DELTA DENTAL OF ILLINOIS: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- DELTA DENTAL OF ILLINOIS (EIN 36-2612058)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-13
- IRS object ID
- 201203189349304140
- Schema version
- 2011v1.2
- 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 | 2012-11-13T17:20:30-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381357951 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10 S RIVERSIDE PLAZA 9TH FLOOR | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60606 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362612058 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF ILLINOIS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | DELT | NameControl |
| Phone | 6307184700 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 SHUMAN BOULEVARD | AddressLine1 |
| City | NAPERVILLE | City |
| State | IL | State |
| ZIP Code | 60563 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | STACEY K BONN | Name |
| Title | CHIEF ADMINISTRATIVE OFFICER | Title |
| Phone | 6307184700 | Phone |
| Date Signed | 2012-11-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DAVID LOWENTHAL | Name |
| PTIN | P00378651 | PTIN |
| Phone | 3122071040 | Phone |
| Date Prepared | 2012-11-13 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | BERNARD GLOSSY | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 SHUMAN BOULEVARD | AddressLine1 |
| City | NAPERVILLE | City |
| State | IL | State |
| ZIP Code | 60563 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 544368487 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.DELTADENTALIL.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1967 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | IMPROVE THE ORAL HEALTH OF ILLINOIS RESIDENTS BY PROVIDING DENTAL BENEFITS & OTHER SERVICES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 167 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 463755 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -14042 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 449918280 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 536227452 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1587292 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1936432 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 55018 | OtherRevenuePriorYear |
| Other Revenue Current Year | 27993 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 451560590 | TotalRevenuePriorYear |
| Total Revenue Current Year | 538191877 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 256000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 675000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 411178869 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 491320354 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 16621989 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 14356304 | 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 | 19784131 | OtherExpensePriorYear |
| Other Expenses Current Year | 21600203 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 447840989 | TotalExpensesPriorYear |
| Total Expenses Current Year | 527951861 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3719601 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 10240016 | RevenuesLessExpensesCY |
| Total Assets BOY | 81234101 | TotalAssetsBOY |
| Total Assets EOY | 130235548 | TotalAssetsEOY |
| Total Liabilities BOY | 36949523 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 76139115 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 44284578 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 54096433 | NetAssetsOrFundBalancesEOY |
| Mission Description | IMPROVE THE ORAL HEALTH OF ILLINOIS RESIDENTS BY PROVIDING DENTAL BENEFITS & OTHER SERVICES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 515050285 | Expense |
| Grants | 675000 | Grants |
| Revenue | 535763697 | Revenue |
| Description | PROMOTE ORAL HEALTH THROUGH THE PROVISION OF DENTAL BENEFITS TO OVER 1,600,000 INDIVIDUALS. | Description |
| Total Program Service Expense | 515050285 | TotalProgramServiceExpense |
| Described In501 C3 | 0 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Subject To Proxy Tax | 1 | 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 | 0 | 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 | 62602 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 167 | 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 | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF ILLINOIS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6307184700 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 SHUMAN BOULEVARD | AddressLine1 |
| City | NAPERVILLE | City |
| State | IL | State |
| ZIP Code | 60563 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (30 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| SHARON K HEATON | |||||||||
| CHAIRMAN | 5.00 | X | 32025 | 0 | 0 | ||||
| CRAIG GRANNON | |||||||||
| COMMITTEE CHAIR | 3.00 | X | 3325 | 0 | 16500 | ||||
| DR ALAN JURGENS | |||||||||
| COMMITTEE CHAIR | 3.00 | X | 14050 | 0 | 391 | ||||
| JOHN MAPLES | |||||||||
| COMMITTEE CHAIR | 3.00 | X | 19125 | 0 | 0 | ||||
| DR RICHARD PERRY | |||||||||
| COMMITTEE CHAIR | 3.00 | X | 24425 | 0 | 0 | ||||
| PATRICIA HUNT-PREHEIM | |||||||||
| COMMITTEE CHAIR | 3.00 | X | 19250 | 0 | 0 | ||||
| MICHAEL BUSSE | |||||||||
| COMMITTEE CHAIR | 3.00 | X | 0 | 0 | 15675 | ||||
| DR FRANK MAGGIO | |||||||||
| COMMITTEE CHAIR | 3.00 | X | 26400 | 0 | 0 | ||||
| LORRAINE ARVIN | |||||||||
| DIRECTOR | 2.00 | X | 14425 | 0 | 0 | ||||
| NANCY COZZI | |||||||||
| DIRECTOR | 2.00 | X | 14137 | 0 | 2462 | ||||
| DR RICHARD HESS | |||||||||
| DIRECTOR | 2.00 | X | 13975 | 0 | 0 | ||||
| DR ALLEN KNOX | |||||||||
| DIRECTOR | 2.00 | X | 12187 | 0 | 62 | ||||
| DR DENNIS MANNING | |||||||||
| DIRECTOR | 2.00 | X | 7415 | 0 | 0 | ||||
| BERNARD GLOSSY | |||||||||
| PRESIDENT & CEO | 40.00 | 607435 | 0 | 34550 | X | ||||
| STACEY BONN | |||||||||
| CAO & INTERIM CFO | 40.00 | 325046 | 0 | 28171 | X | ||||
| HAZEL FISHER-GABLE | |||||||||
| SVP & CHIEF CORPORATE COUNSEL | 40.00 | 352677 | 0 | 31915 | X | ||||
| STEPHEN RETZSCH | |||||||||
| VP NATIONAL ACCOUNTS | 40.00 | 396306 | 0 | 30976 | X | ||||
| MICHAEL WHITE | |||||||||
| VP UNDERWRITING | 40.00 | 219055 | 0 | 23882 | X | ||||
| KARYN GLOGOWSKI | |||||||||
| VP DIRECTOR SALES | 40.00 | 193961 | 0 | 11832 | X | ||||
| TERRI BON | |||||||||
| CONTROLLER | 40.00 | 179147 | 0 | 35522 | X | ||||
| LINDA NASTI | |||||||||
| SR. SALES EXECUTIVE | 40.00 | 172412 | 0 | 36603 | X | ||||
| THERESA MARSHALL | |||||||||
| SR. SALES EXECUTIVE | 40.00 | 166194 | 0 | 38124 | X | ||||
| THOMAS GEARY | |||||||||
| SR. SALES EXECUTIVE | 40.00 | 163596 | 0 | 34789 | X | ||||
| DR KATINA SPADONI-MORELLI | |||||||||
| DENTAL CONSULTANT | 40.00 | 161853 | 0 | 31310 | X | ||||
| THOMAS COLGAN | |||||||||
| FORMER SVP MARKETING | 0.00 | 336366 | 0 | 17233 | X | ||||
| DR ROBERT DENNISON | |||||||||
| FORMER CEO | 0.00 | 288520 | 0 | 0 | X | ||||
| ROSS GOSNELL | |||||||||
| FORMER SVP IT | 0.00 | 137896 | 0 | 0 | X | ||||
| TAMERA ROBINSON | |||||||||
| FORMER SVP & CFO | 0.00 | 126250 | 0 | 2009 | X | ||||
| IRENE VASQUEZ | |||||||||
| FORMER SVP OPERATIONS | 0.00 | 214225 | 0 | 22910 | X | ||||
| JEANETTE BATTISTA | |||||||||
| FORMER VP SALES | 0.00 | 207505 | 0 | 31339 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 4449183 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 446255 | TotalOtherCompensation |
| Number Individuals GT100 K | 29 | NumberIndividualsGT100K |
| Formers Listed | 1 | 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 |
|---|---|---|---|---|---|
| ADVANTECH INC | |||||
| 2801 HOVER ROAD | STEVENS POINT | WI | 54481 | IT SYSTEM MAINTENANCE | 2437895 |
| EMDEON BUSINESS SERVICES | |||||
| 3183 RIDER TRAIL SOUTH | EARTH CITY | MO | 63045 | INVOICE AND CLAIMS PRINTING | 1888900 |
| THE MEYOCKS GROUP | |||||
| 6800 LAKE DRIVE | WEST DES MOINES | IA | 50266 | ADVERTISING AND MARKETING | 656429 |
| RICHARDS GRAPHIC COMMUNICATIONS | |||||
| 2700 VAN BUREN ST | BELLWOOD | IL | 60104 | COMMERCIAL PRINTER | 601307 |
| GTESS | |||||
| 2435 N CENTERAL EXPRESSWAY SUITE | RICHARDSON | TX | 75080 | IMAGE RECOGNITION PROCESSING | 552096 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 16 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| PREMIUMS | 524114 | 535763697 | 535763697 | |
| BUILDING | 531190 | 463755 | 463755 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 536227452 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1799799 | TotalRevenueColumn |
| Exclusion | $1,799,799 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 6313243 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 6176610 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 136633 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 136633 | TotalRevenueColumn |
| Exclusion | $136,633 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER INCOME | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 27993 | TotalRevenueColumn |
| Exclusion | $27,993 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 27993 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 538191877 | TotalRevenueColumn |
| Related Or Exempt Function Income | 535763697 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 463755 | UnrelatedBusinessRevenue |
| Exclusion | $1,964,425 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 675000 | Total |
| Program Services | 675000 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 491320354 | Total |
| Program Services | 491320354 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4704946 | Total |
| Program Services | 568194 | ProgramServices |
| Management And General | 4136752 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5962945 | Total |
| Program Services | 4963143 | ProgramServices |
| Management And General | 999802 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 775091 | Total |
| Program Services | 370752 | ProgramServices |
| Management And General | 404339 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 742106 | Total |
| Program Services | 407511 | ProgramServices |
| Management And General | 334595 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2171216 | Total |
| Program Services | 1341669 | ProgramServices |
| Management And General | 829547 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 136411 | Total |
| Management And General | 136411 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 116013 | Total |
| Management And General | 116013 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 204671 | Total |
| Management And General | 204671 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1017723 | Total |
| Program Services | 339618 | ProgramServices |
| Management And General | 678105 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 903830 | Total |
| Program Services | 108716 | ProgramServices |
| Management And General | 795114 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 852749 | Total |
| Program Services | 800521 | ProgramServices |
| Management And General | 52228 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3623213 | Total |
| Program Services | 3619053 | ProgramServices |
| Management And General | 4160 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 324508 | Total |
| Management And General | 324508 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 174890 | Total |
| Program Services | 49094 | ProgramServices |
| Management And General | 125796 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 91201 | Total |
| Program Services | 25769 | ProgramServices |
| Management And General | 65432 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 537562 | Total |
| Management And General | 537562 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1109554 | Total |
| Program Services | 142237 | ProgramServices |
| Management And General | 967317 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 308386 | Total |
| Management And General | 308386 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BROKER COMMISSIONS | 7761733 | 7761733 | 0 |
| PRINTING & PUBLICATIONS | 2168096 | 1670861 | 497235 |
| INSURANCE DEPT. FEES | 633955 | 588727 | 45228 |
| BANK FEES | 308567 | 0 | 308567 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1327141 | Total |
| Program Services | 297333 | ProgramServices |
| Management And General | 1029808 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 527951861 | Total |
| Program Services | 515050285 | ProgramServices |
| Management And General | 12901576 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 1845055 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8103380 | BOY |
| EOY | 54115397 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 872826 | BOY |
| EOY | 1156181 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 21145841 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1948064 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20054282 | BOY |
| EOY | 19197777 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46704043 | BOY |
| EOY | 48112936 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5259819 | BOY |
| EOY | 5563448 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 239751 | BOY |
| EOY | 244754 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 81234101 | BOY |
| EOY | 130235548 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12144250 | BOY |
| EOY | 11394140 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3475527 | BOY |
| EOY | 4256776 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10302709 | BOY |
| EOY | 10178945 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11027037 | BOY |
| EOY | 50309254 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36949523 | BOY |
| EOY | 76139115 | 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 | 0 | BOY |
| EOY | 0 | EOY |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44284578 | BOY |
| EOY | 54096433 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44284578 | BOY |
| EOY | 54096433 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 81234101 | BOY |
| EOY | 130235548 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 10240016 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -428161 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantially All Dues Nondeduct | 0 | SubstantiallyAllDuesNondeduct |
| Only In House Lobbying | 1 | OnlyInHouseLobbying |
| Agree To Carryover Prior Year | 0 | AgreeToCarryoverPriorYear |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3096941 | OtherCostOrOtherBasis |
| Book Value | 3096941 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 16066877 | OtherCostOrOtherBasis |
| Depreciation | 1038015 | Depreciation |
| Book Value | 15028862 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 282030 | OtherCostOrOtherBasis |
| Depreciation | 199535 | Depreciation |
| Book Value | 82495 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1699993 | OtherCostOrOtherBasis |
| Depreciation | 710514 | Depreciation |
| Book Value | 989479 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 19197777 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| UNPAID CLAIMS AND CLAIMS ADJUSTMENT EXPENSE | $8,301,000 |
| SELF-INSURED UNPAID CLAIMS | $42,008,254 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 50309254 | TotalOfAmounts |
| Total Revenue | 538191877 | TotalRevenue |
| Total Expenses | 527951861 | TotalExpenses |
| Excess Or Deficit For Year | 10240016 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -428161 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -428161 | TotalAdjustments |
| Excess Or Deficit Per FS | 9811855 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 537523451 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 537523451 | RevenueSubtotal |
| Investment Expenses Not Included | 204671 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 463755 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 668426 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 538191877 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 527283435 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 527283435 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 204671 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 463755 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 668426 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 527951861 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE COMPANY'S APPLICATION OF GAAPUSA REGARDING UNCERTAIN TAX POSITIONS HAD NO EFFECT ON ITS FINANCIAL POSITION AS MANAGEMENT BELIEVES THE COMPANY HAS NO MATERIAL UNRECOGNIZED INCOME TAX BENEFITS. THE COMPANY WOULD ACCOUNT FOR ANY POTENTIAL INTEREST OR PENALTIES RELATED TO POSSIBLE FUTURE LIABILITIES FOR UNRECOGNIZED INCOME TAX BENEFITS AS INCOME TAX EXPENSE. THE COMPANY IS NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR FEDERAL, STATE OR LOCAL INCOME TAXES FOR PERIODS BEFORE 2008. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | RENTAL INCOME REPORTED ON PART VII 463,755. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | RENTAL INCOME REPORTED ON PART VII 463,755. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF ILLINOIS FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 SHULMAN BLVD | AddressLine1 |
| City | NAPERVILLE | City |
| State | IL | State |
| ZIP Code | 60563 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 262700504 | EINOfRecipient |
| IRC Section | 501(C)3 | IRCSection |
| Amount Of Cash Grant | 675000 | AmountOfCashGrant |
| Purpose Of Grant | PROMOTE ORAL HEALTH OF THE RESIDENTS OF ILLINOIS | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: DELTA DENTAL OF ILLINOIS DIRECTORS AND OFFICERS HAVE THE MAJORITY OF SEATS ON THE DELTA DENTAL OF ILLINOIS FOUNDATION BOARD, AND THEREFORE MONITOR AND APPROVE HOW GRANT MONEY IS USED AND TRACKED. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | X | FirstClassOrCharterTravel |
| Travel For Companions | X | TravelForCompanions |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (17 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BERNARD GLOSSY | |||||||||||||
| 422831 | 0 | 90000 | 0 | 94604 | 0 | 0 | 0 | 34550 | 0 | 641985 | 0 | 0 | 0 |
| STACEY BONN | |||||||||||||
| 274039 | 0 | 24658 | 0 | 26349 | 0 | 0 | 0 | 28171 | 0 | 353217 | 0 | 0 | 0 |
| HAZEL FISHER-GABLE | |||||||||||||
| 254770 | 0 | 90328 | 0 | 7579 | 0 | 0 | 0 | 31915 | 0 | 384592 | 0 | 0 | 0 |
| STEPHEN RETZSCH | |||||||||||||
| 127386 | 0 | 49480 | 0 | 219440 | 0 | 0 | 0 | 30976 | 0 | 427282 | 0 | 0 | 0 |
| MICHAEL WHITE | |||||||||||||
| 156789 | 0 | 51891 | 0 | 10375 | 0 | 0 | 0 | 23882 | 0 | 242937 | 0 | 0 | 0 |
| KARYN GLOGOWSKI | |||||||||||||
| 123423 | 0 | 0 | 0 | 70538 | 0 | 0 | 0 | 11832 | 0 | 205793 | 0 | 0 | 0 |
| TERRI BON | |||||||||||||
| 132263 | 0 | 46275 | 0 | 609 | 0 | 0 | 0 | 35522 | 0 | 214669 | 0 | 0 | 0 |
| LINDA NASTI | |||||||||||||
| 80819 | 0 | 7036 | 0 | 84557 | 0 | 0 | 0 | 36603 | 0 | 209015 | 0 | 0 | 0 |
| THERESA MARSHALL | |||||||||||||
| 71833 | 0 | 5188 | 0 | 89173 | 0 | 0 | 0 | 38124 | 0 | 204318 | 0 | 0 | 0 |
| THOMAS GEARY | |||||||||||||
| 84597 | 0 | 7052 | 0 | 71947 | 0 | 0 | 0 | 34789 | 0 | 198385 | 0 | 0 | 0 |
| DR KATINA SPADONI-MORELLI | |||||||||||||
| 150789 | 0 | 10568 | 0 | 496 | 0 | 0 | 0 | 31310 | 0 | 193163 | 0 | 0 | 0 |
| THOMAS COLGAN | |||||||||||||
| 0 | 0 | 0 | 0 | 336366 | 0 | 0 | 0 | 17233 | 0 | 353599 | 0 | 0 | 0 |
| DR ROBERT DENNISON | |||||||||||||
| 0 | 0 | 0 | 0 | 288520 | 0 | 0 | 0 | 0 | 0 | 288520 | 0 | 0 | 0 |
| ROSS GOSNELL | |||||||||||||
| 0 | 0 | 0 | 0 | 137896 | 0 | 0 | 0 | 0 | 0 | 137896 | 0 | 0 | 0 |
| TAMERA ROBINSON | |||||||||||||
| 0 | 0 | 0 | 0 | 126250 | 0 | 0 | 0 | 2009 | 0 | 128259 | 0 | 0 | 0 |
| IRENE VASQUEZ | |||||||||||||
| 0 | 0 | 0 | 0 | 214225 | 0 | 0 | 0 | 22910 | 0 | 237135 | 0 | 0 | 0 |
| JEANETTE BATTISTA | |||||||||||||
| 121688 | 0 | 83125 | 0 | 2692 | 0 | 0 | 0 | 31339 | 0 | 238844 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | OFFICERS ARE ALLOWED TO TRAVEL FIRST CLASS WHEN TRAVELING TO ORGANIZATIONAL EVENTS WHERE FLIGHTS ARE OVER 2 HOURS AND THE BENEFIT IS CONSIDERED A TAXABLE FRINGE BENEFIT. THE OFFICERS OF THE ORGANIZATION ARE REIMBURSED FOR HEALTH CLUB MEMBERSHIP DUES UP TO $100 PER MONTH PER COMPANY POLICY. IN ADDITION, WHEN TRAVELING TO CERTAIN ORGANIZATIONAL EVENTS, OFFICERS AND DIRECTORS ARE REIMBURSED FOR THEIR COMPANION'S TRAVEL EXPENSES AS A TAXABLE BENEFIT. |
| PART I, LINE 4A | THOMAS COLGAN, SVP OF MARKETING, RECEIVED SEVERANCE OF $336,366 ROBERT DENNISON, PRESIDENT AND CEO, RECEIVED SEVERANCE OF $288,520 ROSS GOSNELL, SVP OF IT, RECEIVED SEVERANCE OF $137,896 TAMERA ROBINSON, SVP AND CFO, RECEIVED SEVERANCE OF $126,250 IRENE VASQUEZ, SVP OPERATIONS, RECEIVED SEVERANCE OF $214,225 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| TRUASSURE | |||
| SUBSIDIARY | 124467 | SALE OF INSURANCE PRODUCTS BY TRUASSURE TO DELTA DENTAL OF ILLINOIS. | 0 |
| DR ALAN JURGENS THROUGH JURGENS AN | |||
| DIRECTOR | 244348 | PAYMENTS TO DENTAL PRACTICE FOR DENTAL SERVICES PROVIDED UNDER DENTAL INSURANCE POLICY. | 0 |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE L PART V | Identifier |
| Return Reference | RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANZIATION | ReturnReference |
| Explanation | BERNARD GLOSSY, HAZEL FISHER-GABLE, AND STACEY BONN ARE OFFICERS/KEY EMPLOYEES IN BOTH DELTA DENTAL OF ILLINOIS AND TRUASSURE INSURANCE COMPANY. DR. RICHARD PERRY, MR. JOHN MAPLES,DR. FRANK MAGGIO, AND MS. PATRICIA HUNT-PREHEIM ARE DIRECTORS IN BOTH DELTA DENTAL OF ILLINOIS AND TRUASSURE INSURANCE COMPANY. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | UNDER THE ENABLING STATUTE THAT GOVERNS THE ORGANIZATION - THE ILLINOIS DENTAL SERVICE PLAN ACT - THE MEMBERS OF DELTA DENTAL OF ILLINOIS ARE THE PARTICIPATING DENTISTS (DEFINED AS ANY DENTIST LICENSED IN ILLINOIS TO PRACTICE DENTISTRY WHO IS REPUTABLE AND IN GOOD STANDING AND HAS SIGNED AN AGREEMENT TO BECOME A PARTICIPATING DENTIST OF THE ORGANIZATION) AND THE GROUP SUBSCRIBERS WHO PURCHASE A DENTAL BENEFIT PROGRAM FROM THE ORGANIZATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | AT THE ANNUAL MEMBERSHIP MEETING OF THE ORGANIZATION, THE MEMBERS REFERENCED IN PART VI, LINE 6 ELECT THE MEMBERS OF THE GOVERNING BODY, I.E. DIRECTORS, WHOSE TERM OF DIRECTORSHIP HAS EXPIRED. | |
| FORM 990, PART VI, SECTION A, LINE 7B | PLEASE SEE THE RESPONSE FOR ITEM 7A. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE BOARD OF THE ORGANIZATION RETAINS THE SERVICES OF AN INDEPENDENT CPA FIRM TO ASSIST IN THE PREPARATION OF THE ORGANIZATION'S FORM 990. THE CPA FIRM ASSISTS MANAGEMENT IN PREPARING AND FINALIZING FORM 990. THE DRAFT OF FORM 990, INCLUDING ALL SCHEDULES, IS REVIEWED BY THE AUDIT AND FINANCE COMMITTEE, AND THEN DISTRIBUTED TO ALL VOTING MEMBERS OF THE GOVERNING BODY, I.E. THE DIRECTORS. THE ORGANIZATION'S MANAGEMENT, AND IF NEEDED ITS CPA FIRM, ADDRESS ANY QUESTIONS OR COMMENTS SUBMITTED BY THE ORGANIZATION'S GOVERNING BODY BEFORE FILING ITS FORM 990. AFTER THE AUDIT AND FINANCE COMMITTEE'S REVIEW AND MANAGEMENT ADDRESSES QUESTIONS OR COMMENTS FROM THE DIRECTORS, THE DRAFT FORM 990 IS FINALIZED AND FILED WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | LEGAL COUNSEL FOR THE ORGANIZATION REVIEWS THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ANNUALLY WITH THE OFFICERS, DIRECTORS (TRUSTEES) AND KEY EMPLOYEES. AFTER THIS REVIEW, THE INDIVIDUALS OCCUPYING THESE POSITIONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. POTENTIAL CONFLICTS ARE LOGGED WITH THE SECRETARY OF THE ORGANIZATION AND ANY CHANGES TO THE DISCLOSURE FORM ARE TO BE REPORTED TO THE CHIEF LEGAL OFFICER OF THE ORGANIZATION. | |
| FORM 990, PART VI, SECTION B, LINE 15 | CEO COMPENSATION IS REVIEWED BY THE BOARD OF DIRECTORS. THE BOARD PERIODICALLY ENGAGES AN INDEPENDENT CONSULTING FIRM TO ADVISE OF COMPENSATION LEVELS OF SIMILARLY SITUATED CEOS BASED UPON SURVEYS AND DATA PROVIDED BY OTHER ORGANIZATIONS AS LISTED ON THEIR FORM 990. THIS DATA, OR THE DATA REPRESENTED TO THE COMPENSATION COMMITTEE AT SCHEDULED MEETINGS AND MINUTES OF THESE MEETINGS ARE CONTEMPORANEOUSLY PREPARED. THE COMMITTEE MAKES A RECOMMENDATION TO THE BOARD FOR APPROVAL. | |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE THROUGH APPLICABLE GOVERNMENTAL AGENCIES; THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON WRITTEN REQUEST TO THE ORGANIZATION. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -428,161. | CHANGES IN NET ASSETS OR FUND BALANCES: |
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 ILLINOIS FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 SHULMAN BLVD | AddressLine1 |
| City | NAPERVILLE | City |
| State | IL | State |
| ZIP Code | 60563 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 262700504 | EIN |
| Primary Activities | PROMOTE ORAL HEALTH OF THE RESIDENTS OF ILLINOIS | PrimaryActivities |
| Legal Domicile State | IL | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 7 | PublicCharityStatus |
| Controlled Org | 1 | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRUASSURE INSURANCE COMPANY | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 SHUMAN BLVD | AddressLine1 |
| City | NAPERVILLE | City |
| State | IL | State |
| ZIP Code | 60563 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363757528 | EIN |
| Primary Activity | GROUP LIFE AND HEALTH INSURANCE | PrimaryActivity |
| Legal Domicile State | IL | LegalDomicileState |
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 303629 | ShareOfTotalIncome |
| Share Of EOY Assets | 6112479 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| 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 |
| 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 | 0 | 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 | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| TRUASSURE INSURANCE COMPANY | ||
| L | 125467 | MAINTAINED RECORDS AT FMV |
| TRUASSURE INSURANCE COMPANY | ||
| P | 73847 | MAINTAINED RECORDS AT FMV |
| TRUASSURE INSURANCE COMPANY | ||
| Q | 3018896 | MAINTAINED RECORDS AT FMV |
| TRUASSURE INSURANCE COMPANY | ||
| R | 585656 | MAINTAINED RECORDS AT FMV |
| DELTA DENTAL OF ILLINOIS FOUNDATION | ||
| B | 675000 | MAINTAINED RECORDS AT FMV |
Comments