE ANY CONTRIBUTIONS TO. EACH OF THE FOLLOWING PARTICIPANTS CONTRIBUTED $18,000 TO THE PLAN DURING 2015 - JAMES DWYER, BRADLEY BERG, KRISTIN MERLO, LAURA SMITH AND ERIC LO. THE PLAN HAD TOTAL ASSETS OF $992,000 AT DECEMBER 31, 2015.
SCHEDULE J, PART I, LINE 5AFORM 990, PART VII, SECTION A INCLUDES SALES COMMISSION PAID TO TWO EMPLOYEES BASED ON NEW SUBSCRIBERS ACQUIRED.
SCHEDULE J, PART I, LINE 6ATHE BOARD OF DDWA APPROVED A COMPANY-WIDE BONUS MATRIX BASED ON SEVEN METRICS, ONE OF WHICH WAS BASED ON THE OPERATING PROFIT MARGIN FOR THE FISCAL YEAR. THE OTHER METRICS WERE ADMINISTRATIVE COST, NEW SALES FOR SMALL AND LARGE CUSTOMERS, CUSTOMER PERSISTENCY, NETWORK GROWTH AND OPERATIONAL PERFORMANCE.
SCHEDULE J, PART I, LINE 7DDWA PAID COMMISSION TO INTERNAL SALES STAFF BASED ON THE NUMBER OF PRIMARY SUBSCRIBERS ACQUIRED BY THE COMPANY AS A RESULT OF NEW EMPLOYER GROUP SALES.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 1DDWA WILL REVOLUTIONIZE THE ORAL HEALTH INDUSTRY AND IMPROVE OVERALL HEALTH. THIS INCLUDES, BUT IS NOT LIMITED TO, THE FOLLOWING: TO SECURE DENTAL SERVICE FOR EMPLOYER GROUPS, INDIVIDUALS AND THEIR FAMILIES; PROVIDE INNOVATIVE PRODUCTS AND SERVICES; TO ENCOURAGE, FOSTER AND FINANCE PROFESSIONAL AND SCIENTIFIC STUDY AND RESEARCH IN THE GENERAL FIELD OF ORAL HEALTH; AND TO EDUCATE THE PUBLIC CONCERNING THE NEED FOR AND ADVANTAGE OF ADEQUATE DENTAL TREATMENT.
FORM 990, PART III, LINE 3ON SEPTEMBER 21, 2015, DDWA DISTRIBUTED $16,900,000 IN CASH TO ITS SOLE MEMBER WASHINGTON DENTAL SERVICE ("WDS").
FORM 990, PART III, LINE 4ADDWA PROVIDES DENTAL INSURANCE FOR OVER 2,655,000 MEMBERS THROUGHOUT THE STATE OF WASHINGTON AND ACROSS THE NATION. WORKING COLLECTIVELY WITH PRODUCERS AND BENEFIT MANAGERS, WE OFFER STANDARD INSURANCE BENEFITS, AS WELL AS HIGHLY CUSTOMIZED PLANS TO MEET THE NEEDS OF INDIVIDUALS AND THEIR FAMILIES. WE HAVE CONTRACTED WITH NEARLY 4,400 DENTISTS, CREATING A NETWORK OF PROVIDERS SERVING PATIENTS ACROSS THE STATE. AS A MEMBER OF THE DELTA DENTAL PLANS ASSOCIATION, A NATIONAL ASSOCIATION SUPPORTING DELTA INSURERS NATION-WIDE, OUR MEMBERS ARE ABLE TO ACCESS DELTA CONTRACTED PROVIDERS IN EVERY STATE. IN 2015, DDWA PROCESSED OVER 5,600,000 CLAIMS FOR SUBSCRIBERS AND THEIR DEPENDENTS. TO ENSURE PROVIDERS ARE SUBMITTED CLAIMS APPROPRIATELY, WE AUDITED OVER 33,000 INDIVIDUAL CLAIMS, THE RESULTS OF WHICH INCLUDE EDUCATION OF DENTAL OFFICE STAFF ON THE USE OF CDT CODES, INVOICING PROCEDURES AND REDUCING COMMON ERRORS.
FORM 990, PART III, LINE 4BDDWA PROMOTES THE VALUE OF DENTAL BENEFITS AND IMPORTANCE OF ORAL HEALTH THROUGH MARKETING EFFORTS IN MEDIA ADVERTISING, PUBLIC RELATIONS, EVENT SPONSORSHIPS AND DIRECT OUTREACH TO CUSTOMERS. IN 2015, WE MADE SIGNIFICANT REFINEMENTS TO OUR PROMOTIONAL TACTICS AND MESSAGES. MARKET RESEARCH CONFIRMED THAT THESE CHANGES IMPROVED OUR ABILITY TO REACH AND ENCOURAGE AUDIENCES TO EMBRACE GOOD ORAL HEALTH AND MAKE WISE USE OF DENTAL BENEFITS.
FORM 990, PART III, LINE 4CDENTAL DECAY IS THE SINGLE MOST COMMON CHRONIC DISEASE OF EARLY CHILDHOOD - FIVE TIMES MORE COMMON THAN ASTHMA. NEARLY ONE IN FIVE ADULTS, NATIONALLY, HAS UNTREATED DENTAL CAVITIES. THE WASHINGTON DENTAL SERVICE FOUNDATION (THE FOUNDATION), A WHOLLY OWNED SUBSIDIARY OF DDWA, SUPPORTED ALMOST EXCLUSIVELY BY DDWA, FOCUSES MUCH OF THEIR WORK SPECIFICALLY ON CHILDREN AND SENIORS, AND WORKS CLOSELY WITH PARTNER ORGANIZATIONS TO DEVELOP AND IMPLEMENT INNOVATIVE PROGRAMS. THE ACCESS TO BABY AND CHILD DENTISTRY (ABCD) PROGRAM EXPANDS ACCESS TO DENTAL CARE FOR YOUNG CHILDREN IN WASHINGTON STATE BY PROVIDING DENTAL SERVICES, BOTH PREVENTATIVE AND RESTORATIVE - TO APPLE HEALTH-ENROLLED (MEDICAID) CHILDREN UP TO AGE SIX. STATEWIDE, THE UTILIZATION OF DENTAL SERVICES INCREASED FROM 21% TO 52% FROM 1997 TO 2015 AND OVER 1,100 PROVIDERS ARE BILLING FOR CARE. THE EARLY INTERVENTION IN MEDICAL SETTINGS PROGRAM IS TRAINING PEDIATRICIANS IN THE ADVANTAGES AND TECHNIQUES OF ORAL SCREENING, APPLYING FLUORIDATION AND REFERRING HIGH RISK PATIENTS FOR DENTAL CARE. SINCE 2002, TRAININGS HAVE REACHED 45% (>2,000) OF WASHINGTON PRACTICING PRIMARY CARE PHYSICIANS. THE FOUNDATION IS ENGAGING HEALTH PROFESSIONALS, INCLUDING PHARMACISTS AND HOME HEALTH AIDES, TO TAKE PREVENTATIVE STEPS WITH SENIORS BEFORE ORAL HEALTH PROBLEMS AFFECT THEIR OVERALL HEALTH. OVER 65,000 ORAL HEALTH CAREGIVER COURSES HAVE BEEN DELIVERED TO HOME HEALTH AIDES THAT CARE FOR OLDER ADULTS.
FORM 990, PART III, LINE 4D1. WATER FLUORIDATION IS THE MOST IMPORTANT STEP A COMMUNITY CAN TAKE TO IMPROVE THE ORAL HEALTH OF ALL RESIDENTS. THE FOUNDATION PROMOTES LEGISLATION TO ENCOURAGE FLUORIDATION AND PROVIDES ASSISTANCE TO GROUPS WHO ARE COMMITTED TO BRINGING THE BENEFITS OF FLUORIDE TO THEIR COMMUNITIES. SINCE 2001, AN ADDITIONAL 263,000 WASHINGTONIANS ARE RECEIVING THE HEALTH BENEFITS ASSOCIATED WITH FLUORIDATED WATER AS A RESULT OF THE FOUNDATIONS WORK. 2. ASSISTING THE WORK OF THE FOUNDATION ARE DDWA EMPLOYEES VOLUNTEERING THEIR TIME. DDWA ENABLES ALL EMPLOYEES TO ENGAGE WITH THE PUBLIC REGARDING ORAL HEALTH THROUGH THE USE OF TWO VOLUNTEER DAYS PER YEAR. VOLUNTEER TIME IS SPENT WORKING ON THE SMILEMOBILE, A MOBILE DENTAL FACILITY TRAVELING TO UNDERSERVED AREAS OF THE STATE. MORE THAN 20,000 LOW-INCOME AND AT-RISK-CHILDREN STATE-WIDE RECEIVED DENTAL SERVICES IN THE LAST 10 YEARS THROUGH THE FOUNDATION OPERATED SMILEMOBILE. VOLUNTEER TIME IS ALSO SPENT HANDING OUT FLYERS PROMOTING ORAL HEALTH TO WASHINGTON CITIZENS AT FAIRS, THE ZOO, PARADES, AND EVENTS ACROSS THE STATE. 3. DDWA MATCHES DONATIONS MADE BY EMPLOYEES TO NON-PROFIT ORGANIZATIONS WITH OFFICIAL IRS 501(C)(3) STATUS, ALTHOUGH THE FOLLOWING ORGANIZATIONS/EVENTS ARE NOT ELIGIBLE FOR MATCHING: CHURCHES, POLITICAL CAMPAIGNS/ORGANIZATIONS, CAPITAL FUNDING, FRATERNAL/LABOR ORGANIZATIONS, TRIPS/TOURS, MASS MAILINGS, ORGANIZATIONS/GROUPS THAT DISCRIMINATE FOR ANY REASON INCLUDING, BUT NOT LIMITED TO, RACE, COLOR, RELIGION, CREED, AGE, SEX, SEXUAL ORIENTATION OR NATIONAL ORIGIN. 4. DDWA SUPPORTED THE UNIVERSITY OF WASHINGTON'S SCHOOL OF DENTISTRY BY CREATING THE DDWA DENTIST OF THE FUTURE FUND. THIS FUND PROVIDES TRAINING FOR DENTAL STUDENTS AND PRACTICING DENTISTS EMPHASIZING EVIDENCE BASED INSTRUCTION, INTER-PROFESSIONAL EDUCATION, RISK ASSESSMENT AND BEHAVIORAL CHANGES AND MORE FULLY INCORPORATING ORAL HEALTH INTO OVERALL HEALTH IN PATIENT MANAGEMENT. DDWA ALSO SUPPORTED ESTABLISHING A 20 CHAIR DENTAL TEACHING CENTER AT THE PACIFIC TOWER COMMUNITY HEALTH AND INNOVATION CENTER. THE CENTER WILL PROVIDE DENTAL CARE FOR A LOW INCOME, HIGHLY DIVERSE POPULATION, INCLUDING UNDERSERVED ADULTS WHO ARE MEDICAID INSURED OR UNINSURED AND WILL WORK WITH REFERRING ORGANIZATIONS TO ADDRESS BARRIERS TO CARE.
FORM 990, PART VI, SECTION A, LINE 6DDWA'S MEMBER DENTISTS ARE CONSIDERED MEMBERS OF THE COMPANY'S PARENT COMPANY, WDS. MEMBER DENTISTS ELECT THE DENTAL MEMBERS OF THE WDS BOARD OF DIRECTORS. WDS DIRECTORS ALSO SERVE AS DIRECTORS ON THE DDWA BOARD.
FORM 990, PART VI, SECTION A, LINE 7ATHE GOVERNANCE & NOMINATING COMMITTEE (GNC) OF THE BOARD OF DIRECTORS SOLICITS ADVICE ON CANDIDATES AND SUBMITS NOMINEES TO THE BOARD FOR CONSIDERATION AND APPROVAL TO BE VOTED UPON. THE ENTIRE MEMBERSHIP ELECTS AND RE-ELECTS MEMBER DIRECTORS, WHO COMPRISE A MINORITY OF THE BOARD. THE INCUMBENT INDEPENDENT DIRECTORS NOMINATE AND ELECT OR RE-ELECT INDEPENDENT DIRECTORS. A MEMBER ADVISORY PANEL (MAP) CONSISTING OF TEN TO FIFTEEN MEMBERS ARE SELECTED BY THE BOARD FROM NOMINEES BY THE GNC. THE MAP PROVIDES CONSULTATION TO THE COMPANY, INCLUDING THE GNC AND BOARD, ON A VARIETY OF MATTERS.
FORM 990, PART VI, SECTION A, LINE 7BRECOMMENDED CHANGES TO THE WDS CORPORATE BY-LAWS BY THE WDS BOARD ARE SUBJECT TO APPROVAL BY THE WDS MEMBER DENTISTS.
FORM 990, PART VI, SECTION B, LINE 11BTHE 990 IS COMPLETED BY KPMG. THE FORM 990 AND SUPPORTING DOCUMENTATION IS REVIEWED AND APPROVED BY THE ACCOUNTING SUPERVISOR, DIRECTOR OF FINANCE AND THE CFO/COO. ELECTRONIC COPIES OF THE RETURN ARE PROVIDED FOR REVIEW TO ALL BOARD MEMBERS PRIOR TO SUBMISSION TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE INVESTMENT AND AUDIT COMMITTEE OF THE BOARD IS CHARGED WITH MONITORING PROPOSED OR ON-GOING TRANSACTIONS FOR CONFLICTS OF INTEREST AND ADDRESSING ANY POTENTIAL OR ACTUAL CONFLICTS. PURSUANT TO THE CONFLICT OF INTEREST POLICY, AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE, AIMED AT DETERMINING ANY FAMILY AND BUSINESS RELATIONSHIPS AND TRANSACTIONS, OR OTHER TRANSACTIONS THAT MAY POSE A POTENTIAL CONFLICT, IS DISTRIBUTED TO ALL COVERED PERSONS (I.E. BOARD MEMBERS, OFFICERS AND EXECUTIVE LEADERSHIP OR KEY EMPLOYEES). COVERED PERSONS ARE REQUIRED TO DISCLOSE REAL OR POTENTIAL CONFLICTS AT THE TIME WHEN SUCH CONFLICTS ARISE. WHEN SOMEONE BECOMES A COVERED PERSON AND ANNUALLY THEREAFTER, THEY ARE REQUIRED TO EXPLICITLY ACKNOWLEDGE A STATEMENT AFFIRMING THAT HE/SHE: (1) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (2) HAS READ THE POLICY AND UNDERSTANDS SAID POLICY; AND (3) AGREES TO COMPLY WITH ALL REQUIREMENTS OF THE POLICY, INCLUDING COMPLETING THE CONFLICT OF INTEREST QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES THAT NOTE ANY CONFLICTS ARE REVIEWED BY THE BOARD AND ANY PERSONS WITH ACTUAL OR POTENTIAL CONFLICTS ARE INFORMED VIA WRITTEN COMMUNICATION. THE PROCEDURES FOR ADDRESSING ANY CONFLICT OF INTEREST INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: (1) THE CONFLICTING INTEREST IS FULLY DISCLOSED TO THE BOARD; (2) THE INTERESTED PERSON RESPONDS TO FACTUAL QUESTIONS RELATED TO THE SUBSTANCE OF THE TRANSACTION OR ARRANGEMENT BEING CONSIDERED, AFTER WHICH HE/SHE SHALL LEAVE THE MEETING; (3) THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION; (4) ALTERNATIVES TO THE PROPOSED TRANSACTION ARE INVESTIGATED, COMPETITIVE BIDS OR COMPARABLE VALUATIONS ARE OBTAINED; (5) AND CONFLICTING ISSUES DURING THE COURSE OF A BOARD MEETING WHICH CANNOT BE RESOLVED ARE REFERRED TO THE GOVERNANCE COMMITTEE; AND (6) THE TRANSACTION OR ACTION MUST BE APPROVED BY A MAJORITY OF DISINTERESTED PERSONS.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD APPOINTS THE HRCC, NONE OF WHOM MAY HAVE A CONFLICT OF INTEREST WITH RESPECT TO ANY COMPENSATION ARRANGEMENTS, TO BE ACCOUNTABLE FOR SETTING A REASONABLE COMPENSATION PACKAGE FOR THE CEO AND ALSO REASONABLE TOTAL COMPENSATION RANGES FOR OTHER OFFICERS AND KEY EMPLOYEES (INCLUDING THE COO/CFO). THE HRCC DEVELOPS, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA FOR OFFICERS AND KEY EMPLOYEES. THE HRCC ALSO HIRES A QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALIST (INDEPENDENT EXPERT) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFIT PACKAGES OF OFFICERS AND KEY EMPLOYEES. APPROPRIATE COMPARABILITY DATA IS OBTAINED FROM THE INDEPENDENT EXPERTS, I.E., TOTAL ECONOMIC BENEFITS PAID BY SIMILAR SITUATED ORGANIZATIONS (BOTH TAXABLE AND TAX-EXEMPT) FOR SIMILAR JOB RESPONSIBILITIES. THE HRCC'S WRITTEN RECORDS INCLUDE THE (1) TERMS OF THE ARRANGEMENTS WITH THE OFFICERS AND KEY EMPLOYEES (INCLUDING THE DATE THE ARRANGEMENT WAS APPROVED); (2) A LIST OF MEMBERS PRESENT DURING THE DISCUSSION ON ANY ARRANGEMENTS; AND (3) A DESCRIPTION OF THE COMPARABLE DATA RELIED UPON BY THE HRCC. KEY DELIBERATIONS OF THE HRCC ARE ALSO DOCUMENTED IN MINUTES WHICH ARE APPROVED AT THE NEXT HRCC MEETING.
FORM 990, PART VI, SECTION C, LINE 19FINANCIAL STATEMENTS AND DISCLOSURES ARE FILED QUARTERLY AND ANNUALLY WITH THE WASHINGTON STATE OFFICE OF THE INSURANCE COMMISSIONER (OIC) AS A MATTER OF PUBLIC RECORD. ALL DOCUMENTS SO FILED ARE AVAILABLE TO THE PUBLIC ON THE OIC WEBSITE. AMENDMENTS TO BYLAWS ARE FILED WITH THE WASHINGTON SECRETARY OF STATE'S OFFICE FROM TIME-TO-TIME AS THEY ARE APPROVED BY THE GOVERNING BODY. GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VII, SECTION A, LINE 1ATHE FOLLOWING DIRECTORS ALSO RECEIVED CLINICAL REIMBURSEMENTS ADDITIONAL TO THEIR DIRECTORS FEES REPORTED IN COLUMN D REPORTABLE COMPENSATION FROM THE ORGANIZATION. BECK, GEORGE - $96,732 ------------------------------- DIRECTOR FEE - $87,882 CLINICAL REIMBURSEMENT - $8,850 LABBERTON, WELLS, K. $282,007 ------------------------------- DIRECTOR FEE - $71,806 CLINICAL REIMBURSEMENT - $210,201 PHIPPS, GERALD S. $77,762 ------------------------------- DIRECTOR FEE - $76,741 CLINICAL REIMBURSEMENT - $1,021 RUTHERFORD, EVE $482,308 ------------------------------- DIRECTOR FEE - $66,724 CLINICAL REIMBURSEMENT - $415,584
FORM 990, PART XI, LINE 9DISTRIBUTION TO ITS SOLE MEMBER WDS: 16,900,000

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1WASHINGTON DENTAL SERVICE FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line19706 4TH AVE NEAddressLine1Txt
CitySEATTLECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98115ZIPCd
FieldValueIRS element (for citing)
EIN910621480EIN
Primary ActivitiesEDUCATIONPrimaryActivitiesTxt
Legal Domicile StateWALegalDomicileStateCd
Total Income$116,000TotalIncomeAmt
End Of Year Assets$1,708,000EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1DDWABusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
WASHINGTON DENTAL SERVICE FUND
9706 4TH AVE NESEATTLEWA98115911281990EDUCATIONWA501(c)(3)9DDWAYes (true)
WASHINGTON DENTAL SERVICE
9706 4TH AVE NESEATTLEWA98115270937829HOLDING CO.501(c)(4)NAYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
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 OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
WASHINGTON DENTAL SERVICE
r$16,900,000CASH/INVESTMENT
WASHINGTON DENTAL SERVICE
o$763,220CASH
WASHINGTON DENTAL SERVICE
q$14,400SHARED SERVICES

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