DELTA DENTAL PLAN OF NEW JERSEY: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL PLAN OF NEW JERSEY (EIN 22-1896118)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201323199349307102
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

FieldValueIRS element (for citing)
Timestamp2013-11-15T13:48:51-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WithumSmithBrown PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1465 South St Ste 200AddressLine1
CityMorristownCity
StateNJState
ZIP Code079606497ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN221896118EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF NEW JERSEY INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% JAMES SULESKIInCareOfName
Name ControlDELTNameControl
Phone9732854029Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11639 ROUTE 10 PO BOX 222AddressLine1
Address Line2SuiteAddressLine2
CityPARSIPPANYCity
StateNJState
ZIP Code070540222ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJAMES SULESKIName
TitleCFOTitle
Phone9738989494Phone
Date Signed2013-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameAnthony J PanicoName
Phone9738989494Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonWALTER VANBRUNTNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11639 ROUTE 10AddressLine1
CityPARSIPPANYCity
StateNJState
ZIP Code070540222ZIPCode
FieldValueIRS element (for citing)
Gross Receipts694699433GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitedeltadentalnj.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1969YearFormation
State Legal DomicileNJStateLegalDomicile
Activity Or Mission DescriptionTO PROMOTE ORAL HEALTH TO THE GREATEST NUMBER OF PEOPLE BY PROVIDING ACCESSIBLE DENTAL BENEFIT PROGRAMS OF THE HIGHEST QUALITY, SERVICE AND VALUE.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees339TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year568365246ProgramServiceRevenuePriorYear
Program Service Revenue CY586736484ProgramServiceRevenueCY
Investment Income Prior Year10307155InvestmentIncomePriorYear
Investment Income Current Year9541554InvestmentIncomeCurrentYear
Other Revenue Prior Year1551813OtherRevenuePriorYear
Other Revenue Current Year1623175OtherRevenueCurrentYear
Total Revenue Prior Year580224214TotalRevenuePriorYear
Total Revenue Current Year597901213TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year900000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1900000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year513306702BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY529982972BenefitsPaidToMembersCY
Salaries Etc Prior Year29637280SalariesEtcPriorYear
Salaries Etc Current Year31492351SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year27082387OtherExpensePriorYear
Other Expenses Current Year26681511OtherExpensesCurrentYear
Total Expenses Prior Year570926369TotalExpensesPriorYear
Total Expenses Current Year590056834TotalExpensesCurrentYear
Revenues Less Expenses Prior Year9297845RevenuesLessExpensesPriorYear
Revenues Less Expenses CY7844379RevenuesLessExpensesCY
Total Assets BOY292503594TotalAssetsBOY
Total Assets EOY296891583TotalAssetsEOY
Total Liabilities BOY82742516TotalLiabilitiesBOY
Total Liabilities EOY72710526TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY209761078NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY224181057NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PROMOTE ORAL HEALTH TO THE GREATEST NUMBER OF PEOPLE BY PROVIDING ACCESSIBLE DENTAL BENEFIT PROGRAMS OF THE HIGHEST QUALITY, SERVICE AND VALUE. THE ORGANIZATION ALSO OFFERS AFFORDABLE DENTAL COVERAGE FOR THOSE INDIVIDUALS IN NEW JERSEY WITHOUT ACCESS TO A GROUP DENTAL PLAN. THE ORGANIZATION'S PLANS PROVIDE ACCESS TO A BROAD ARRAY OF DENTAL SERVICES THROUGH ITS VAST NETWORK OF PARTICIPATING DENTISTS. THE ORGANIZATION'S PLANS OFFER QUALITY COVERAGE OPTIONS AT COMPETITIVE RATES. FOR MORE THAN 40 YEARS, DELTA DENTAL OF NEW JERSEY HAS REACHED OUT TO SERVE THE PEOPLE OF NEW JERSEY AND MORE RECENTLY IN CONNECTICUT. IT IS OUR MISSION TO PROMOTE ORAL HEALTH TO THE GREATEST NUMBER OF PEOPLE BY PROVIDING ACCESSIBLE DENTAL BENEFIT PROGRAMS OF THE HIGHEST QUALITY, SERVICE, AND VALUE. IN 1986, WE FORMED THE DELTA DENTAL OF NEW JERSEY FOUNDATION, INC. TO AID IN CREATING ACCESS TO CARE FOR THE UNDER-INSURED AND UN-INSURED, AND SUPPORT DENTAL EDUCATION PROGRAMS FOR CHILDREN, AS WELL AS DENTAL ASSISTMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense582151512Expense
Grants1900000Grants
Revenue586736484Revenue
DescriptionEXPENSES INCURRED IN PROMOTING ORAL HEALTH TO THE GREATEST NUMBER OF PEOPLE BY PROVIDING ACCESSIBLE DENTAL BENEFIT PROGRAMS OF THE HIGHEST QUALITY, SERVICE AND VALUE; PRIMARILY THROUGH CONTRACTS WITH INDEPENDENT DENTISTS TO MEMBER SUBSCRIBERS.Description
Total Program Service Expense582151512TotalProgramServiceExpense
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109651014NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees339NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccounttrueForeignFinancialAccount
Name Of Foreign CountryBDNameOfForeignCountry
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJAMES SULESKINamePerson
Telephone Number9732854029TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11639 ROUTE 10AddressLine1
CityPARSIPPANYCity
StateNJState
ZIP Code070540222ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (33 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
RONALD DEBLINGER DMD
CHAIRMAN - TRUSTEE20.01.0XX13151401588
GERALD A SYDELL DDS
VICE CHAIRMAN - TRUSTEE7.01.0XX8336601588
ROBERT H BARNEY ESQ
TRUSTEE (1/1-10/31)1.4X3852001324
CARL CHAITYN DDS
TRUSTEE2.21.0X3924501588
WILLIAM F FAHERTY JR
TRUSTEE (1/1-8/31)1.3X2439001059
WILLIAM FAULKNER
TRUSTEE3.5X434172000940
JEROME FELDMAN DDS
TRUSTEE2.2X3939401156
JOHN P HALL JR
TRUSTEE4.1X4242001588
HENRY F HENDERSON JR
TRUSTEE3.51.0X4460501588
W THOMAS MARGETTS ESQ
TRUSTEE3.21.0X4318401588
GEORGE C MCLAUGHLIN DMD
TRUSTEE2.71.0X470780940
GENE NAPOLIELLO DDS
TRUSTEE2.26.0X4094801588
MORTON REINHART
TRUSTEE3.5X4427020001588
DEBRA G SALMAN DDS
TRUSTEE2.3X3860802702
HOWARD A SCHWARTZ DDS
TRUSTEE2.5X381580940
WALTER VANBRUNT
PRESIDENT/CEO50.00.7X1238410089365
JAMES SULESKI
SENIOR VP/CFO50.00.4X395754090554
DOUGLAS G SANBORN ESQ
SR VP/GENERAL COUNSEL50.00.4X631610090065
BRUCE SILVERMAN
SENIOR VP/COO50.0X520224091514
STEVEN FLEISCHER
VICE PRESIDENT50.0X314690091514
DONALD SCOTT NAVARRO DDS
VICE PRESIDENT50.00.6X281750088585
KATHLEEN FENNELL-BORGES
VICE PRESIDENT50.0X227497085780
THOMAS C KAHLER
VICE PRESIDENT50.0X227445086674
STEPHEN STOLL
VICE PRESIDENT50.0X223245086733
VINCENT FARINELLA
VICE PRESIDENT50.0X178023051966
DIANE BELLE
VICE PRESIDENT44.06.0X175809052061
ROBERT ZARCONE
VICE PRESIDENT50.0X157935070261
LORI ACKER
VICE PRESIDENT50.0X152494046482
JOHN GUMKOWSKI
DIRECTOR - MARKETING50.0275954090318X
KIM WHITE WAPELHORST
ACCOUNT EXECUTIVE50.0235748088987X
DAVID ATHA
DIRECTOR50.0213525080470X
ALLAN BERKIN
ACCOUNT EXECUTIVE50.0200877080754X
DOREEN PILIGIAN
DIRECTOR/ASST GENERAL COUNSEL50.0162657047028X
FieldValueIRS element (for citing)
Total Reportable Comp From Org6552764TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs4000TotalReportableCompFrmRltdOrgs
Total Other Compensation1430876TotalOtherCompensation
Number Individuals GT100 K44NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensationAddress Line1AddressOfContractor/AddressForeign/AddressLine1CityAddressOfContractor/AddressForeign/CityProvince Or StateAddressOfContractor/AddressForeign/ProvinceOrStateCountryAddressOfContractor/AddressForeign/Country
DENTAL ASSOCIATES OF CONNECTICUT
36 PADANARAM ROADDANBURYCT06811DENTAL PROVIDER1892834
ACCENTURE LLP
1345 AVENUE OF THE AMERICASNEW YORKNY10105CONSULTING1790214
DECARE SYSTEMS IRELAND LTD
SYSTEMS DEVELOPER1644126CURRANHEEN ROADCORK0EI
BROWN BROWN BENEFIT ADVISORS
5 REGENT STREETLIVINGSTONNJ07039BROKERAGE1456783
HAMILTON DENTAL ASSOCIATES
2501 KUSER ROADTRENTONNJ08691DENTAL PROVIDER1339968
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1012NumberOfContractorsGT100K
Info In Schedule O Part VIIIXInfoInScheduleOPartVIII
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionDENTAL BENEFITS COVERAGE REVENUEDescription
Business Code524114BusinessCode
Total Revenue Column586736484TotalRevenueColumn
Related Or Exempt Function Income586736484RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue586736484TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5665172TotalRevenueColumn
Exclusion$5,665,172ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1498720Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real2184454Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-685734Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-685734TotalRevenueColumn
Exclusion-$685,734ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities98490148Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities94613766Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities3876382Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column3876382TotalRevenueColumn
Exclusion$3,876,382ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
REINSURANCE REIMBURSEMENT9000992290094$2,290,094
LEGAL SETTLEMENTS90009918815$18,815
FieldValueIRS element (for citing)
Total Other Revenue2308909TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column597901213TotalRevenueColumn
Related Or Exempt Function Income586736484RelatedOrExemptFunctionIncome
Exclusion$11,164,729ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1900000Total
Program Services1900000ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total529982972Total
Program Services529982972ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total6507323Total
Program Services5205858ProgramServices
Management And General1301465ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total14372044Total
Program Services11497635ProgramServices
Management And General2874409ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4634703Total
Program Services4171233ProgramServices
Management And General463470ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4209057Total
Program Services3788151ProgramServices
Management And General420906ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1769224Total
Program Services1592302ProgramServices
Management And General176922ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total89253Total
Program Services80328ProgramServices
Management And General8925ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total198560Total
Program Services178704ProgramServices
Management And General19856ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total88882Total
Program Services79994ProgramServices
Management And General8888ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4176415Total
Program Services3758773ProgramServices
Management And General417642ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total646157Total
Program Services581541ProgramServices
Management And General64616ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total5203373Total
Program Services4683036ProgramServices
Management And General520337ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total708035Total
Program Services637232ProgramServices
Management And General70803ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1308768Total
Program Services1177891ProgramServices
Management And General130877ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total338057Total
Program Services304252ProgramServices
Management And General33805ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2330177Total
Program Services2097159ProgramServices
Management And General233018ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total624896Total
Program Services562406ProgramServices
Management And General62490ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
BROKERAGE COMMISSIONS905183081466479051830
MEMBERSHIPS667074600367667070
BANK SERVICE FEES464605418145464600
REGULATORY FEES404980364482404980

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total380449Total
Program Services342404ProgramServices
Management And General38045ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total590056834Total
Program Services582151512ProgramServices
Management And General7905322ManagementAndGeneral
Fundraising0Fundraising
FieldValueIRS element (for citing)
Info In Schedule O Part XXInfoInScheduleOPartX

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY10269230BOY
EOY9718445EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY40986562BOY
EOY40996489EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1646014BOY
EOY2123715EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis37757489LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec12910725LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY26022311BOY
EOY24846764EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY181234843BOY
EOY184635667EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY18134026BOY
EOY22303666EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY9749161BOY
EOY8747973EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY196774BOY
EOY176512EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4264673BOY
EOY3342352EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY292503594BOY
EOY296891583EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY10217391BOY
EOY9577676EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY72525125BOY
EOY63132850EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY82742516BOY
EOY72710526EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY25000BOY
EOY25000EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY218568952BOY
EOY226413332EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY-8832874BOY
EOY-2257275EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY209761078BOY
EOY224181057EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY292503594BOY
EOY296891583EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses7844379ReconcilationRevenueExpenses
Reconciliation Unrealized Invest1620583ReconciliationUnrealizedInvest
Reconcilation Other Changes4955017ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis10060407OtherCostOrOtherBasis
Book Value10060407BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7597676OtherCostOrOtherBasis
Depreciation452488Depreciation
Book Value7145188BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1310329OtherCostOrOtherBasis
Depreciation752726Depreciation
Book Value557603BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis18326361OtherCostOrOtherBasis
Depreciation11303886Depreciation
Book Value7022475BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis462716OtherCostOrOtherBasis
Depreciation401625Depreciation
Book Value61091BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings24846764TotalOfBookValueLandBuildings
Financial DerivativesFinancialDerivatives
Closely Held Equity InterestsCloselyHeldEquityInterests

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionEQUITY SECURITIESDescription
Book Value22303666BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities22303666TotalOfBookValueSecurities
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
UNPAID CLAIMS$36,550,000
UNPAID CLAIMS ADJUSTMENT EXPENSES$2,349,000
DEPOSITS AND ADVANCES$5,098,220
ACCRUED PENSION COSTS$18,275,281
OTHER LIABILITIES$300,125
DUE TO AFFILIATES$445,935
SECURITY DEPOSITS$114,289
FieldValueIRS element (for citing)
Total Of Amounts63132850TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt606199463TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1620583NetUnrealizedGainsInvestments
Other Revenues8967761OtherRevenues
Revenue Not Rptd F99010588344RevenueNotRptdF990
Revenue Subtotal595611119RevenueSubtotal
Other Revenues Not Included2290094OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt2290094RevenueNotRptdOnFinStmt
Total Revenue Per Form990597901213TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt590636928TotExpensesEtcAuditedFinclStmt
Other Expenses Included4012744OtherExpensesIncluded
Expenses Not Rptd F9904012744ExpensesNotRptdF990
Expenses Subtotal586624184ExpensesSubtotal
Other Expenses Not Included3432650OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt3432650ExpensesNotRptdOnFinStmt
Total Expenses Per Form990590056834TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
TEXT OF ASC 740 AUDITED FINANCIAL STATEMENT FOOTNOTESCHEDULE D, PART XAN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE TAXPAYER AND ITS AFFILIATES FOR THE YEARS ENDED DECEMBER 31, 2012 AND DECEMBER 31, 2011; RESPECTIVELY, AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES BY ENTITY. THE FIN 48 (ASC 740) FOOTNOTE BELOW IS FROM THE ORGANIZATION'S 2012 CONSOLIDATED AUDITED FINANCIAL STATEMENTS: THE PLAN FOLLOWS THE RECOGNITION AND DISCLOSURE PROVISIONS OF THE ACCOUNTING STANDARD RELATED TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. UNDER THIS STANDARD, TAX POSITIONS ARE EVALUATED FOR RECOGNITION USING A MORE-LIKELY-THAN-NOT THRESHOLD, AND THOSE TAX POSITIONS REQUIRING RECOGNITION ARE MEASURED AT THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED UPON ULTIMATE SETTLEMENT WITH A TAXING AUTHORITY THAT HAS FULL KNOWLEDGE OF ALL RELEVANT INFORMATION. THE PLAN HAS EVALUATED THE LIKELIHOOD OF THEIR TAX POSITIONS BEING CHALLENGED AS REMOTE AND, ACCORDINGLY HAS NOT INCLUDED ANY INCOME TAX PROVISIONS, INCLUDING INTEREST AND PENALTIES, IN THE FINANCIAL STATEMENTS RELATED TO POTENTIAL VIOLATIONS. THE PLAN HAS NO OPEN YEARS PRIOR TO 2009.
RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURNSCHEDULE D, PART XI, LINE 2DOTHER AMOUNTS INCLUDED ON AUDITED FINANCIAL STATEMENTS BUT NOT ON FORM 990: -INTERCOMPANY RENT PAID TO DISREGARDED ENTITY - $1,828,290; -EXPENSES OF DISREGARDED ENTITY - $2,184,454; -NET CHANGE RELATED TO ACCRUED PENSION - $4,955,017.
RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURNSCHEDULE D, PART XII, LINE 4BOTHER AMOUNTS INCLUDED ON FORM 990 BUT NOT ON AUDITED FINANCIAL STATEMENTS: -REINSURANCE REIMBURSEMENT - $2,290,094;
RECONCILIATION OF EXPENSE PER AUDITED FINANCIAL STATEMENTS WITH RETURNSCHEDULE D, PART XII, LINE 2DOTHER AMOUNTS INCLUDED ON AUDITED FINANCIAL STATEMENTS BUT NOT ON FORM 990: -INTERCOMPANY RENT PAID TO DISREGARDED ENTITY - $1,828,290; -EXPENSES OF DISREGARDED ENTITY - $2,184,454.
RECONCILIATION OF EXPENSE PER AUDITED FINANCIAL STATEMENTS WITH RETURNSCHEDULE D, PART XII, LINE 4BOTHER AMOUNTS INCLUDED ON AUDITED FINANCIAL STATEMENTS BUT NOT ON FORM 990: -REINSURANCE REIMBURSEMENT - $2,290,094; -NET INCOME OF DISREGARDED ENTITY - $1,142,556.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF NEW JERSEY FOUNDATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11639 ROUTE 10AddressLine1
CityPARSIPPANYCity
StateNJState
ZIP Code07054ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient222764745EINOfRecipient
IRC Section501(c)(3)IRCSection
Amount Of Cash Grant1900000AmountOfCashGrant
Purpose Of GrantPROGRAM SUPPORTPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierGRANT FUND MONITORINGIdentifier
Return ReferenceSCHEDULE I, PART I, QUESTION 2ReturnReference
ExplanationDELTA DENTAL OF NEW JERSEY FOUNDATION, INC. ("FOUNDATION"); A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, IS FUNDED SOLELY BY DELTA DENTAL OF NEW JERSEY, INC. THE MONIES DISBURSED BY THE FOUNDATION ARE BASED ON GRANT REQUESTS WHICH ARE REVIEWED AND APPROVED BY THE FOUNDATION BOARD OF TRUSTEES BASED ON NEED. IN THE CASE OF LARGE GRANT REQUESTS THAT MAY SPAN MULTIPLE YEARS, THE DISBURSEMENT MAY BE MADE FROM THE ORGANIZATION AND NOT ITS RELATED FOUNDATION. THE ORGANIZATION'S BOARD OF TRUSTEES' APPROVAL IS REQUIRED FOR THIS TYPE OF COMMITMENT. PROGRESS ON GRANTS OF THIS NATURE IS MONITORED BY THE ORGANIZATION WITH UPDATES PROVIDED TO THE BOARD OF TRUSTEES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelXFirstClassOrCharterTravel
Travel For CompanionsXTravelForCompanions
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Club Dues Or FeesXClubDuesOrFees
Personal ServicesXPersonalServices
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (18 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
WALTER VANBRUNT
PRESIDENT/CEO5084340256763047321305275003661501327775000
JAMES SULESKI
SENIOR VP/CFO2370470875560711510527500378040486308000
DOUGLAS G SANBORN ESQ
SR VP/GENERAL COUNSEL313217012988001885130527500373150721675000
BRUCE SILVERMAN
SENIOR VP/COO294571010221401234390527500387640611738000
STEVEN FLEISCHER
VICE PRESIDENT235819070363085080527500387640406204000
DONALD SCOTT NAVARRO DDS
VICE PRESIDENT1991540639240186720527500358350370335000
KATHLEEN FENNELL-BORGES
VICE PRESIDENT1643830519950111190486010371790313277000
THOMAS C KAHLER
VICE PRESIDENT1576460520100177890486100380640314119000
STEPHEN STOLL
VICE PRESIDENT166009051905053310479690387640309978000
VINCENT FARINELLA
VICE PRESIDENT134068040624033310379640140020229989000
DIANE BELLE
VICE PRESIDENT134615040084011100374590146020227870000
ROBERT ZARCONE
VICE PRESIDENT139223016881018310334960367650228196000
LORI ACKER
VICE PRESIDENT128368022910012160325800139020198976000
JOHN GUMKOWSKI
DIRECTOR - MARKETING198808072774043720525530377650366272000
KIM WHITE WAPELHORST
ACCOUNT EXECUTIVE177193056398021570502220387650324735000
DAVID ATHA
DIRECTOR1737430229510168310451550353150293995000
ALLAN BERKIN
ACCOUNT EXECUTIVE176735020604035380424700382840281631000
DOREEN PILIGIAN
DIRECTOR/ASST GENERAL COUNSEL1452561707003310344260126020209685000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
COMPENSATION INFORMATIONSCHEDULE J, PART I; QUESTIONS 1A AND 1BTHE ORGANIZATION'S PRESIDENT/CEO TRAVELS FIRST CLASS ON BUSINESS RELATED FLIGHTS EXCEEDING THREE HOURS TO ATTEND ORGANIZATION RELATED WORK EVENTS. THIS PROVIDES THE PRESIDENT/CEO THE ABILITY TO WORK ON ORGANIZATIONAL MATTERS DURING TRAVEL. ON OCCASION, TRAVEL EXPENSES FOR SPOUSES OF SENIOR OFFICERS ARE PAID BY THE ORGANIZATION WHEN RELATED TO A COMPANY EVENT (DELTA DENTAL PLANS ASSOCIATION ANNUAL MEETING, ETC). THE EXCESS COST OVER STANDARD RELATED TO THE 1ST CLASS AND SPOUSAL TRAVEL WAS NOT INCLUDED IN THE RESPECTIVE INDIVIDUAL'S 2012 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. THE ORGANIZATION REIMBURSES ITS PRESIDENT/CEO, WALTER VANBRUNT, FOR A MEMBERSHIP IN A COUNTRY CLUB. DURING 2012, MR. VANBRUNT'S 2012 FORM W-2, BOX 5, MEDICARE WAGES, INCLUDES $5,341 OF TAXABLE COMPENSATION WHICH RELATES TO HIS PERSONAL USAGE OF THE COUNTRY CLUB. THE ORGANIZATION PAID FOR FINANCIAL/TAX PLANNING SERVICES FOR CERTAIN EMPLOYEES. THE FINANCIAL/TAX PLANNING SERVICES AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S RESPECTIVE 2012 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: WALTER VANBRUNT, $400; BRUCE SILVERMAN, $470; STEVEN FLEISCHER, $625; DAVID SCOTT NAVARRO, D.D.S., $750; THOMAS C. KAHLER, $170 KATHLEEN FENNELL-BORGES, $450 AND DIANE BELLE, $160. THE ORGANIZATION'S PRESIDENT/CEO, WALTER VANBRUNT'S 2012 FORM W-2, BOX 5, INCLUDES A TAX GROSS-UP PAYMENT OF $11,417, RELATED TO HIS FORM W-2, BOX 5, TAXABLE COMPENSATION RESULTING FROM THE PERSONAL USAGE OF AN AUTO, COUNTRY CLUB DUES AND FINANCIAL/TAX PLANNING SERVICES. THE ORGANIZATION'S SENIOR VICE PRESIDENT/OPERATIONS, BRUCE SILVERMAN'S 2012 FORM W-2, BOX 5, INCLUDES A TAX GROSS-UP PAYMENT OF $5,464, RELATED TO HIS FORM W-2, BOX 5, TAXABLE COMPENSATION RESULTING FROM FINANCIAL/TAX PLANNING SERVICES AND AUTO ALLOWANCE. THE ORGANIZATION'S SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER, JAMES SULESKI'S 2012 FORM W-2, BOX 5, INCLUDES A TAX GROSS-UP PAYMENT OF $3,896, RELATED TO HIS FORM W-2, BOX 5, TAXABLE COMPENSATION RESULTING FROM AN AUTO ALLOWANCE. THE ORGANIZATION'S SENIOR VICE PRESIDENT/GENERAL COUNSEL, DOUGLAS G. SANBORN, ESQ.'S 2012 FORM W-2, BOX 5, INCLUDES A TAX GROSS-UP PAYMENT OF $5,153, RELATED TO HIS FORM W-2, BOX 5, TAXABLE COMPENSATION RESULTING FROM THE PERSONAL USAGE OF AN AUTO. IN ADDITION, CERTAIN BOARD OF TRUSTEE MEMBERS 2012 FORM 1099-MISC INCLUDES TAX GROSS-UP PAYMENTS RELATED TO COMPENSATION PAID TO THEM FOR PERSONAL USAGE OF AN AUTO AND/OR FINANCIAL/TAX PLANNING SERVICES.
COMPENSATION INFORMATIONSCHEDULE J, PART I; QUESTION 4BTHE AMOUNTS REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDE PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") BECAUSE THE AMOUNTS ARE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2012 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: WALTER VANBRUNT, $429,296; BRUCE SILVERMAN, $101,174; JAMES SULESKI, $43,636 AND DOUGLAS G. SANBORN, ESQ., $159,041. PLEASE NOTE THAT THE AMOUNTS REFLECTED INCLUDE A GROSS UP FOR 50% OF THE TAX LIABILITY WITH RESPECT TO THE SERP PAYMENTS.
COMPENSATION INFORMATIONSCHEDULE J, PART I; QUESTION 7 AND CORE FORM, PART VIICERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2012 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2012 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonCLIFTON ENDODONTICS ASSOCIATIONNamePerson
FieldValueIRS element (for citing)
RelationshipCOMPANY-DEBLINGER,TRUSTEERelationship
Amount Of Transaction182311AmountOfTransaction
Description Of TransactionDENTAL CARE PROVIDERDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierBUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONSIdentifier
Return ReferenceSCHEDULE L, PART IVReturnReference
ExplanationRONALD DEBLINGER, DMD, IS THE CHAIRMAN OF THE BOARD OF TRUSTEES OF THE ORGANIZATION. THE ORGANIZATION UTILIZED THE SERVICES OF HIS DENTAL PRACTICE, CLIFTON ENDODONTICS ASSOCIATION, DURING 2012. TOTAL FEES PAID TO CLIFTON ENDODONTICS ASSOCIATION DURING 2012 WERE $182,311. SERVICES WERE PAID BASED ON THE SAME FEE CRITERIA AS APPLY TO SIMILARLY SITUATED DENTISTS THROUGHOUT THE CORPORATION'S DENTAL NETWORK.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION A; QUESTION 3The organization retained the services of an outside property manager TO MANAGE THE DAY TO DAY ACTIVITIES AND OPERATIONS OF its single member LIMITED LIABILITY COMPANY; 1639 Real Estate, LLC.
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7MEMBERS OF THE ORGANIZATION SERVE AS THE TRUSTEES OF THE ORGANIZATION AND EXISTING MEMBERS VOTE TO ELECT NEW MEMBERS OF THE ORGANIZATION.
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION B; QUESTION 11BTHE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF ITS GOVERNING BODY (ITS BOARD OF TRUSTEES) PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. AS PART OF THE TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED WITHUMSMITH+BROWN, PC, A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION, TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S SENIOR MANAGEMENT AND VARIOUS OTHER INDIVIDUALS OF THE ORGANIZATION TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S FINANCE PERSONNEL AND OTHER INDIVIDUALS FOR THEIR REVIEW. THE ORGANIZATION'S SENIOR MANAGEMENT AND OTHER INDIVIDUALS REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S SENIOR MANAGEMENT AND VARIOUS OTHER INDIVIDUALS FOR FINAL REVIEW AND APPROVAL PRIOR TO PROVIDING IT TO EACH VOTING MEMBER OF ITS GOVERNING BODY.
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION B; QUESTION 12THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS, SENIOR MANAGEMENT AND OTHER KEY PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO MEMBERS OF THE ORGANIZATION'S SENIOR MANAGEMENT. SENIOR MANAGEMENT PROVIDES THE COMPLETED QUESTIONNAIRES TO THE ORGANIZATION'S AUDIT COMMITTEE FOR ITS REVIEW AND DISCUSSION WITH RESPECT TO CONFLICTS AND ANY ASSOCIATED MITIGATING BEHAVIOR. THE AUDIT COMMITTEE THEN REPORTS TO THE ORGANIZATION'S BOARD OF TRUSTEES.
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION B; QUESTION 14THE ORGANIZATION IS CURRENTLY IN THE PROCESS OF ADOPTING A FORMAL WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. THE ORGANIZATION CURRENTLY FOLLOWS STATE AND INTERNAL REVENUE SERVICE RULES AND REGULATIONS WITH RESPECT TO DOCUMENT RETENTION AND DESTRUCTION POLICIES AND PROCEDURES.
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION B; QUESTION 15THE ORGANIZATION'S BOARD OF TRUSTEES HAS AN EXECUTIVE AND HUMAN RESOURCES COMMITTEE ("COMMITTEE"). THE BOARD HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT TEAM, WHICH INCLUDES THE PRESIDENT/CHIEF EXECUTIVE OFFICER, SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER, SENIOR VICE PRESIDENT/GENERAL COUNSEL AND THE SENIOR VICE PRESIDENT/CHIEF OPERATING OFFICER. THE "TOTAL COMPENSATION" OF THE INDIVIDUALS REVIEWED INCLUDES BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THIS REVIEW IS DONE ON AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. COMPENSATION FOR THE SENIOR VICE PRESIDENT & GENERAL COUNSEL, SENIOR VICE PRESIDENT & CHIEF FINANCIAL OFFICER AND SENIOR VICE PRESIDENT/CHIEF OPERATING OFFICER, WHO REPRESENT SENIOR MANAGEMENT OF THE ORGANIZATION, IS REVIEWED AND APPROVED BY THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF TRUSTEES ANNUALLY, AND IS EFFECTIVE EACH JANUARY 1ST. THE PRESIDENT & CHIEF EXECUTIVE OFFICER'S PERFORMANCE IS REVIEWED BY THE EXECUTIVE AND HUMAN RESOURCES COMMITTEE OF THE BOARD OF TRUSTEES, WHICH PROVIDES INPUT TO THE FULL BOARD. COMPENSATION OF THE PRESIDENT & CHIEF EXECUTIVE OFFICER IS DETERMINED AND APPROVED BY THE BOARD OF TRUSTEES.
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION C; QUESTION 19THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY.
OTHER CHANGES IN NET ASSETSCORE FORM, PART XI; QUESTION 9OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDES: - NET CHANGE ARISING DURING THE PERIOD RELATED TO ACCRUED PENSION; $4,955,017.
AUDITED FINANCIAL STATEMENTSCORE FORM, PART XII; QUESTION 2AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE TAXPAYER AND ITS AFFILIATES FOR THE YEARS ENDED DECEMBER 31, 2012 AND DECEMBER 31, 2011; RESPECTIVELY, AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES BY ENTITY. AN UNQUALIFIED OPINION WAS ISSUED BY THE INDEPENDENT CPA FIRM EACH YEAR. THE ORGANIZATION'S AUDIT COMMITEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
DELTA DENTAL OF NEW JERSEY PAC INC
1639 ROUTE 10PARSIPPANYNJ07054223754874RELATEDNJ1195030309NA
1639 REAL ESTATE LLC
1639 ROUTE 10PARSIPPANYNJ07054RELATEDNJ332701023117957DDNJ

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF NJ FOUNDATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11639 ROUTE 10AddressLine1
CityPARSIPPANYCity
StateNJState
ZIP Code07054ZIPCode
FieldValueIRS element (for citing)
EIN222764745EIN
Primary ActivitiesPUBLIC SRVC.PrimaryActivities
Legal Domicile StateNJLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status509(A)(3)PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1DDNJBusinessNameLine1
FieldValueIRS element (for citing)
Controlled OrgtrueControlledOrg

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipControlled OrgControlledOrgAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
DDPNJ CORPORATION
1639 ROUTE 10PARSIPPANYNJ07054223085009HOLDING COMPANYNJDDNJC CORP.079953761.00000true
FLAGSHIP HEALTH SYSTEMS INC
1639 ROUTE 10PARSIPPANYNJ07054222671069DENTAL PLAN ORG.NJDDPNJC CORP.true
DENTAL REINSURANCE COMPANY LTD
980160853FOREIGN REINS.DDPNJC CORP.true44 CHURCH STREETHAMILTONBDBD
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
DELTA DENTAL OF NJ FOUNDATION INC
B1900000COST
FLAGSHIP HEALTH SYSTEMS INC
L841484COST

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