DELTA DENTAL OF IOWA: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- DELTA DENTAL OF IOWA (EIN 42-0959302)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-12
- IRS object ID
- 201313169349302746
- 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 | 2013-11-12T10:43:34-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421229486 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BROOKS LODDEN PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1441 29TH STREET STE 305 | AddressLine1 |
| City | WEST DES MOINES | City |
| State | IA | State |
| ZIP Code | 502661357 | 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 | 420959302 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF IOWA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | DELT | NameControl |
| Phone | 5152615500 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9000 NORTHPARK DRIVE | AddressLine1 |
| City | JOHNSTON | City |
| State | IA | State |
| ZIP Code | 50131 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SHERRY PERKINS | Name |
| Title | VICE PRES FINANCE & CONTROLLER | Title |
| Phone | 5152615500 | Phone |
| Date Signed | 2013-11-04 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRENT L ALEXANDER | Name |
| PTIN | P00075113 | PTIN |
| Phone | 5152237300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JEFFREY S RUSSELL | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9000 NORTHPARK DRIVE | AddressLine1 |
| City | JOHNSTON | City |
| State | IA | State |
| ZIP Code | 50131 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 86301474 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.DELTADENTALIA.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1970 | YearFormation |
| State Legal Domicile | IA | StateLegalDomicile |
| Activity Or Mission Description | DENTAL HEALTH CARE: TO IMPROVE THE ORAL HEALTH OF THE PEOPLE WE SERVE. THIS IS ACCOMPLISHED THROUGH THE PROVISION OF DENTAL INSURANCE AND PUBLIC HEALTH CONTRIBUTIONS THAT FOCUS ON ACCESS TO ORAL HEALTH SERVICES AND EDUCATION RELATED TO GOOD ORAL HEALTH BEHAVIORS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 3 | NbrIndependentVotingMembers |
| Total Nbr Employees | 75 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 101431 | 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 | 72381744 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 77053693 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1290713 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1590837 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 101066 | OtherRevenuePriorYear |
| Other Revenue Current Year | 101431 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 73773523 | TotalRevenuePriorYear |
| Total Revenue Current Year | 78745961 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 2880371 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 4223695 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 48289991 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 50683913 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 7595505 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 7990922 | 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 | 9766543 | OtherExpensePriorYear |
| Other Expenses Current Year | 11289139 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 68532410 | TotalExpensesPriorYear |
| Total Expenses Current Year | 74187669 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 5241113 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 4558292 | RevenuesLessExpensesCY |
| Total Assets BOY | 59976161 | TotalAssetsBOY |
| Total Assets EOY | 67779369 | TotalAssetsEOY |
| Total Liabilities BOY | 12229165 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 13537217 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 47746996 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 54242152 | NetAssetsOrFundBalancesEOY |
| Mission Description | DENTAL HEALTH CARE: TO IMPROVE THE ORAL HEALTH OF THE PEOPLE WE SERVE. THIS IS ACCOMPLISHED THROUGH THE PROVISION OF DENTAL INSURANCE AND PUBLIC HEALTH CONTRIBUTIONS THAT FOCUS ON ACCESS TO ORAL HEALTH SERVICES AND EDUCATION RELATED TO GOOD ORAL HEALTH BEHAVIORS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 67432777 | Expense |
| Grants | 4223695 | Grants |
| Revenue | 77053693 | Revenue |
| Description | SINCE 1970, DELTA DENTAL OF IOWA HAS EXPANDED ACCESS TO DENTAL CARE BY PROVIDING AFFORDABLE, NETWORK BASED DENTAL BENEFITS PLANS TO IOWA EMPLOYERS AND INDIVIDUALS THAT RESULT IN LONG-TERM COST SAVINGS AND SUPPORT GOOD ORAL HEALTH. DELTA DENTAL OF IOWA'S DENTAL BENEFIT PLANS STRIVE TO INCORPORATE THE CURRENT BEST PRACTICES IN DENTAL SCIENCE. DELTA DENTAL IS COMMITTED TO ITS VISION OF IMPROVING THE ORAL HEALTH OF THE PEOPLE AND COMMUNITIES IT SERVES. DELTA DENTAL FULFILLS ITS NOT-FOR-PROFIT VISION BY ACTIVELY PARTICIPATING IN THE COMMUNITIES IT SERVES AS A CHAMPION AND MAJOR FUNDER OF ORAL HEALTH INITIATIVES IN THE STATE OF IOWA. DELTA DENTAL INVESTS IN ORAL HEALTH PROJECTS THAT MEET THE NEEDS OF UNDERSERVED POPULATIONS AND THAT FOCUS ON ACCESS TO CARE, PREVENTION, EDUCATION AND RESEARCH. | Description |
| Total Program Service Expense | 67432777 | 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 | 1 | 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 | 0 | 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 | 17712 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 75 | 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 | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 3 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | 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 | 0 | 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 HARDING | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5152615500 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9000 NORTHPARK DRIVE | AddressLine1 |
| City | JOHNSTON | City |
| State | IA | State |
| ZIP Code | 50131 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per Week RelatedAverageHoursPerWeekRelated | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| ED HANSELL | ||||||||
| DIRECTOR | 1.60 | X | 11500 | 0 | 0 | |||
| CHARLES EDWARD BROWN | ||||||||
| DIRECTOR | 1.60 | X | 12400 | 0 | 0 | |||
| ANNE HENNESSEY DDS | ||||||||
| DIRECTOR | 1.60 | X | 13100 | 0 | 0 | |||
| JOHN KEARNS DDS | ||||||||
| DIRECTOR | 2.20 | X | 500 | 600 | 12400 | 1.00 | ||
| MERRITT KRAUSE | ||||||||
| DIRECTOR | 2.20 | X | 14400 | 0 | 0 | |||
| JEFF PLAGGE | ||||||||
| DIRECTOR | 1.60 | X | 6350 | 0 | 5700 | |||
| RENIE NEUBERGER | ||||||||
| DIRECTOR | 2.20 | X | 12600 | 400 | 0 | 0.50 | ||
| TOM ALLER | ||||||||
| DIRECTOR | 2.50 | X | 19800 | 0 | 0 | |||
| WILLIAM WEVER DDS | ||||||||
| DIRECTOR | 1.60 | X | 13200 | 0 | 0 | |||
| DONN HUTCHINS | ||||||||
| PRESIDENT AND CEO | 40.00 | X | 620455 | 0 | 156659 | 1.00 | X | |
| CHERYL HARDING | ||||||||
| VICE PRESIDENT AND COO | 40.00 | 368092 | 0 | 84416 | 1.00 | X | ||
| GREGORY SHIREMAN | ||||||||
| VP SALES AND CUSTOMER RELATIONS | 40.00 | 313992 | 0 | 62206 | X | |||
| SHERRY PERKINS | ||||||||
| VICE PRESIDENT FINANCE & CONTROLLER | 40.00 | 159556 | 0 | 37841 | 1.00 | X | ||
| RICHARD RUSSELL | ||||||||
| HEALTH CARE REFORM IMPLEMENTATION LEADER | 40.00 | 240124 | 0 | 49277 | X | |||
| SUZANNE HECKENLAIBLE | ||||||||
| VICE PRESIDENT PUBLIC AFFAIRS | 20.00 | 140956 | 0 | 36175 | 20.00 | X | ||
| TAMI RUBINO | ||||||||
| VP MARKETING & BUSINESS DEVELOPMENT | 40.00 | 46624 | 0 | 11523 | X | |||
| ED SCHOOLEY DDS | ||||||||
| DENTAL DIRECTOR | 20.00 | 144327 | 0 | 11557 | 1.00 | X | ||
| SHERRY MALY | ||||||||
| DIRECTOR OF CLIENT SERVICES | 40.00 | 156767 | 0 | 11511 | X | |||
| BRENDA JENSEN | ||||||||
| ACCOUNT EXECUTIVE | 40.00 | 196365 | 0 | 23689 | X | |||
| RANAE CALVERT | ||||||||
| DIRECTOR, RISK MANAGEMENT | 40.00 | 137806 | 0 | 29757 | X | |||
| CAROL RAMSEY-SMITH | ||||||||
| DIRECTOR, COMPLIANCE AND QUALITY ASSURANCE | 40.00 | 124909 | 0 | 11641 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2753823 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1000 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 544352 | TotalOtherCompensation |
| Number Individuals GT100 K | 16 | 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 |
|---|---|---|---|---|---|
| UNIVERSITY OF IOWA | |||||
| 322 DENTAL SCIENCE BLDG S | IOWA CITY | IA | 52242 | DENTAL SERVICES | 3658879 |
| APPLEWHITE DENTAL IOWA PC | |||||
| 1340 DELHI ST | DUBUQUE | IA | 52001 | DENTAL SERVICES | 1670141 |
| CONSAMUS AND HAMPTON DENTAL CLINIC PLC | |||||
| 3324 ORION DR | AMES | IA | 50010 | DENTAL SERVICES | 1564397 |
| DENTAL ASSOCIATES PC | |||||
| 3700 WESTOWN PKWY | WEST DES MOINES | IA | 50266 | DENTAL SERVICES | 1426971 |
| IOWA ORAL & MAXILL SURGEONS PC | |||||
| 1469 29TH ST | WEST DES MOINES | IA | 50266 | DENTAL SERVICES | 1387845 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 502 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PREMIUMS EARNED | 524114 | 66542611 | 66542611 |
| ADMINISTRATIVE SERVICE REVENUE | 524292 | 10511082 | 10511082 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 77053693 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1449052 | TotalRevenueColumn |
| Exclusion | $1,449,052 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 7697298 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 7555513 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 141785 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 141785 | TotalRevenueColumn |
| Exclusion | $141,785 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MANAGEMENT FEES | Description |
| Business Code | 541610 | BusinessCode |
| Total Revenue Column | 101431 | TotalRevenueColumn |
| Unrelated Business Revenue | 101431 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 101431 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 78745961 | TotalRevenueColumn |
| Related Or Exempt Function Income | 77053693 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 101431 | UnrelatedBusinessRevenue |
| Exclusion | $1,590,837 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4223695 | Total |
| Program Services | 4223695 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50683913 | Total |
| Program Services | 50683913 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2753823 | Total |
| Program Services | 995880 | ProgramServices |
| Management And General | 1757943 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3503979 | Total |
| Program Services | 2585442 | ProgramServices |
| Management And General | 918537 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 622290 | Total |
| Program Services | 263058 | ProgramServices |
| Management And General | 359232 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 722558 | Total |
| Program Services | 639522 | ProgramServices |
| Management And General | 83036 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 388272 | Total |
| Program Services | 241296 | ProgramServices |
| Management And General | 146976 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 92703 | Total |
| Program Services | 8738 | ProgramServices |
| Management And General | 83965 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 171415 | Total |
| Program Services | 15 | ProgramServices |
| Management And General | 171400 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50004 | Total |
| Management And General | 50004 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 165255 | Total |
| Management And General | 165255 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1665576 | Total |
| Program Services | 802912 | ProgramServices |
| Management And General | 862664 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 582750 | Total |
| Program Services | 531609 | ProgramServices |
| Management And General | 51141 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1728524 | Total |
| Program Services | 1290392 | ProgramServices |
| Management And General | 438132 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1230612 | Total |
| Program Services | 1230612 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 310961 | Total |
| Management And General | 310961 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 169732 | Total |
| Program Services | 84236 | ProgramServices |
| Management And General | 85496 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 75909 | Total |
| Program Services | 28361 | ProgramServices |
| Management And General | 47548 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 336669 | Total |
| Program Services | 62780 | ProgramServices |
| Management And General | 273889 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 172934 | Total |
| Management And General | 172934 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BROKER COMMISSIONS | 3170055 | 3170055 | |
| PREMIUM TAXES | 549939 | 549939 | |
| RECRUITING | 296165 | 296165 | |
| DDPA DUES | 192178 | 192178 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 327758 | Total |
| Program Services | 40322 | ProgramServices |
| Management And General | 287436 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 74187669 | Total |
| Program Services | 67432777 | ProgramServices |
| Management And General | 6754892 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4861869 | BOY |
| EOY | 7196427 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 604056 | BOY |
| EOY | 646546 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1667768 | BOY |
| EOY | 1933447 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 10234908 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1882603 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8621731 | BOY |
| EOY | 8352305 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43505201 | BOY |
| EOY | 48933605 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 241927 | BOY |
| EOY | 233542 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 473609 | BOY |
| EOY | 483497 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 59976161 | BOY |
| EOY | 67779369 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7912287 | BOY |
| EOY | 9227761 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4316878 | BOY |
| EOY | 4309456 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12229165 | BOY |
| EOY | 13537217 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 475819 | BOY |
| EOY | 475819 | EOY |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47271177 | BOY |
| EOY | 53766333 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47746996 | BOY |
| EOY | 54242152 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 59976161 | BOY |
| EOY | 67779369 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 4558292 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 1936864 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| 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
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2665500 | OtherCostOrOtherBasis |
| Book Value | 2665500 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5099092 | OtherCostOrOtherBasis |
| Depreciation | 308070 | Depreciation |
| Book Value | 4791022 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2470316 | OtherCostOrOtherBasis |
| Depreciation | 1574533 | Depreciation |
| Book Value | 895783 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 8352305 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| UNEARNED PREMIUMS | $1,483,747 |
| CLAIMS UNPAID | $2,566,046 |
| OTHER POLICY RESERVES | $259,663 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 4309456 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 238709905 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 160230630 | OtherRevenues |
| Revenue Not Rptd F990 | 160230630 | RevenueNotRptdF990 |
| Revenue Subtotal | 78479275 | RevenueSubtotal |
| Investment Expenses Not Included | 165255 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 101431 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 266686 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 78745961 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 234151613 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 160230630 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 160230630 | ExpensesNotRptdF990 |
| Expenses Subtotal | 73920983 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 165255 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 101431 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 266686 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 74187669 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | DELTA DENTAL OF IOWA IS ORGANIZED AS A NONPROFIT DENTAL CARE PLAN FOR FEDERAL INCOME TAX PURPOSES UNDER SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE AND, AS SUCH, DOES NOT PAY FEDERAL INCOME TAXES. THE COMPANY IS EXEMPT FROM STATE INCOME TAXES. THE COMPANY EVALUATES TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING ITS TAX RETURNS TO DETERMINE WHETHER IT IS "MORE LIKELY THAN NOT" THAT EACH TAX POSITION WOULD BE SUSTAINED UPON EXAMINATION BY A TAXING AUTHORITY BASED ON THE TECHNICAL MERITS OF THE POSITION. DURING THE YEARS ENDED DECEMBER 31, 2012 AND 2011, THE COMPANY DID NOT RECORD ANY RESERVE FOR UNCERTAIN TAX POSITIONS IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. NO EXAMINATIONS ARE IN PROGRESS OR ANTICIPATED AT THIS TIME. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | ADMINISTRATIVE SERVICE CLAIMS (NETTED WITH REVENUE) 160,230,630. | |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | MANAGEMENT FEES (NETTED WITH EMPLOYEE BENEFITS) 101,431. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | ADMINISTRATIVE SERVICE CLAIMS (NETTED WITH REVENUE) 160,230,630. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | MANAGEMENT FEES - NETTED WITH EXPENSES FOR FINANCIALS 101,431. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| DELTA DENTAL OF IOWA FOUNDATION | |||||||
| 9000 NORTHPARK DRIVE | JOHNSTON | IA | 50131 | 260762771 | 501(C)(3) | 3693955 | CONTRIBUTION TO DELTA DENTAL OF IOWA FOUNDATION TO SUPPORT & IMPROVE THE ORAL HEALTH OF IOWANS. |
| COMMUNITY FOUNDATION OF GREATER DES MOINES | |||||||
| 1915 GRAND AVE | DES MOINES | IA | 50309 | 426139033 | 501(C)(3) | 150000 | CONTRIBUTION TO CFGDM FOR THE DDIA DONOR ADVISED FUND. THE DONOR ADVISED FUND IS USED FOR THE REPAYMENT OF DENTAL EDUCATION DEBT FOR A DENTIST WHO AGREES TO ESTABLISH AN OFFICE IN A RURAL, UNDERSERVED AREA. |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | PART I, QUESTION 1: IN 2012, DELTA DENTAL OF IOWA GRANTED $150,000 TO THE COMMUNITY FOUNDATION OF GREATER DES MOINES. DELTA DENTAL OF IOWA MAINTAINS A DONOR ADVISED FUND AT THE COMMUNITY FOUNDATION OF GREATER DES MOINES FOR THE PURPOSE OF AWARDING LOAN REPAYMENT AWARDS TO DENTISTS WHO AGREE TO PRACTICE IN AN UNDERSERVED AREA IN THE STATE OF IOWA AND TO DEDICATE A PORTION OF THEIR PRACTICE TO LOW INCOME PATIENTS. DELTA DENTAL OF IOWA ADVISES THE COMMUNITY FOUNDATION OF GREATER DES MOINES ON HOW TO AWARD THIS MONEY AND THE COMMUNITY FOUNDATION OF GREATER DES MOINES ONLY GRANTS THIS MONEY TO DENTISTS IN THE STATE OF IOWA. THE COMMUNITY FOUNDATION OF GREATER DES MOINES AND DELTA DENTAL OF IOWA MAINTAIN RECORDS TO SUBSTANTIATE THE AMOUNT OF GRANTS, THE GRANTEES' ELIGIBILITY AND THE SELECTION CRITERIA. DELTA DENTAL OF IOWA ALSO MAKES GRANTS TO THE DELTA DENTAL OF IOWA FOUNDATION. THE DELTA DENTAL OF IOWA FOUNDATION MAINTAINS RECORDS TO SUBSTANTIATE THE AMOUNT OF GRANTS, THE GRANTEES' ELIGIBILITY AND THE SELECTION CRITERIA. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| 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 | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 1 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DONN HUTCHINS | ||||||||||||||
| PRESIDENT AND CEO | 425186 | 0 | 179303 | 0 | 15966 | 0 | 144253 | 0 | 12406 | 0 | 777114 | 0 | 0 | 0 |
| CHERYL HARDING | ||||||||||||||
| VICE PRESIDENT AND COO | 272756 | 0 | 90607 | 0 | 4729 | 0 | 66323 | 0 | 18093 | 0 | 452508 | 0 | 0 | 0 |
| GREGORY SHIREMAN | ||||||||||||||
| VP SALES AND CUSTOMER RELATIONS | 232930 | 0 | 78421 | 0 | 2641 | 0 | 50322 | 0 | 11884 | 0 | 376198 | 0 | 0 | 0 |
| SHERRY PERKINS | ||||||||||||||
| VICE PRESIDENT FINANCE & CONTROLLER | 131726 | 0 | 26047 | 0 | 1783 | 0 | 19826 | 0 | 18015 | 0 | 197397 | 0 | 0 | 0 |
| RICHARD RUSSELL | ||||||||||||||
| HEALTH CARE REFORM IMPLEMENTATION LE | 172982 | 0 | 64829 | 0 | 2313 | 0 | 31232 | 0 | 18045 | 0 | 289401 | 0 | 0 | 0 |
| SUZANNE HECKENLAIBLE | ||||||||||||||
| VICE PRESIDENT PUBLIC AFFAIRS | 114888 | 0 | 24485 | 0 | 1583 | 0 | 18160 | 0 | 18015 | 0 | 177131 | 0 | 0 | 0 |
| ED SCHOOLEY DDS | ||||||||||||||
| DENTAL DIRECTOR | 111610 | 0 | 31027 | 0 | 1690 | 0 | 11557 | 0 | 0 | 0 | 155884 | 0 | 0 | 0 |
| SHERRY MALY | ||||||||||||||
| DIRECTOR OF CLIENT SERVICES | 104200 | 0 | 27373 | 0 | 25194 | 0 | 5295 | 0 | 6216 | 0 | 168278 | 0 | 0 | 0 |
| BRENDA JENSEN | ||||||||||||||
| ACCOUNT EXECUTIVE | 49170 | 0 | 145455 | 0 | 1740 | 0 | 15858 | 0 | 7831 | 0 | 220054 | 0 | 0 | 0 |
| RANAE CALVERT | ||||||||||||||
| DIRECTOR, RISK MANAGEMENT | 109973 | 0 | 26100 | 0 | 1733 | 0 | 11712 | 0 | 18045 | 0 | 167563 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | TAX GROSS UP PAYMENTS ARE RELATED TO TAXABLE FRINGE BENEFITS INCLUDED AS COMPENSATION FOR ALL COMPANY EMPLOYEES INCLUDING THE PERSONS LISTED IN PART VII, SECTION A, LINE 1. THE PAYMENTS REPRESENT 1% OR LESS OF COMPENSATION FOR THE INDIVIDUALS. |
| PART I, LINES 4A-B | THE DIRECTOR OF SALES AND ACCOUNT MANAGEMENT (SHERRY MALY) WAS TERMINATED FROM EMPLOYMENT BECAUSE THE POSITION WAS ELIMINATED. THE EMPLOYEE RECEIVED A SEVERANCE PAYMENT EQUAL TO TEN WEEKS OF COMPENSATION. OFFICERS OF THE COMPANY PARTICIPATE IN A SEC. 457(F) PLAN. THE COMPANY MAKES A CONTRIBUTION TO THE PLAN ANNUALLY ON BEHALF OF THE OFFICERS. THIS CONTRIBUTION IS A PERCENTAGE OF SALARY AND IS SET AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE OFFICERS CANNOT ACCESS THE FUNDS UNTIL RETIREMENT, LEAVING THE COMPANY, OR DEATH. OFFICERS WHO RECEIVED DEPOSITS IN 2012 AND AMOUNTS ARE: DONN HUTCHINS $124,253 CHERYL HARDING $ 46,323 GREG SHIREMAN $ 31,815 SHERRY PERKINS $ 6,850 SUZANNE HECKENLAIBLE $ 6,183 TAMI RUBINO $ 5,348 RICHARD RUSSELL $ 11,726 |
| PART I, LINE 5 | ONE EMPLOYEE OF THE COMPANY HAS COMPENSATION CONTINGENT ON REVENUES. THE INDIVIDUAL IS AN ACCOUNT EXECUTIVE OF THE COMPANY WHO RECEIVES COMMISSIONS BASED ON SALES OF GROUP BUSINESS. THIS ACCOUNT EXECUTIVE IS RESPONSIBLE FOR SELLING NEW BUSINESS. |
| PART I, LINE 6 | CONSISTENT WITH THE COMPANY'S TOTAL COMPENSATION POLICY, THE OFFICERS AND KEY EMPLOYEES, ALONG WITH ALL EMPLOYEES OF THE COMPANY, PARTICIPATE IN A COMPANY INCENTIVE COMPENSATION PLAN. THIS PLAN CONTAINS EIGHT METRICS WHICH REPRESENT KEY GOALS FOR THE PLAN YEAR. AN OVERALL WEIGHTED SCORE IS CALCULATED. A BONUS WILL BE PAID IF THE COMPANY MEETS A RANGE OF GOAL ACCOMPLISHMENTS FOR THE YEAR. THE AMOUNT OF THE BONUS IS BASED ON THE TOTAL SCORE. ONE OF THESE METRICS IS PROFITABILITY, WHICH IS DEFINED AS "TOTAL NET GAIN IN DOLLARS PRIOR TO ORAL HEALTH CONTRIBUTIONS FOR THE FISCAL YEAR PER AUDITED FINANCIAL RESULTS." |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| JOHN KEARNS DDS | |||
| DIRECTOR | 248954 | INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES | 0 |
| ANNE HENNESSEY DDS | |||
| DIRECTOR | 139242 | INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES | 0 |
| WILLIAM WEVER DDS | |||
| DIRECTOR | 111162 | INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES | 0 |
| MERRITT KRAUSE | |||
| DDIA DIRECTOR & OFFICER OF EMPLOYER WHO PURCHASES DENTAL BENEFITS FROM DDIA | 335149 | PAYMENTS TO DDIA FOR ADMINISTRATIVE SERVICES | 0 |
| CHARLES EDWARD BROWN | |||
| DDIA DIRECTOR & OFFICER OF EMPLOYER WHO PURCHASES DENTAL BENEFITS FROM DDIA | 223005 | PAYMENTS TO DDIA FOR ADMINISTRATIVE SERVICES | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | TWO DIRECTORS HAVE A BUSINESS RELATIONSHIP. JEFF PLAGGE IS PRESIDENT OF A COMPANY THAT PURCHASES BENEFITS FROM A BROKER COMPANY IN WHICH MERRITT KRAUSE SERVES AS PRESIDENT. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBERS OF THE CORPORATION CONSIST OF THE PROVIDERS (PARTICIPATING DENTISTS), AND SUBSCRIBERS. | |
| FORM 990, PART VI, SECTION A, LINE 7A | DECISIONS OF THE GOVERNING BODY ARE NOT SUBJECT TO APPROVAL BY THE MEMBERSHIP WITH THE EXCEPTION OF CHANGES TO THE ARTICLES OF INCORPORATION. THOSE CHANGES MUST BE APPROVED BY THE MEMBERSHIP. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 AND ALL RELATED SCHEDULES WERE REVIEWED BY BOTH THE MANAGEMENT OF THE COMPANY AND THE BOARD OF DIRECTORS PRIOR TO FILING. THE FORM 990 WAS REVIEWED BY MANAGEMENT OF THE COMPANY PRIOR TO PRESENTATION TO THE BOARD. THE MEMBERS OF THE MANAGEMENT TEAM WHO REVIEWED THE FORM 990 WERE THE CEO, COO, COMPLIANCE DIRECTOR, AND VICE PRESIDENT FINANCE. AN ELECTRONIC COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS IN OCTOBER OF 2013. ALL MEMBERS OF THE BOARD REVIEWED THE FORM 990 AND RELATED SCHEDULES PRIOR TO FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE COMPLIANCE DIRECTOR, ON BEHALF OF THE GOVERNANCE COMMITTEE, CONDUCTS AN ANNUAL CONFLICT OF INTEREST REVIEW FOR COMPLIANCE WITH FEDERAL AND STATE LAW. THE REVIEW INCLUDES ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES. COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES AND DISCLOSURES ARE COMPARED TO THE GROUP FOR POTENTIALLY CONFLICTING TRANSACTIONS, BUSINESS AND FAMILY RELATIONSHIPS, AND AFFILIATIONS. ANNUAL COMPENSATION, REIMBURSEMENTS, BENEFIT PAYMENTS, AND OTHER TRANSACTIONS ARE REVIEWED FOR APPROPRIATENESS. A WRITTEN REPORT OF THE FINDINGS IS PRESENTED TO THE GOVERNANACE COMMITTEE, BOARD OF DIRECTORS AND SENIOR MANAGEMENT. SOLUTIONS TO POTENTIAL CONFLICTS ARE DISCUSSED AND DOCUMENTED IN THE BOARD OF DIRECTOR'S MEETING MINUTES. | |
| FORM 990, PART VI, SECTION B, LINE 15 | ON A BI-ANNUAL BASIS, DELTA DENTAL OF IOWA DOES A MARKET PRICE AND BENCHMARKING COMPARISON OF THE COMPENSATION OF THE LEADERSHIP TEAM AND THE STAFF. THIS ANALYSIS IS PERFORMED BY AN INDEPENDENT THIRD PARTY. THIS ANALYSIS INCLUDES THE USE OF DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THE DOCUMENTED RESULTS AND RECOMMENDATIONS OF THIS ANALYSIS ARE PRESENTED TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS REVIEWS THE DOCUMENTATION AND APPROVES THE COMPENSATION. THESE DECISIONS ARE DOCUMENTED IN THE MINUTES OF THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | DELTA DENTAL OF IOWA'S GOVERNING DOCUMENTS BECOME A MATTER OF PUBLIC RECORD WHEN THEY ARE FILED WITH THE IOWA SECRETARY OF STATE. THE FINANCIAL STATEMENTS BECOME A MATTER OF PUBLIC RECORD WHEN THEY ARE FILED WITH THE IOWA INSURANCE DIVISION. BOTH AGENCIES HAVE ONLINE PUBLIC VIEWING ACCESS. THE CONFLICT OF INTEREST POLICY IS NOT FILED WITH THE STATE AGENCIES; HOWEVER, IT WOULD BE MADE AVAILABLE UPON REQUEST. | |
| FORM 990, PART XI, LINE 2C: | THE ORGANIZATION HAS A FINANCE AND AUDIT COMMITTEE THAT HAS RESPONSIBILITY FOR SELECTION OF THE INDEPENDENT ACCOUNTANT AND OVERSIGHT OF THE AUDIT. THE BOARD OF DIRECTORS APPROVES THE ANNUAL APPOINTMENT OF THE INDEPENDENT ACCOUNTANT. | |
| SCHEDULE R, PART II, COLUMN B: | DELTA DENTAL OF IOWA'S VISION IS TO IMPROVE THE ORAL HEALTH OF THOSE WE SERVE. AN AMOUNT IS SET ASIDE EACH YEAR TO FUND THIS MISSION. THE AMOUNT IS DETERMINED BY THE PERFORMANCE AND FINANCIAL STRENGTH OF THE COMPANY. AFTER THE AUDITED FINANCIALS ARE COMPLETE, AN AMOUNT IS PAID TO THE DELTA DENTAL OF IOWA FOUNDATION. THE DELTA DENTAL OF IOWA FOUNDATION IS A SEC. 501(C)(3) ORGANIZATION AND IS A TYPE 1 SUPPORTING ORGANIZATION UNDER SEC. 509(A)(3). IT IS THE RESPONSIBILITY OF THE FOUNDATION TO DISTRIBUTE THE MONIES CONSISTENT WITH IT'S MISSION AND FOUNDING DOCUMENTS. THE MISSION OF THE DELTA DENTAL OF IOWA FOUNDATION IS TO SUPPORT AND IMPROVE THE ORAL HEALTH OF IOWANS. THE FOUNDATION WILL PROVIDE FUNDS TO OTHER SEC. 501(C)(3) ORGANIZATIONS, GOVERNMENTS, OR ACADEMIC INSTITUTIONS THAT ARE UNDERTAKING PROJECTS THAT SUPPORT AND IMPROVE THE ORAL HEALTH OF IOWANS. THE FOUNDATION WILL PROVIDE FUNDS TO OTHER TAX-EXEMPT ORGANIZATIONS THROUGH THEIR GRANTS PROGRAM THAT ALIGN WITH THE PROJECTS OF ACCESS TO CARE, RESEARCH, EDUCATION AND PREVENTION. THE AMOUNT CONTRIBUTED TO THE FOUNDATION IN 2012 WAS $3,843,955. ADDITIONALLY, DELTA DENTAL OF IOWA PROVIDES MANAGEMENT SERVICES FOR THE FOUNDATION. THIS INCLUDES DUTIES PERFORMED BY THE CHIEF EXECUTIVE OFFICER AND THE VICE PRESIDENT OF FINANCE. THE EXECUTIVE DIRECTOR OF THE FOUNDATION IS THE VICE PRESIDENT OF PUBLIC AFFAIRS FOR DELTA DENTAL OF IOWA. ALSO, DELTA DENTAL OF IOWA PROVIDES SOME ACOUNTING FUNCTIONS. THE FOUNDATION REIMBURSES DELTA DENTAL OF IOWA FOR ALL STAFF CHARGES RELATED TO THE FOUNDATION. THE AMOUNT REIMBURSED TO DELTA DENTAL OF IOWA IN 2012 WAS $226,086 FOR MANAGEMENT FEES AND $29,233 FOR OTHER EXPENSES. | PRIMARY ACTIVITY OF DELTA DENTAL PLAN OF IOWA FOUNDATION: |
| SCHEDULE R, PART IV, COLUMN B: | VERATRUS BENEFIT SOLUTIONS, INC. (VERATRUS) IS A FOR-PROFIT CORPORATION AND A WHOLLY-OWNED SUBSIDIARY OF DELTA DENTAL OF IOWA. VERATRUS WAS ORGANIZED TO DISTRIBUTE THE DELTA VISION PRODUCT. DELTA DENTAL OF IOWA INVESTED $60,000 IN PAID-IN CAPITAL IN VERATRUS DURING 2012. DELTA DENTAL OF IOWA COLLECTS PREMIUMS FROM GROUPS FOR VISION COVERAGE AND TRANSFERS THIS PREMIUM TO VERATRUS. IN 2012, DELTA DENTAL OF IOWA TRANSFERRED $872,981 TO VERATRUS FOR PREMIUMS COLLECTED ON THEIR BEHALF. IN ADDITION, DELTA DENTAL OF IOWA PROVIDES MANAGEMENT SERVICES TO VERATRUS. VERATRUS REIMBURSES DELTA DENTAL OF IOWA FOR ALL STAFF CHARGES RELATED TO VERATRUS. THE AMOUNT REIMBURSED TO DELTA DENTAL OF IOWA IN 2012 WAS $101,431 FOR MANAGEMENT FEES AND $86,256 FOR OTHER EXPENSES. DELTA DENTAL OF IOWA ALSO PURCHASES VISION BENEFITS FROM VERATRUS FOR DDIA EMPLOYEES. THE AMOUNT PAID TO VERATRUS IN 2012 FOR VISION BENEFITS FOR DDIA EMPLOYEES WAS $11,003. | PRIMARY ACTIVITY OF VERATRUS BENEFIT SOLUTIONS, INC.: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF IOWA FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9000 NORTHPARK DRIVE | AddressLine1 |
| City | JOHNSTON | City |
| State | IA | State |
| ZIP Code | 50131 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 260762771 | EIN |
| Primary Activities | CHARITABLE ORGANIZATION TO SUPPORT AND IMPROVE THE ORAL HEALTH OF IOWANS. | PrimaryActivities |
| Legal Domicile State | IA | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 11A, I | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF IOWA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 1 | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VERATRUS BENEFIT SOLUTIONS INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9000 NORTHPARK DRIVE | AddressLine1 |
| City | JOHNSTON | City |
| State | IA | State |
| ZIP Code | 50131 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 271584394 | EIN |
| Primary Activity | FOR-PROFIT CORPORATION ORGANIZED TO DISTRIBUTE THE DELTA VISION PRODUCT. | PrimaryActivity |
| Legal Domicile State | IA | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DENTAL DENTAL OF IOWA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | -68384 | ShareOfTotalIncome |
| Share Of EOY Assets | 404128 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Controlled Org | 1 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | 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 | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | 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 | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (8 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| DELTA DENTAL OF IOWA FOUNDATION | ||
| B | 3693955 | SEE PART VII - SUPPLEMENTAL INFO. |
| DELTA DENTAL OF IOWA FOUNDATION | ||
| O | 226086 | SEE PART VII - SUPPLEMENTAL INFO. |
| DELTA DENTAL OF IOWA FOUNDATION | ||
| Q | 29233 | SEE PART VII - SUPPLEMENTAL INFO. |
| VERATRUS BENEFIT SOLUTIONS INC | ||
| B | 60000 | SEE PART VII - SUPPLEMENTAL INFO. |
| VERATRUS BENEFIT SOLUTIONS INC | ||
| O | 101431 | SEE PART VII - SUPPLEMENTAL INFO. |
| VERATRUS BENEFIT SOLUTIONS INC | ||
| R | 872961 | SEE PART VII - SUPPLEMENTAL INFO. |
| VERATRUS BENEFIT SOLUTIONS INC | ||
| Q | 86256 | SEE PART VII - SUPPLEMENTAL INFO. |
| VERATRUS BENEFIT SOLUTIONS INC | ||
| M | 11003 | SEE PART VII - SUPPLEMENTAL INFO. |
Form990 Schedule R Part VII Form990ScheduleRPartVII (9 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| METHOD OF DETERMINING AMOUNT INVOLVED - | FORM 990, SCHEDULE R, PART V, LINE 2(8), COLUMN D: | ACTUAL COST OF INVOICES PAID BY DDIA ON BEHALF OF VERATRUS BENEFIT SOLUTIONS, INC. |
| METHOD OF DETERMINING AMOUNT INVOLVED - | FORM 990, SCHEDULE R, PART V, LINE 2(9), COLUMN D: | VISION PREMIUMS PAID TO VERATRUS BENEFIT SOLUTIONS, INC. FOR DDIA EMPLOYEES. |
| METHOD OF DETERMINING AMOUNT INVOLVED - | FORM 990, SCHEDULE R, PART V, LINE 2(1), COLUMN D: | PERCENTAGE OF REVENUE BASED ON BOARD APPROVED POLICY |
| METHOD OF DETERMINING AMOUNT INVOLVED - | FORM 990, SCHEDULE R, PART V, LINE 2(2), COLUMN D: | FEES CHARGED TO DELTA DENTAL OF IOWA FOUNDATION BASED ON HOURS WORKED |
| METHOD OF DETERMINING AMOUNT INVOLVED - | FORM 990, SCHEDULE R, PART V, LINE 2(3), COLUMN D: | ACTUAL COST OF INVOICES PAID BY DDIA ON BEHALF OF DELTA DENTAL OF IOWA FOUNDATION |
| METHOD OF DETERMINING AMOUNT INVOLVED - | FORM 990, SCHEDULE R, PART V, LINE 2(4), COLUMN D: | CASH TRANSFERRED FROM DDIA TO DELTA DENTAL OF IOWA FOUNDATION |
| METHOD OF DETERMINING AMOUNT INVOLVED - | FORM 990, SCHEDULE R, PART V, LINE 2(5), COLUMN D: | CAPITAL CONTRIBUTION TO SUBSIDIARY (VERATRUS BENEFIT SOLUTIONS, INC.) |
| METHOD OF DETERMINING AMOUNT INVOLVED - | FORM 990, SCHEDULE R, PART V, LINE 2(6), COLUMN D: | MANAGEMENT FEES CHARGED TO VERATRUS BENEFIT SOLUTIONS, INC. BASED ON HOURS WORKED |
| METHOD OF DETERMINING AMOUNT INVOLVED - | FORM 990, SCHEDULE R, PART V, LINE 2(7), COLUMN D: | VISION PREMIUMS BILLED AND COLLECTED BY DDIA ON BEHALF OF VERATRUS BENEFIT SOLUTIONS, INC. CASH WAS TRANSFERRED FROM DDIA TO VERATRUS FOR THESE PREMIUMS. |
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