HAWAII DENTAL SERVICE: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- HAWAII DENTAL SERVICE (EIN 99-0107971)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-14
- IRS object ID
- 201303189349303935
- Schema version
- 2012v2.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-14T13:10:20-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205325889 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ACCUITY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 999 BISHOP STREET STE 1900 | AddressLine1 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96813 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990107971 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAWAII DENTAL SERVICE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HAWA | NameControl |
| Phone | 8085211431 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 BISHOP STREET NO 700 | AddressLine1 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96813 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CHERYL TAKITANI-SMITH | Name |
| Title | VP - FINANCIAL AFFAIRS | Title |
| Phone | 8085211431 | Phone |
| Date Signed | 2013-11-08 | DateSigned |
| Authorize Third Party | 0 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ACCUITY LLP | Name |
| PTIN | P00037058 | PTIN |
| Phone | 8085313400 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | FAYE W KURREN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 BISHOP STREET SUITE 700 | AddressLine1 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96813 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 223471845 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.HAWAIIDENTALSERVICE.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1962 | YearFormation |
| State Legal Domicile | HI | StateLegalDomicile |
| Activity Or Mission Description | 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 101 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 182496411 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 183236375 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 4113361 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4079635 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 277429 | OtherRevenuePriorYear |
| Other Revenue Current Year | 17092 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 186887201 | TotalRevenuePriorYear |
| Total Revenue Current Year | 187333102 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1535028 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 2068508 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 164709135 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 158461708 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 8451269 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10082412 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4428566 | OtherExpensePriorYear |
| Other Expenses Current Year | 4766869 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 179123998 | TotalExpensesPriorYear |
| Total Expenses Current Year | 175379497 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 7763203 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 11953605 | RevenuesLessExpensesCY |
| Total Assets BOY | 144353905 | TotalAssetsBOY |
| Total Assets EOY | 155904958 | TotalAssetsEOY |
| Total Liabilities BOY | 28473858 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 23776689 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 115880047 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 132128269 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SEE SCHEDULE O. | MissionDescription |
| Significant New Program Services | 1 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 167118378 | Expense |
| Grants | 2068508 | Grants |
| Revenue | 183253467 | Revenue |
| Description | 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. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 543165 | Expense |
| Grants | 0 | Grants |
| Revenue | 0 | Revenue |
| Description | MANAGING THE DENTAL BENEFITS OF ELIGIBLE BENEFICIARIES COVERED BY THE STATE OF HAWAII MEDICAID PROGRAM. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 167661543 | TotalProgramServiceExpense |
| Described In501 C3 | 0 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 2941 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 101 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHERYL TAKITANI-SMITH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8085211431 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 BISHOP STREET SUITE 700 | AddressLine1 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96813 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (25 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| T KIMO BLAISDELL | ||||||||
| CHAIR | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| JOHN BLACK | ||||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| PAUL CHANG | ||||||||
| DIRECTOR | 1.00 | 1.00 | X | 0 | 0 | 0 | ||
| NORMAN S CHUN | ||||||||
| TREASURER | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| HAROLD J DIAS JR | ||||||||
| DIRECTOR (THROUGH 5/2012) | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| CLAY R HIRAMOTO | ||||||||
| DIRECTOR (THROUGH 5/2012) | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| SUZY HOLLINGER | ||||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| JOHN I KOTAKE | ||||||||
| DIRECTOR | 1.00 | 1.00 | X | 0 | 0 | 0 | ||
| KIM JAMES LAWLER | ||||||||
| DIRECTOR | 1.00 | 1.00 | X | 0 | 0 | 0 | ||
| SUSAN A LI | ||||||||
| SECRETARY | 1.00 | 1.00 | X | 0 | 0 | 0 | ||
| GARY K NAKATA | ||||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| PATSY NANBU | ||||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| GARRETT B K OKA | ||||||||
| DIRECTOR | 1.00 | 1.00 | X | 0 | 0 | 0 | ||
| MICHAEL J O'MALLEY | ||||||||
| VICE CHAIR | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| CASEY Z TAMASHIRO | ||||||||
| DIRECTOR | 1.00 | 1.00 | X | 0 | 0 | 0 | ||
| TRAVIS UMEMOTO | ||||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| JON YOSHINO | ||||||||
| ASST TREASURER/SECRETARY | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| FAYE W KURREN | ||||||||
| PRESIDENT & CEO | 40.00 | 1.00 | 3596144 | 0 | 104371 | X | ||
| KATHY FAY | ||||||||
| VP - OPERATIONS | 40.00 | 0.00 | 215761 | 0 | 110520 | X | ||
| CHERYL TAKITANI-SMITH | ||||||||
| VP - FINANCIAL AFFAIRS | 40.00 | 1.00 | 216242 | 0 | 81458 | X | ||
| TOM DELANEY | ||||||||
| DIRECTOR OF INFORMATION SYSTEM | 40.00 | 0.00 | 153712 | 0 | 65573 | X | ||
| ROBERT SHERMAN | ||||||||
| DENTAL DIRECTOR | 40.00 | 0.00 | 158851 | 0 | 58451 | X | ||
| JIM JOHNSON | ||||||||
| DIR. OF CLAIMS & CUSTOMER SVC. | 40.00 | 0.00 | 129353 | 0 | 58636 | X | ||
| LYNETTE ARAKAWA | ||||||||
| DIRECTOR OF MARKETING & SALES | 40.00 | 0.00 | 130149 | 0 | 78148 | X | ||
| ROQUE ARANADOR | ||||||||
| MANAGER OF INFORMATION SYSTEMS | 40.00 | 0.00 | 122518 | 0 | 52478 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 4722730 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 609635 | TotalOtherCompensation |
| Number Individuals GT100 K | 8 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| STRATEGIC COMMUNICATIONS | |||||
| PO BOX 283137 | HONOLULU | HI | 968283137 | ADVERTISING | 450260 |
| ERNST & YOUNG LLP | |||||
| 55 MERCHANT STREET 1900 | HONOLULU | HI | 96813 | ACCOUNTING SERVICE | 246309 |
| BENEFIT PLAN SOLUTIONS INC | |||||
| 680 IWILEI ROAD 528 | HONOLULU | HI | 96817 | BROKER | 190455 |
| TOWERS WATSON DELAWARE INC | |||||
| PO BOX 741909 | ATLANTA | GA | 303741909 | BROKER | 130313 |
| HEALTHENTIC INC | |||||
| 9706 FOURTH AVE NE 208 | SEATTLE | WA | 98115 | REPORTING | 115000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| SUBSCRIPTIONS EARNED | 621300 | 183235700 | 183235700 |
| MEMBERSHIP DUES | 621300 | 675 | 675 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 183236375 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2954027 | TotalRevenueColumn |
| Exclusion | $2,954,027 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 6000 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 6000 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 37258351 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 36131376 | Securities |
| Other | 1367 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1126975 | Securities |
| Other | -1367 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1125608 | TotalRevenueColumn |
| Exclusion | $1,125,608 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| ALL OTHER REVENUE | 900099 | 13875 | 13875 |
| FMG - VA HERO | 900099 | 3217 | 3217 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 17092 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 187333102 | TotalRevenueColumn |
| Related Or Exempt Function Income | 183253467 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $4,079,635 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2068508 | Total |
| Program Services | 2068508 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 158461708 | Total |
| Program Services | 158461708 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3928957 | Total |
| Management And General | 3928957 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3558284 | Total |
| Program Services | 2982792 | ProgramServices |
| Management And General | 575492 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1333345 | Total |
| Program Services | 694010 | ProgramServices |
| Management And General | 639335 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 753503 | Total |
| Program Services | 405912 | ProgramServices |
| Management And General | 347591 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 508323 | Total |
| Program Services | 230829 | ProgramServices |
| Management And General | 277494 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 125254 | Total |
| Program Services | 31523 | ProgramServices |
| Management And General | 93731 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 218245 | Total |
| Program Services | 16204 | ProgramServices |
| Management And General | 202041 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18848 | Total |
| Management And General | 18848 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1410521 | Total |
| Program Services | 908994 | ProgramServices |
| Management And General | 501527 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 304754 | Total |
| Program Services | 199691 | ProgramServices |
| Management And General | 105063 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 468630 | Total |
| Program Services | 468630 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 596748 | Total |
| Program Services | 486729 | ProgramServices |
| Management And General | 110019 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 143416 | Total |
| Program Services | 80665 | ProgramServices |
| Management And General | 62751 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 530728 | Total |
| Program Services | 285903 | ProgramServices |
| Management And General | 244825 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89494 | Total |
| Program Services | 32261 | ProgramServices |
| Management And General | 57233 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48934 | Total |
| Program Services | 15947 | ProgramServices |
| Management And General | 32987 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 147802 | Total |
| Program Services | 3888 | ProgramServices |
| Management And General | 143914 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 217123 | Total |
| Program Services | 180109 | ProgramServices |
| Management And General | 37014 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| DUES & SUBSCRIPTIONS | 282327 | 1677 | 280650 |
| BANK CHARGES | 76051 | 76051 | |
| ALL OTHER EXPENSES | 72439 | 13957 | 58482 |
| ORAL HEALTH EDUCATION | 15555 | 15555 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 175379497 | Total |
| Program Services | 167661543 | ProgramServices |
| Management And General | 7717954 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38746650 | BOY |
| EOY | 43706220 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9335462 | BOY |
| EOY | 8692280 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3098067 | BOY |
| EOY | 2438365 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 4810535 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4590979 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 325228 | BOY |
| EOY | 219556 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 92848498 | BOY |
| EOY | 100848537 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 144353905 | BOY |
| EOY | 155904958 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9906285 | BOY |
| EOY | 8352796 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2076380 | BOY |
| EOY | 2472565 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16491193 | BOY |
| EOY | 12951328 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28473858 | BOY |
| EOY | 23776689 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 115880047 | BOY |
| EOY | 132128269 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 115880047 | BOY |
| EOY | 132128269 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 144353905 | BOY |
| EOY | 155904958 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 11953605 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 4805591 | ReconciliationUnrealizedInvest |
| Reconcilation Invest Expenses | -716505 | ReconcilationInvestExpenses |
| Reconcilation Other Changes | 205531 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1363581 | OtherCostOrOtherBasis |
| Depreciation | 1304339 | Depreciation |
| Book Value | 59242 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2572452 | OtherCostOrOtherBasis |
| Depreciation | 2424714 | Depreciation |
| Book Value | 147738 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 874502 | OtherCostOrOtherBasis |
| Depreciation | 861926 | Depreciation |
| Book Value | 12576 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 219556 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| CLAIMS PAYABLE TO DENTISTS | $8,603,911 |
| REFUNDABLE GROUP SUBSCRIPTIONS | $4,347,417 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 12951328 | TotalOfAmounts |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| CHILDREN'S DISCOVERY CENTER | |||||||
| 111 OHE ST | HONOLULU | HI | 96813 | 990241632 | 501(C)(3) | 6560 | TO PROMOTE ORAL HEALTH |
| HAWAII DENTAL SERVICE FOUNDATION | |||||||
| 700 BISHOP ST STE 700 | HONOLULU | HI | 96813 | 990246999 | 501(C)(4) | 2000000 | SUPPORT ORGANIZATION PROGRAMS |
| ALOHA UNITED WAY | |||||||
| 200 N VINEYARD BLVD | HONOLULU | HI | 96817 | 990073494 | 501(C)(3) | 10000 | GENERAL SUPPORT |
| GIRL SCOUTS OF AMERICA | |||||||
| 420 WYLLIE STREET | HONOLULU | HI | 96817 | 990073488 | 501(C)(3) | 10000 | GENERAL SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS FROM 990, SCHEDULE I THE PURPOSE OF THE GRANTS AWARDED 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 CHAIR REPORTS ON THE USE OF GRANTS TO HDS BOARD OF DIRECTORS. OTHER GRANTS ARE AWARDED TO VARIOUS PUBLIC CHARITABLE ORGANIZATIONS TO SUPPORT THE EXEMPT FUNCTIONS OF THE ORGANIZATIONS AND ARE NOT MONITORED. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Discretionary Spending Account | X | DiscretionarySpendingAccount |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FAYE W KURREN | ||||||||||||||
| PRESIDENT & CEO | 418063 | 0 | 143215 | 0 | 3034866 | 0 | 93690 | 0 | 10681 | 0 | 3700515 | 0 | 1661515 | 0 |
| KATHY FAY | ||||||||||||||
| VP - OPERATIONS | 166221 | 0 | 49540 | 0 | 0 | 0 | 100619 | 0 | 9901 | 0 | 326281 | 0 | 0 | 0 |
| CHERYL TAKITANI-SMITH | ||||||||||||||
| VP - FINANCIAL AFFAIRS | 166702 | 0 | 49540 | 0 | 0 | 0 | 66606 | 0 | 14852 | 0 | 297700 | 0 | 0 | 0 |
| TOM DELANEY | ||||||||||||||
| DIRECTOR OF INFORMATION SYSTEM | 140635 | 0 | 13077 | 0 | 0 | 0 | 57024 | 0 | 8549 | 0 | 219285 | 0 | 0 | 0 |
| ROBERT SHERMAN | ||||||||||||||
| DENTAL DIRECTOR | 149179 | 0 | 9672 | 0 | 0 | 0 | 52530 | 0 | 5921 | 0 | 217302 | 0 | 0 | 0 |
| JIM JOHNSON | ||||||||||||||
| DIR. OF CLAIMS & CUSTOMER SVC. | 121425 | 0 | 7928 | 0 | 0 | 0 | 44787 | 0 | 13849 | 0 | 187989 | 0 | 0 | 0 |
| LYNETTE ARAKAWA | ||||||||||||||
| DIRECTOR OF MARKETING & SALES | 121781 | 0 | 8368 | 0 | 0 | 0 | 67712 | 0 | 10436 | 0 | 208297 | 0 | 0 | 0 |
| ROQUE ARANADOR | ||||||||||||||
| MANAGER OF INFORMATION SYSTEMS | 115009 | 0 | 7509 | 0 | 0 | 0 | 38697 | 0 | 13781 | 0 | 174996 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL INFORMATION | Identifier |
| Return Reference | PART III | ReturnReference |
| Explanation | SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 1A HDS HAS 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: THE CEO RECEIVES AN ALLOWANCE OF $6,000 ANNUALLY FOR BUSINESS USE OF PERSONAL AUTOMOBILE. THIS AMOUNT HAS BEEN INCLUDED IN FORM W-2 AS COMPENSATION. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: CEO RECEIVES GROSS UP PAYMENTS FOR LIFE INSURANCE PREMIUMS OVER $50,000 AND PARKING OVER INTERNAL REVENUE SERVICE LIMITS. CEO, VP FINANCIAL AFFAIRS, AND DIRECTOR OF MARKETING RECEIVE GROSS UP PAYMENT FOR PARKING EXCEEDING INTERNAL REVENUE SERVICE LIMITS. THE PAYMENTS TO THE INDIVIDUALS ABOVE ARE INCLUDED IN THEIR W-2S AS COMPENSATION. SCHEDULE J, 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. THE BENEFIT WAS RETROACTIVE FROM 9/3/03. BENEFIT PAYMENTS OF $3,028,866 FOR THE PERIOD FROM 9/3/03 THROUGH 12/31/12 WERE PAID TO FAYE KURREN ON DECEMBER 31, 2012 IN ACCORDANCE WITH THE TERMS OF THE EMPLOYMENT AGREEMENT. SCHEDULE J, PART I, LINE 7 HDS HAS AN INCENTIVE BONUS PLAN DETAILING THE BONUS CALCULATION WHEN THE COMPANY ACHIEVES CERTAIN PERFORMANCE STANDARDS AND STRATEGIC GOALS. BONUS AMOUNT VARIES EACH YEAR DEPENDING ON PERFORMANCE AND ACHIEVEMENT OF STRATEGIC GOALS. BONUS AMOUNT FOR OFFICERS AND CERTAIN DIRECTORS WITH REPORTABLE COMPENSATION EXCEEDING $150,000 ARE PRESENTED TO AND APPROVED BY THE BOARD OF DIRECTORS COMPENSATION COMMITTEE WHICH IS DOCUMENTED IN MINUTES. BONUS PAYMENTS FOR MANAGEMENT AND STAFF ARE CALCULATED BY HUMAN RESOURCES AND APPROVED BY OFFICERS. ON DECEMBER 31, 2009, THE BOARD OF DIRECTORS APPROVED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) FOR THE PRESIDENT & CEO, FAYE KURREN. THE BENEFIT WAS RETROACTIVE EFFECTIVE FROM 9/3/03. BENEFIT PAYMENTS OF $3,028,866 FOR THE PERIOD FROM 9/3/03 THROUGH 12/31/12 WERE PAID TO FAYE KURREN ON DECEMBER 31, 2012. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (9 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| PAUL CHANG | |||
| OFFICER IS DIR OF HDS | 2312191 | PREMIUM FOR DENTAL PLAN | 0 |
| SUSAN LI | |||
| OFFICER IS DIR OF HDS | 2721055 | PREMIUM FOR DENTAL PLAN | 0 |
| PATSY NANBU | |||
| OFFICER IS DIR OF HDS | 2721055 | PREMIUM FOR DENTAL PLAN | 0 |
| NORMAN CHUN | |||
| DIRECTOR | 419171 | DENTAL SVCS TO HDS SUBSCRIBERS | 0 |
| JOHN BLACK | |||
| DIRECTOR | 112544 | DENTAL SVCS TO HDS SUBSCRIBERS | 0 |
| JOHN KOTAKE | |||
| DIRECTOR | 362240 | DENTAL SVCS TO HDS SUBSCRIBERS | 0 |
| KIM LAWLER | |||
| DIRECTOR | 215638 | DENTAL SVCS TO HDS SUBSCRIBERS | 0 |
| GARRET OKA | |||
| DIRECTOR | 181580 | DENTAL SVCS TO HDS SUBSCRIBERS | 0 |
| CASEY TAMASHIRO | |||
| DIRECTOR | 256080 | DENTAL SVCS TO HDS SUBSCRIBERS | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION MISSION STATEMENT | 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, IN 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 WHICH HAVE PROGRAMS IN PLACE TO SUPPORT ORAL HEALTH INITIATIVES IN THE COMMUNITY. |
| NEW PROGRAM SERVICES | FORM 990, PART III, LINE 2 | IN 2012 HAWAII DENTAL SERVICE WAS AWARDED THE STATE OF HAWAII MEDICAID CONTRACT AND WILL BE RESPONSIBLE FOR MANAGING THE DENTAL BENEFITS OF ELIGIBLE BENEFICIARIES COVERED BY THE MEDICAID PROGRAM, FURTHER EXPANDING THE ABILITY OF HDS TO ACCOMPLISH ITS GOAL TO MAKE AVAILABLE, IN A BROAD SCALE, THE BENEFITS OF THE SCIENCE OF DENTISTRY TO MEMBERS OF THE PUBLIC. |
| 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 SERVICES AND EXPENSES OF ADMINISTERING THE DENTAL SERVICE CONTRACTS. IN ADDITION, HDS FUNDED $2,000,000 TO HDS FOUNDATION IN 2012 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 6 | DESCRIPTION OF ORGANIZATION'S MEMBERS: MEMBERSHIP IN THE CORPORATION IS COMPRISED OF DENTIST AND PUBLIC MEMBERS. DENTIST MEMBERSHIP IS 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 IS 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) ARE INVITED TO BECOME PUBLIC MEMBERS AND APPROVED BY THE BOARD OF DIRECTORS. BOTH MEMBERSHIPS OF THE CORPORATION 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: DENTISTS AND PUBLIC MEMBERS RESPECTIVELY ELECT DENTISTS AND PUBLIC DIRECTORS TO THE BOARD OF DIRECTORS FOR A THREE YEAR TERM. DUE TO STAGGERED TERMS 1/3 OF DIRECTORS ARE ELECTED ANNUALLY. | |
| FORM 990, PART VI, SECTION A, LINE 7B | APPROVAL OF DECISIONS: AMENDMENTS TO THE BYLAWS REQUIRE APPROVAL OF NOT LESS THAN A MAJORITY OF EACH CLASS OF MEMBERSHIP. | |
| 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 CEO AND OFFICERS ARE DETERMINED BASED ON ADVICE FROM AN INDEPENDENT COMPENSATION CONSULTANT WHO USES DELTA DENTAL PLANS ASSOCIATION SURVEY AND THE HAWAII EMPLOYERS COUNCIL SURVEYS FOR COMPARABLE POSITIONS. THE INDEPENDENT CONSULTANT ALSO USES THEIR OWN COMPENSATION SURVEY AS APPROPRIATE TO PROVIDE ADVICE. OFFICER COMPENSATION IS PRESENTED TO AND APPROVED BY THE BOD COMPENSATION COMMITTEE. AMOUNTS ARE DOCUMENTED IN MINUTES AND HUMAN RESOURCE DEPARTMENT RECONCILES THE PAYMENT AT END OF EACH YEAR. COMPENSATION FOR MANAGEMENT AND STAFF POSITIONS ARE EVALUATED AND DETERMINED BASED ON HAWAII EMPLOYERS COUNCIL SURVEYS AND APPROVED BY THE PRESIDENT AND CEO ANNUALLY. | |
| FORM 990, PART VI, SECTION C, LINE 19 | PUBLIC DISCLOSURE OF ORGANIZATION GOVERNING DOCUMENTS: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 9: | CHANGE IN ACCRUED POSTRETIREMENT LIABILITIES 205,531. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAWAII DENTAL SERVICE FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 BISHOP STREET SUITE 700 | AddressLine1 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96813 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990246999 | EIN |
| Primary Activities | SUPPORT COMM. | PrimaryActivities |
| Legal Domicile State | HI | LegalDomicileState |
| Exempt Code Section | 501(C)(4) | ExemptCodeSection |
| Public Charity Status | N/A | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 1 | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAWAII CLIENT SERVICES CORPORATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 BISHOP STREET SUITE 710 | AddressLine1 |
| City | HONOLULU | City |
| State | HI | State |
| ZIP Code | 96813 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 452740308 | EIN |
| Primary Activity | ADMIN SERVICES | PrimaryActivity |
| Legal Domicile State | HI | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HI DENTAL SCVS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 368147 | ShareOfTotalIncome |
| Share Of EOY Assets | 989565 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Controlled Org | 1 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| HAWAII DENTAL SERVICE FOUNDATION | ||
| B | 2000000 | CASH |
| HAWAII CLIENT SERVICES CORPORATION | ||
| O | 183386 | CASH |
| HAWAII CLIENT SERVICES CORPORATION | ||
| A | 6000 | CASH |
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