HAWAII DENTAL SERVICE: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- HAWAII DENTAL SERVICE (EIN 99-0107971)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-10-22
- IRS object ID
- 201512959349301511
- Schema version
- 2014v5.0
- 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 | 2015-10-22T20:44:12-05:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 205325889 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ACCUITY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 999 BISHOP STREET STE 1900 | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96813 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990107971 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAWAII DENTAL SERVICE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HAWA | BusinessNameControlTxt |
| Phone | 8085211431 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 BISHOP STREET NO 700 | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96813 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK H YAMAKAWA | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 8085211431 | PhoneNum |
| Signature | 2015-10-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KIM AT JONES | PreparerPersonNm |
| PTIN | P00940140 | PTIN |
| Phone | 8085313400 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARK H YAMAKAWA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 BISHOP STREET SUITE 700 | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96813 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $241,320,426 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.HAWAIIDENTALSERVICE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1962 | FormationYr |
| Legal Domicile State | HI | LegalDomicileStateCd |
| Activity Or Mission | PROMOTE AND ENCOURAGE THE BETTERMENT OF THE GENERAL MEDICAL AND DENTAL HEALTH OF THE PUBLIC (CONTINUED) FOR THE COMMON GOOD AND GENERAL WELFARE OF THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 100 | 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 | $191,703,878 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $199,192,901 | CYProgramServiceRevenueAmt |
| PY Investment Income | $15,491,940 | PYInvestmentIncomeAmt |
| CY Investment Income | $7,088,875 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | -$634,294 | CYOtherRevenueAmt |
| PY Total Revenue | $207,195,818 | PYTotalRevenueAmt |
| CY Total Revenue | $205,647,482 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,089,976 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $4,073,267 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $163,129,532 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $169,259,033 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,222,984 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,403,185 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,056,401 | PYOtherExpensesAmt |
| CY Other Expenses | $8,029,122 | CYOtherExpensesAmt |
| PY Total Expenses | $181,498,893 | PYTotalExpensesAmt |
| CY Total Expenses | $190,764,607 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $25,696,925 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $14,882,875 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $176,648,172 | TotalAssetsBOYAmt |
| Total Assets EOY | $196,655,246 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $22,508,722 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $30,160,888 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $154,139,450 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $166,494,358 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $179,172,765 | ExpenseAmt |
| Grant | $4,073,267 | GrantAmt |
| Revenue | $195,323,845 | RevenueAmt |
| Desc | TO PROMOTE AND ENCOURAGE THE BETTERMENT OF THE GENERAL MEDICAL AND DENTAL HEALTH OF THE PUBLIC FOR THE COMMON GOOD AND GENERAL WELFARE OF THE COMMUNITY. SEE SCHEDULE O - FORM 990, PART III, LINE 4A FOR PROGRAM SERVICE ACCOMPLISHMENTS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,941,414 | ExpenseAmt |
| Revenue | $3,850,000 | RevenueAmt |
| Desc | MANAGING THE DENTAL BENEFITS OF ELIGIBLE BENEFICIARIES COVERED BY THE STATE OF HAWAII MEDICAID PROGRAM. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $182,114,179 | 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 | 0 | 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 | 0 | 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 | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | 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 | 3225 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 100 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | 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 | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHERYL TAKITANI-SMITH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8085211431 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 BISHOP STREET SUITE 700 | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96813 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| MICHAEL J O'MALLEY | |||||||||
| CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN BLACK | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| PAUL CHANG | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SUZY HOLLINGER | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN I KOTAKE | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KIM JAMES LAWLER TERM 914 | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| PATSY NANBU | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| CASEY Z TAMASHIRO | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TRAVIS UMEMOTO | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| DAVID K TODANI | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| M'LISS H MOORE | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MASON A SAVAGE DDS APPT 1214 | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| CHARLES R SUGIYAMA DDS | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| NORMAN S CHUN | |||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JON YOSHINO | |||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| SUSAN A LI | |||||||||
| VICE CHAIR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| T KIMO BLAISDELL | |||||||||
| CHAIR (TERM. 5/14) | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| GARRETT BK OKA | |||||||||
| DIRECTOR (TERM. 5/14) | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MARK H YAMAKAWA | |||||||||
| PRESIDENT & CEO (AS OF 11/3/14) | 40.00 | $43,750 | $0 | $1,584 | Yes (X) | ||||
| FAYE W KURREN | |||||||||
| PRESIDENT & CEO (RETIRED 2014) | 40.00 | 1.00 | $2,237,483 | $0 | $121,156 | Yes (X) | |||
| CHERYL TAKITANI-SMITH | |||||||||
| VP - FINANCIAL AFFAIRS | 40.00 | 2.00 | $240,198 | $0 | $78,214 | Yes (X) | |||
| KATHY FAY | |||||||||
| VP - OPERATIONS | 40.00 | 1.00 | $240,031 | $0 | $122,095 | Yes (X) | |||
| TOM DELANEY | |||||||||
| DIRECTOR OF INFORMATION SY | 40.00 | $164,488 | $0 | $48,799 | Yes (X) | ||||
| ROBERT SHERMAN | |||||||||
| DENTAL DIRECTOR | 40.00 | $165,993 | $0 | $61,650 | Yes (X) | ||||
| JIM JOHNSON | |||||||||
| DIR. OF CLAIMS & CUSTOMER SERVICE | 40.00 | $142,670 | $0 | $54,325 | Yes (X) | ||||
| CLESSON PANG | |||||||||
| DIRECTOR OF UNDERWRITING | 40.00 | $149,074 | $0 | $31,234 | Yes (X) | ||||
| ROQUE ARANADOR | |||||||||
| INFORMATION SYSTEMS MANAGER | 40.00 | $129,837 | $0 | $37,414 | Yes (X) | ||||
| MINNA MARI LEHTI | |||||||||
| DIRECTOR OF COMPLIANCE | 40.00 | $126,364 | $0 | $19,317 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,639,888 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $575,788 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 13 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| DENTAQUEST | |||||
| 465 MEDFORD STREET | BOSTON | MA | 02129 | CLAIM PROCESSING | $1,526,766 |
| COMMUNITY CASE MANAGEMENT | |||||
| 91-1360 KARAYAN STREET | EWA BEACH | HI | 96706 | CARE COORDINATION | $1,000,000 |
| DELTA DENTAL OF CALIFORNIA | |||||
| PO BOX 44460 | SAN FRANCISCO | CA | 94144 | CLAIM PROCESSING | $259,565 |
| BENEFIT PLAN SOLUTIONS INC | |||||
| 680 IWILEI ROAD 528 | HONOLULU | HI | 96817 | BROKER | $168,288 |
| ALSTON HUNT FLOYD & ING | |||||
| 1001 BISHOP STREET ASB TOWER 18TH | HONOLULU | HI | 96813 | LEGAL SERVICE | $146,629 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| RISK SUBSCRIPTIONS EARNED | 621300 | $161,887,152 | $161,887,152 |
| ASC SUBSCRIPTIONS EARNED | 621300 | $17,123,919 | $17,123,919 |
| MEDICAL PARTNERS (WHOLESALE) | 621300 | $16,312,774 | $16,312,774 |
| MEDICAID | 621300 | $3,850,000 | $3,850,000 |
| MEMBERSHIP DUES | 621300 | $175 | $175 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,881 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,881 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $199,192,901 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,950,211 | TotalRevenueColumnAmt |
| Exclusion | $2,950,211 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,000 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,000 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $36,806,908 | SecuritiesAmt |
| Other | $3,001,700 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $35,661,708 | SecuritiesAmt |
| Other | $8,236 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,145,200 | SecuritiesAmt |
| Other | $2,993,464 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,138,664 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,993,464 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,145,200 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | FMG DENTAL INSUR. CONTRACTS (NET) | Desc |
| Business | 621300 | BusinessCd |
| Total Revenue Column | -$634,294 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$634,294 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | -$634,294 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $205,647,482 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $201,552,071 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,095,411 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,073,267 | TotalAmt |
| Program Services | $4,073,267 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,259,033 | TotalAmt |
| Program Services | $169,259,033 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,692,463 | TotalAmt |
| Program Services | $74,491 | ProgramServicesAmt |
| Management And General | $2,617,972 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,431,169 | TotalAmt |
| Program Services | $2,782,781 | ProgramServicesAmt |
| Management And General | $1,648,388 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $922,460 | TotalAmt |
| Program Services | $332,639 | ProgramServicesAmt |
| Management And General | $589,821 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $881,636 | TotalAmt |
| Program Services | $227,696 | ProgramServicesAmt |
| Management And General | $653,940 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $475,457 | TotalAmt |
| Program Services | $171,450 | ProgramServicesAmt |
| Management And General | $304,007 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,557 | TotalAmt |
| Program Services | $36,682 | ProgramServicesAmt |
| Management And General | $37,875 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,419 | TotalAmt |
| Management And General | $160,419 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,848 | TotalAmt |
| Management And General | $18,848 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $353,505 | TotalAmt |
| Management And General | $353,505 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,817,468 | TotalAmt |
| Program Services | $2,608,211 | ProgramServicesAmt |
| Management And General | $209,257 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,177 | TotalAmt |
| Management And General | $43,177 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $609,425 | TotalAmt |
| Program Services | $495,477 | ProgramServicesAmt |
| Management And General | $113,948 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $231,966 | TotalAmt |
| Program Services | $126,819 | ProgramServicesAmt |
| Management And General | $105,147 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $537,069 | TotalAmt |
| Program Services | $273,368 | ProgramServicesAmt |
| Management And General | $263,701 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,430 | TotalAmt |
| Program Services | $30,172 | ProgramServicesAmt |
| Management And General | $59,258 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,332 | TotalAmt |
| Program Services | $5,127 | ProgramServicesAmt |
| Management And General | $122,205 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,631 | TotalAmt |
| Program Services | $65,090 | ProgramServicesAmt |
| Management And General | $53,541 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $225,705 | TotalAmt |
| Program Services | $182,878 | ProgramServicesAmt |
| Management And General | $42,827 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BROKER COMMISSIONS | $972,021 | $972,021 | |
| ACA & CONNECTOR FEES | $901,742 | $901,742 | |
| DUES & SUBSCRIPTIONS | $339,188 | $247,629 | $91,559 |
| PRINTING | $189,358 | $71,163 | $118,195 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,281 | TotalAmt |
| Program Services | $78,185 | ProgramServicesAmt |
| Management And General | $141,096 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $190,764,607 | TotalAmt |
| Program Services | $182,114,179 | ProgramServicesAmt |
| Management And General | $8,650,428 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,867,389 | BOYAmt |
| EOY | $42,273,988 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,838,685 | BOYAmt |
| EOY | $10,192,885 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,087,764 | BOYAmt |
| EOY | $7,933,068 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,851,524 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,635,852 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $249,157 | BOYAmt |
| EOY | $215,672 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,605,177 | BOYAmt |
| EOY | $136,039,633 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $176,648,172 | BOYAmt |
| EOY | $196,655,246 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,146,151 | BOYAmt |
| EOY | $10,243,223 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,946,649 | BOYAmt |
| EOY | $3,263,803 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,415,922 | BOYAmt |
| EOY | $16,653,862 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,508,722 | BOYAmt |
| EOY | $30,160,888 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $154,139,450 | BOYAmt |
| EOY | $166,494,358 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $154,139,450 | BOYAmt |
| EOY | $166,494,358 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $176,648,172 | BOYAmt |
| EOY | $196,655,246 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $14,882,875 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,467,405 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$3,995,372 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,352,504 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,352,504 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,606,766 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,406,184 | DepreciationAmt |
| Book Value | $200,582 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $892,254 | OtherCostOrOtherBasisAmt |
| Depreciation | $877,164 | DepreciationAmt |
| Book Value | $15,090 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $215,672 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| CLAIMS PAYABLE TO DENTISTS | $9,397,000 |
| REFUNDABLE GROUP SUBSCRIPTIONS | $7,256,862 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $16,653,862 | TotalLiabilityAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| HAWAII DENTAL SERVICE FOUNDATION | |||||||
| 700 BISHOP ST STE 700 | HONOLULU | HI | 96813 | 990246999 | 501(C)(4) | $4,000,000 | SUPPORT ORGANIZATION MISSION |
| ALOHA UNITED WAY | |||||||
| 200 N VINEYARD BLVD | HONOLULU | HI | 96817 | 990073494 | 501(C)(3) | $12,000 | PROGRAM SUPPORT |
| AMERICAN RED CROSS HI CHAPTER | |||||||
| 4155 DIAMOND HEAD ROAD | HONOLULU | HI | 96816 | 990073477 | 501(C)(3) | $5,000 | PROGRAM SUPPORT |
| AMERICAN HEART ASSOCIATION | |||||||
| PO BOX 4002030 | DES MOINES | IA | 50340 | 135613797 | 501(C)(3) | $5,000 | PROGRAM SUPPORT |
| QUEEN'S HEALTH SYSTEMS - FUND DEVELOPMENT | |||||||
| PO BOX 861 | HONOLULU | HI | 96808 | 990073524 | 501(C)(3) | $5,000 | SUPPORT ORGANIZATION MISSION |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 4 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FROM 990, SCHEDULE I | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS: THE PURPOSE OF THE MONIES DISBURSED BY HAWAII DENTAL SERVICE (HDS) ARE REVIEWED AND APPROVED BY HDS CEO EXCEPT FOR GRANTS TO HDS FOUNDATION, WHICH ARE APPROVED BY THE HDS BOARD OF DIRECTORS. HDS FOUNDATION ("FOUNDATION"), A RELATED INTERNAL REVENUE CODE SECTION 501(C)(4) TAX EXEMPT ORGANIZATION, IS FUNDED SOLELY BY HDS. THE MONIES DISBURSED BY THE FOUNDATION ARE BASED ON GRANT REQUESTS WHICH ARE REVIEWED AND APPROVED BY THE FOUNDATION BOARD OF TRUSTEES. MONITORING USAGE OF THE GRANTS IS REPORTED TO THE HDS BOARD OF DIRECTORS BY THE FOUNDATION CHAIR. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Discretionary Spending Acct | Yes (X) | DiscretionarySpendingAcctInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FAYE W KURREN | ||||||||||||||
| PRESIDENT & CEO (RETIRED 2014) | $424,360 | $0 | $392,752 | $0 | $1,420,371 | $0 | $113,138 | $0 | $8,018 | $0 | $2,358,639 | $0 | $0 | $0 |
| CHERYL TAKITANI-SMITH | ||||||||||||||
| VP - FINANCIAL AFFAIRS | $180,198 | $0 | $60,000 | $0 | $0 | $0 | $65,575 | $0 | $12,639 | $0 | $318,412 | $0 | $0 | $0 |
| KATHY FAY | ||||||||||||||
| VP - OPERATIONS | $180,031 | $0 | $60,000 | $0 | $0 | $0 | $112,540 | $0 | $9,555 | $0 | $362,126 | $0 | $0 | $0 |
| TOM DELANEY | ||||||||||||||
| DIRECTOR OF INFORMATION SY | $149,488 | $0 | $15,000 | $0 | $0 | $0 | $36,815 | $0 | $11,984 | $0 | $213,287 | $0 | $0 | $0 |
| ROBERT SHERMAN | ||||||||||||||
| DENTAL DIRECTOR | $155,984 | $0 | $10,009 | $0 | $0 | $0 | $55,698 | $0 | $5,952 | $0 | $227,643 | $0 | $0 | $0 |
| JIM JOHNSON | ||||||||||||||
| DIR. OF CLAIMS & CUSTOMER SERVICE | $131,710 | $0 | $10,960 | $0 | $0 | $0 | $39,297 | $0 | $15,028 | $0 | $196,995 | $0 | $0 | $0 |
| CLESSON PANG | ||||||||||||||
| DIRECTOR OF UNDERWRITING | $143,354 | $0 | $5,720 | $0 | $0 | $0 | $21,863 | $0 | $9,371 | $0 | $180,308 | $0 | $0 | $0 |
| ROQUE ARANADOR | ||||||||||||||
| INFORMATION SYSTEMS MANAGER | $121,351 | $0 | $8,486 | $0 | $0 | $0 | $31,802 | $0 | $5,612 | $0 | $167,251 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | ON DECEMBER 31, 2009, THE BOARD OF DIRECTORS APPROVED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) FOR HDS'S PRESIDENT & CEO, FAYE KURREN. BENEFIT PAYMENTS OF $1,222,359 FOR THE PERIOD 01/01/2013 THROUGH 12/31/2014 WERE PAID TO FAYE KURREN ON DECEMBER 31,2014. |
| SCHEDULE J, PART I, LINE 1A | SUPPLEMENTAL COMPENSATION INFORMATION: HDS HOLDS A CORPORATE MEMBERSHIP IN A SOCIAL CLUB IN WHICH THE CLUB REQUIREMENTS DICTATE THAT AN INDIVIDUAL BE IDENTIFIED TO AUTHORIZE TRANSACTIONS. AS SUCH, HDS'S CEO HAS BEEN DESIGNATED AS THE AUTHORIZED INDIVIDUAL. ONLY BUSINESS TRANSACTIONS ARE ALLOWED AND SUBSTANTIATED BY PROPER DOCUMENTATION. DISCRETIONARY SPENDING ACCOUNT: ONLY BUSINESS RELATED TRANSACTIONS ARE ALLOWED AND SUBSTANTIATED BY PROPER DOCUMENTATION. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: CEO RECEIVES GROSS UP PAYMENTS FOR LIFE INSURANCE PREMIUMS OVER $50,000, AN AUTO ALLOWANCE, AND PARKING OVER INTERNAL REVENUE SERVICE LIMITS. THE PAYMENTS TO THE INDIVIDUALS ABOVE ARE INCLUDED IN THEIR W-2S AS COMPENSATION. |
| SCHEDULE J, PART I, LINE 7 | NON-FIXED PAYMENTS: HDS HAS AN INCENTIVE PLAN DETAILING THE INCENTIVE CALCULATION WHEN THE COMPANY ACHIEVES CERTAIN PERFORMANCE STANDARDS AND STRATEGIC GOALS. THE INCENTIVE AMOUNT VARIES EACH YEAR DEPENDING ON PERFORMANCE AND ACHIEVEMENT OF STRATEGIC GOALS. INCENTIVE AMOUNTS FOR OFFICERS AND CERTAIN DIRECTORS WITH REPORTABLE COMPENSATION EXCEEDING $150,000 ARE APPROVED BY THE BOARD OF DIRECTORS COMPENSATION COMMITTEE WHICH IS DOCUMENTED IN MINUTES. INCENTIVE AMOUNTS FOR MANAGEMENT AND STAFF ARE APPROVED BY OFFICERS. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (9 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| SUSAN LI | |||
| DIRECTOR | $2,901,951 | SEE NOTE A | 0 |
| PATSY NANBU | |||
| DIRECTOR | $2,901,951 | SEE NOTE A | 0 |
| DAVID TODANI | |||
| DIRECTOR | $715,123 | SEE NOTE A | 0 |
| NORMAN CHUN | |||
| DIRECTOR | $439,594 | SEE NOTE B | 0 |
| JOHN KOTAKE | |||
| DIRECTOR | $398,332 | SEE NOTE B | 0 |
| CASEY TAMASHIRO | |||
| DIRECTOR | $274,126 | SEE NOTE B | 0 |
| JOHN BLACK | |||
| DIRECTOR | $229,544 | SEE NOTE B | 0 |
| KIM LAWLER | |||
| DIRECTOR | $101,912 | SEE NOTE B | 0 |
| CHARLES SUGIYAMA | |||
| DIRECTOR | $133,620 | SEE NOTE B | 0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART IV | FormAndLineReferenceDesc |
| Explanation | NOTE A - PREMIUMS FOR DENTAL PLAN - EMPLOYER GROUP PURCHASES AN HDS DENTAL PLAN BUT THE DIRECTOR DOES NOT INFLUENCE DECISION MAKING IN PURCHASING THE DENTAL PLAN FROM HDS.NOTE B - DENTIST PARTICIPATING IN HDS NETWORK OFFERING DENTAL SERVICES TO HDS SUBSCRIBERS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 1 | HAWAII DENTAL SERVICE OPERATES FOR THE PROMOTION OF THE COMMON GOOD AND GENERAL WELFARE OF THE PEOPLE. ITS GOAL IS TO INNOVATE AND CONDUCT PROGRAMS FOR DENTAL CARE AND TO MAKE AVAILABLE, ON A BROAD SCALE, THE BENEFITS OF THE SCIENCE OF DENTISTRY TO MEMBERS OF THE PUBLIC. DENTAL COVERAGE IS AVAILABLE TO THE GENERAL PUBLIC AS HAWAII DENTAL SERVICE MAINTAINS AN ENROLLMENT POLICY THAT IS OPEN TO INDIVIDUALS AND FAMILIES, AS WELL AS SMALL AND LARGE GROUPS. IN ADDITION, HAWAII DENTAL SERVICE PROVIDES FUNDING TO HAWAII DENTAL SERVICE FOUNDATION THAT GRANTS TO ORGANIZATIONS THAT HAVE PROGRAMS IN PLACE TO SUPPORT ORAL HEALTH INITIATIVES IN THE COMMUNITY. |
| FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE: | HAWAII DENTAL SERVICE (HDS) OFFERS AND ADMINISTERS DENTAL CARE PROGRAMS TO SUBSCRIBER GROUPS AND INDIVIDUALS THROUGHOUT THE STATE OF HAWAII. THE TERMS OF THE AGREEMENTS GENERALLY PROVIDE THAT THE SUBSCRIBER GROUPS OR INDIVIDUALS PAY HDS A STIPULATED AMOUNT, INCLUDING AN ADMINISTRATIVE FEE, WHICH IS USED TO PAY FOR DENTAL BENEFITS AND EXPENSES OF ADMINISTERING THE DENTAL CARE PROGRAMS. IN ADDITION, HDS FUNDED $4,000,000 TO HDS FOUNDATION IN 2014 TO SUPPORT ORAL HEALTH INITIATIVES IN THE COMMUNITY. |
| FORM 990, PART IV, LINE 12B, AUDITED FINANCIAL STATEMENTS: | THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF HAWAII DENTAL SERVICE, HAWAII DENTAL SERVICE FOUNDATION, AND HAWAII CLIENT SERVICES CORPORATION. THE AUDIT COMMITTEE, WHICH CONSISTS OF BOARD MEMBERS, SELECTS THE AUDITORS AND REVIEWS THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. |
| FORM 990, PART VI, SECTION A, LINE 4 | REFER TO SCHEDULE O RESPONSE TO PART VI, SECTION A, LINE 6 |
| FORM 990, PART VI, SECTION A, LINE 6 | DESCRIPTION OF ORGANIZATION'S MEMBERS: PRIOR TO MAY 8, 2014, MEMBERSHIP IN THE CORPORATION WAS COMPRISED OF DENTIST AND PUBLIC MEMBERS. DENTIST MEMBERSHIP WAS AVAILABLE TO ALL DENTISTS AND DENTAL SURGEONS WHO HAVE BEEN DULY LICENSED TO PRACTICE IN THE STATE OF HAWAII BY THE BOARD OF DENTAL EXAMINERS OF THE STATE OF HAWAII. APPLICATION WAS MADE IN WRITING AND APPROVED BY THE BOARD OF DIRECTORS. CERTAIN ORGANIZATIONS (COMPANIES, ORGANIZATIONS, OR ENTITIES CONTRACTING WITH HDS FOR DENTAL BENEFITS FOR AT LEAST 2 CONSECUTIVE YEARS WITH MORE THAN 100 OR MORE ELIGIBLE SUBSCRIBERS AT THE TIME OF SUCH DESIGNATION) WERE INVITED TO BECOME PUBLIC MEMBERS AND APPROVED BY THE BOARD OF DIRECTORS. BOTH MEMBERSHIPS OF THE CORPORATION COULD AT ANY TIME DEPOSE OR REMOVE FROM OFFICE ANY DIRECTOR, WITH OR WITHOUT CAUSE, EXCEPT AS SUCH REMOVAL WOULD BE CONTRARY TO LAW. EFFECTIVE MAY 8, 2014, MEMBERSHIP IS SOLEY AVAILABLE TO DENTISTS WHO HAVE BEEN DULY LICENSED TO PRACTICE IN THE STATE OF HAWAII AND WHO MEET ANY ADDITIONAL REQUIREMENTS CONSISTENT WITH APPLICABLE LAW ESTABLISHED BY THE BOARD OF DIRECTORS FROM TIME TO TIME. APPLICATION IS MADE IN WRITING AND APPROVED BY THE BOARD OF DIRECTORS. MEMBERS MAY AT ANY TIME DEPOSE OR REMOVE FROM OFFICE ANY DIRECTOR, WITH OR WITHOUT CAUSE, EXCEPT AS SUCH REMOVAL WOULD BE CONTRARY TO LAW. |
| FORM 990, PART VI, SECTION A, LINE 7A | ELECT BOARD MEMBERS: A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS SHALL BE COMPRISED OF NON-DENTIST REPRESENTATIVE FROM THE GENERAL PUBLIC AND THE REMAINING MEMBERS SHALL BE MEMBER DENTISTS. DENTISTS AND PUBLIC DIRECTORS RESPECTIVELY ELECT DENTISTS AND PUBLIC DIRECTORS TO THE BOARD OF DIRECTORS FOR A THREE YEAR TERM. |
| FORM 990, PART VI, SECTION A, LINE 7B | APPROVAL OF DECISIONS: PRIOR TO MAY 8, 2014, AMENDMENTS TO THE BYLAWS REQUIRED APPROVAL OF NOT LESS THAN A MAJORITY OF EACH CLASS OF MEMBERSHIP. EFFECTIVE MAY 8, 2014, BYLAWS AND ARTICLES OF INCORPORATION MAY BE ALTERED OR REPEALED, OR NEW BYLAWS AND ARTICLES OF INCORPORATION MAY BE ADOPTED IN LIEU THEREOF, BY ADOPTION OF A RESOLUTION BY THE BOARD OF DIRECTORS SETTLING FORTH THE PROPOSED AMENDMENT AND DIRECTING THAT IT BE SUBMITTED TO A VOTE AT THE ANNUAL OR SPECIAL MEETING OF THE MEMBERS. THE PROPOSED AMENDMENT SHALL BE ADOPTED UPON RECEIVING AT LEAST TWO-THIRDS OF THE VOTES WHICH MEMBERS PRESENT IN PERSON AT THE MEETING ARE ENTITLED TO CAST. THE BYLAWS MAY ALSO BE AMENDED BY AFFIRMATIVE VOTE OF THE DIRECTORS THEN IN OFFICE, WHITHOUT FURTHER ACTION BY THE MEMBERS, FOR THE PURPOSE OF CURING AMBIGUITIES, CORRECTING OR SUPPLEMENTING DEFECTIVE OR INCONSISTENT PROVISIONS, OR ENABLING THE CORPORATION TO COMPLY WITH APPLICABLE LAWS AND REGULATIONS. |
| FORM 990, PART VI, SECTION B, LINE 11 | APPROVED COPY OF FORM 990: THE RETURN IS THOROUGHLY REVIEWED BY THE CONTROLLER PRIOR TO FINAL REVIEW WITH THE VP-FINANCIAL AFFAIRS AND PRESIDENT. A COPY OF FORM 990 IS PROVIDED TO BOARD OF DIRECTORS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | WRITTEN CONFLICT OF INTEREST POLICY: PURSUANT TO THE HDS CONFLICTS OF INTEREST POLICY, EMPLOYEES AND DIRECTORS OF HDS ARE PROVIDED WITH THE CONFLICTS OF INTEREST POLICY AND ARE REQUIRED TO SUBMIT A CONFLICTS OF INTEREST DISCLOSURE STATEMENT ANNUALLY. COMPLIANCE DEPARTMENT REVIEWS THE ANNUAL CONFLICTS OF INTEREST DISCLOSURE STATEMENTS AND REPORTS POTENTIAL CONFLICTS OF INTERESTS TO THE HDS BOARD OF DIRECTORS. THE BOARD OF DIRECTORS ARE NOT ALLOWED TO PARTICIPATE IN DELIBERATIONS OR VOTE ON ISSUES/TRANSACTIONS WHICH THEY HAVE A CONFLICT OF INTEREST IN. |
| FORM 990, PART VI, SECTION B, LINE 15 | PROCESS FOR DETERMINING COMPENSATION: COMPENSATION FOR THE OFFICERS (PRESIDENT & CEO AND VICE PRESIDENTS) ARE DETERMINED BASED ON ADVICE FROM AN INDEPENDENT COMPENSATION CONSULTANT WHO USES DELTA DENTAL PLANS ASSOCIATION AND HAWAII EMPLOYERS COUNCIL COMPENSATION SURVEY INFORMATION FOR COMPARABLE POSITIONS. OFFICER COMPENSATION IS APPROVED ANNUALLY BY THE BOD COMPENSATION COMMITTEE. AMOUNTS ARE DOCUMENTED IN MINUTES AND RECONCILED AT THE END OF EACH YEAR. PERIODICALLY AN INDEPENDENT CONSULTANT IS HIRED TO REVIEW THE COMPENSATION FOR MANAGEMENT AND STAFF POSITIONS. COMPENSATION FOR THESE POSITIONS ARE APPROVED ANNUALLY BY THE PRESIDENT AND CEO. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABILITY OF REQUIRED DOCUMENTS: TAX RETURNS AND OTHER REQUIRED DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN ACCRUED POSTRETIREMENT LIABILITIES -3,995,372. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAWAII DENTAL SERVICE FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 BISHOP STREET SUITE 700 | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96813 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990246999 | EIN |
| Primary Activities | ORAL HEALTH SUPPORT | PrimaryActivitiesTxt |
| Legal Domicile State | HI | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(4) | ExemptCodeSectionTxt |
| Public Charity Status | N/A | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAWAII CLIENT SERVICES CORPORATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 BISHOP STREET SUITE 710 | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96813 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 452740308 | EIN |
| Primary Activities | ADMIN SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | HI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HI DENTAL SCVS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | -$29,693 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $863,637 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| HAWAII DENTAL SERVICE FOUNDATION | ||
| B | $4,000,000 | CASH |
| HAWAII CLIENT SERVICES CORPORATION | ||
| O | $200,600 | CASH |
| HAWAII CLIENT SERVICES CORPORATION | ||
| A | $3,000 | CASH |
| HAWAII CLIENT SERVICES CORPORATION | ||
| Q | $228,925 | CASH |