DELTA FAMILY CARE MEDICAL TR: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
DELTA FAMILY CARE MEDICAL TR (EIN 36-6791916)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-15
IRS object ID
201431359349304068
Schema version
2012v2.0
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

FieldValueIRS element (for citing)
Timestamp2014-05-15T10:42:42-07:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN366791916EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1DELTA FAMILY CARE MEDICAL TRBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlDELTNameControl
Phone4047152600Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11030 Delta BlvdAddressLine1
Address Line2Dept 216AddressLine2
CityAtlantaCity
StateGAState
ZIP Code30354ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRobert KightName
TitleSVP-Global HR Svcs & Lbr RelationsTitle
Phone4047152400Phone
Date Signed2014-04-03DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRobert KightNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11030 Delta BlvdAddressLine1
Address Line2Dept 216AddressLine2
CityAtlantaCity
StateGAState
ZIP Code30354ZIPCode
FieldValueIRS element (for citing)
Gross Receipts44748796GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.delta.comWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1984YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionDisburse payments on behalf of participants related to medical, dental, mental health and prescription drugs.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year19607417ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year66503330ProgramServiceRevenuePriorYear
Program Service Revenue CY44725482ProgramServiceRevenueCY
Investment Income Prior Year15005InvestmentIncomePriorYear
Investment Income Current Year23314InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year86125752TotalRevenuePriorYear
Total Revenue Current Year44748796TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year53758458BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY48430545BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4495857OtherExpensePriorYear
Other Expenses Current Year3552513OtherExpensesCurrentYear
Total Expenses Prior Year58254315TotalExpensesPriorYear
Total Expenses Current Year51983058TotalExpensesCurrentYear
Revenues Less Expenses Prior Year27871437RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-7234262RevenuesLessExpensesCY
Total Assets BOY23957105TotalAssetsBOY
Total Assets EOY15560013TotalAssetsEOY
Total Liabilities BOY5743708TotalLiabilitiesBOY
Total Liabilities EOY4580878TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY18213397NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY10979135NetAssetsOrFundBalancesEOY
Mission DescriptionDisburse payments on behalf of paarticipants related to medical, dental, mental health, and prescription drugs.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense51983058Expense
Grants0Grants
Revenue44748796Revenue
DescriptionDisburse payments on behalf of participants related to medical, dental, mental health and prescription drugs.Description
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense51983058TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy0ConflictOfInterestPolicy
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Delta Air Lines IncBusinessNameLine1
Business Name Line2Corporate BenefitsBusinessNameLine2
FieldValueIRS element (for citing)
Telephone Number4047152600TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11030 Delta BlvdAddressLine1
Address Line2Dept 837AddressLine2
CityAtlantaCity
StateGAState
ZIP Code30354ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationInstitutional TrusteeInstitutionalTrustee
Robert L Kight
Chairman Admin Comm, Member Invest Comm10X000
Christopher M Collins
Member Admin Comm10X000
Gregory S Tahvonen
Member Admin Comm10X000
Paul A Jacobson
Member Invest Comm10X000
Garrett Chase
Member Invest Comm10X000
Sandy P Gordon
Member Invest Comm10X000
Craig M Meynard
Member Invest Comm10X000
Kiko Harvey
Member Invest Comm10X000
Jeffery A Arinder
Member Invest Comm10X000
Mary Anne Bell
Member Admin Subcomm10X000
Kenneth Morge
Chair and Member, Invest Comm10X000
JP Morgan Chase
Trustee101282800X
FieldValueIRS element (for citing)
Total Reportable Comp From Org12828TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Employer Contributions90009922130833221308330$0
Employee Contributions90009922594649225946490$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue44725482TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column23314TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$23,314ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other0Other
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column44748796TotalRevenueColumn
Related Or Exempt Function Income44725482RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$23,314ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total48430545Total
Program Services48430545ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2157799Total
Program Services2157799ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total19000Total
Program Services19000ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1375714Total
Program Services1375714ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total51983058Total
Program Services51983058ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY14413753BOY
EOY13412927EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY9543352BOY
EOY2147086EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY23957105BOY
EOY15560013EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY636891BOY
EOY328188EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY5106817BOY
EOY4252690EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5743708BOY
EOY4580878EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY18213397BOY
EOY10979135EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY18213397BOY
EOY10979135EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY23957105BOY
EOY15560013EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-7234262ReconcilationRevenueExpenses
Reconciliation Unrealized Invest0ReconciliationUnrealizedInvest
Reconcilation Donated Services0ReconcilationDonatedServices
Reconcilation Invest Expenses0ReconcilationInvestExpenses
Reconcilation Prior Adjustment0ReconcilationPriorAdjustment
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionBenefits Claims PayableDescription
Amount$4,252,690Amount
FieldValueIRS element (for citing)
Total Of Amounts4252690TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt44748796TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments0NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues0OtherRevenues
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal44748796RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99044748796TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt51983058TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal51983058ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99051983058TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierSchD_P10_S00_L02Identifier
Return ReferenceSchedule D, Part X, Line 2ReturnReference
ExplanationThe other liability noted here encompasses the benefit claims payable, which is made up of the IBNR. Effective July 1, 2009, the Plan recognizes a tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained upon examination by the taxing authority, based on the technical merits of the position. The Plan is exempt from federal and state income taxes under Section 401(a) of the Internal Revenue Code. Tax years that remain subject to the examination by major tax jurisdictions date back to the year ending June 30, 2011. All federal and state income tax positions taken or anticipated to be taken in the income tax returns are attributable to the plan sponsor and not the Plan. As of June 30, 2013, there are no known items which would result in a material accrual related to where the plan has federal or state attributable tax positions.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11bThe Form 990 is completed each year by Delta Air Lines, Inc's Corporate Benefits Department. An analyst enters all information and gathers the necessary files and schedules for support. The return goes through two levels of managerial review; and then the return is reviewed with the Principal Officer prior to signing the form.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19The financial statements of the Family Care Medical Trust are made available to the public upon request.

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