DELTA DENTAL OF SOUTH DAKOTA: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL OF SOUTH DAKOTA (EIN 46-0309258)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-09-27
IRS object ID
201242719349300404
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

FieldValueIRS element (for citing)
Timestamp2012-09-27T06:43:51-07:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Stulken Petersen Lingle Walti & Jones LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 578AddressLine1
CityPierreCity
StateSDState
ZIP Code575010578ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN460309258EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL PLAN OF SOUTH DAKOTABusinessNameLine1
FieldValueIRS element (for citing)
Name ControlDELTNameControl
Phone6052247345Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1157AddressLine1
CityPIERRECity
StateSDState
ZIP Code57501ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSCOTT JONESName
TitlePresident & CEOTitle
Date Signed2012-09-27DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDAVID J LINGLEName
Phone6052245828Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts99000358GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501cXOrganization501c
Web Sitewww.deltadentalsd.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1963YearFormation
State Legal DomicileSDStateLegalDomicile
Activity Or Mission DescriptionDELTA DENTAL OF SOUTH DAKOTA IS DEDICATED TO ADVANCING AND PROMOTING THE IMPROVEMENT OF ORAL HEALTH.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees60TotalNbrEmployees
Total Gross UBI1110444TotalGrossUBI
Contributions Grants Prior Year25500ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year85067583ProgramServiceRevenuePriorYear
Program Service Revenue CY90705158ProgramServiceRevenueCY
Investment Income Prior Year453073InvestmentIncomePriorYear
Investment Income Current Year820194InvestmentIncomeCurrentYear
Other Revenue Prior Year926529OtherRevenuePriorYear
Other Revenue Current Year1094659OtherRevenueCurrentYear
Total Revenue Prior Year86472685TotalRevenuePriorYear
Total Revenue Current Year92620011TotalRevenueCurrentYear
Grants And Similar Amnts CY2092314GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year3837461SalariesEtcPriorYear
Salaries Etc Current Year4187020SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year81619318OtherExpensePriorYear
Other Expenses Current Year85160206OtherExpensesCurrentYear
Total Expenses Prior Year85456779TotalExpensesPriorYear
Total Expenses Current Year91439540TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1015906RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1180471RevenuesLessExpensesCY
Total Assets BOY37651027TotalAssetsBOY
Total Assets EOY37956302TotalAssetsEOY
Total Liabilities BOY7452629TotalLiabilitiesBOY
Total Liabilities EOY7739491TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY30198398NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY30216811NetAssetsOrFundBalancesEOY
Mission DescriptionDELTA DENTAL OF SOUTH DAKOTA IS DEDICATED TO ADVANCING AND PROMOTING THE IMPROVEMENT OF ORAL HEALTH.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense83184659Expense
Grants2092314Grants
Revenue90705158Revenue
DescriptionDELTA DENTAL PAID THROUGH ITS CONTRACTS WITH INDEPENDENT DENTISTS 468,403 CLAIMS FOR DENTAL BENEFIT SERVICES FOR APPROXIMATELY 216,500 INDIVIDUALS WITH GROUP PLANS 26,000 INDIVIDUALS WITH DENTAL ACCIDENT PLANS, 115,000 SOUTH DAKOTA MEDICAID RECIPIANTS AND 95,000 NATIVE AMERICANS UNDER ABERDEEN AREA HEALTH SERVICES. DELTA DENTAL ALSO GRANTED THE DELTA DENTAL PHILANTHRIPIC FUND, A 501(C)(3) CHARITABLE ORGANIZATION, $2,000,000 TO PROMOTE THE IMPROVEMENT OF ORAL HEALTH.Description
Total Program Service Expense83184659TotalProgramServiceExpense
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
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 StmtfalseConsolidatedAuditFinancialStmt
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
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
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 RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10962981NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees60NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKIRBY SCOTTNamePerson
Telephone Number6052247345TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1720 NORTH EUCLID PIERRE SDAddressLine1
CityPIERRECity
StateSDState
ZIP Code57501ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
MIKE HOUK
Director1.00X275000
JOHN CLAUSEN
Treasurer1.00X945000
JEFF FEIOCK
Director1.00X225000
JIM RUSSELL
Director1.00X470000
PAUL REZICH
Director1.00X525000
ANN LEE ROLA
Director1.00X425000
RYAN VAN LACKEN
Director1.00X350000
MARY HITZEMANN
Director1.00X600000
PAT HERMANSON
Director1.00X450000
GREG HANSON
Director1.00X525000
G VERNE GOODSELL
Director1.00X571500
DALE GIBSON
Chairman1.00X1100000
GREG GERTSEN
Secretary1.00X545000
STEVE CULHANE
Director1.00X525000
ELLEN LEE
Director1.00X525000
MONTY BECHTOLD
VICE CHAIRMAN1.00X525000
JEFF MILLER
VP-UNDERWRITING40.0013303600X
CONNIE HALVERSON
V.P.-PUBLIC REL40.0011234300X
MICK HECKENLAIBLE
VP-OPERATIONS40.0013991800X
GENE TETZLAFF
V.P.-INFO TECHN40.0013445300X
NANCE ORSBON
V.P.-PROF. RTNS40.0011860400X
KIRBY SCOTT
V PRES-FINANCE40.0014851200X
SCOTT JONES
President & CEO40.005143270226311X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1387008TotalReportableCompFromOrg
Total Other Compensation226311TotalOtherCompensation
Number Individuals GT100 K7NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionDELTA BENEFITS COVERAGEDescription
Total Revenue Column90705158TotalRevenueColumn
Related Or Exempt Function Income90705158RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue90705158TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column859588TotalRevenueColumn
Exclusion$859,588ExclusionAmount

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)
Real30475Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real46260Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-15785Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-15785TotalRevenueColumn
Exclusion-$15,785ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities6294693Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities6334087Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-39394Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-39394TotalRevenueColumn
Exclusion-$39,394ExclusionAmount

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

FieldValueIRS element (for citing)
DescriptionMANAGEMENT SERVICE FEESDescription
Total Revenue Column1110444TotalRevenueColumn
Unrelated Business Revenue1110444UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue1110444TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column92620011TotalRevenueColumn
Related Or Exempt Function Income90705158RelatedOrExemptFunctionIncome
Unrelated Business Revenue1110444UnrelatedBusinessRevenue
Exclusion$804,409ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total2092314Total
Program Services2092314ProgramServices

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)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1613319Total
Management And General1613319ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1592904Total
Management And General1592904ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total232440Total
Management And General232440ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total578499Total
Management And General578499ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total169858Total
Management And General169858ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total788Total
Management And General788ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total67342Total
Management And General67342ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total54011Total
Management And General54011ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total30692Total
Management And General30692ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total133436Total
Management And General133436ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total58733Total
Management And General58733ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total40176Total
Management And General40176ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total322202Total
Management And General322202ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total48521Total
Management And General48521ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
Postage and Shipping215949215949
DUES TAXES AND LICENCES657460657460
BROKERAGE AND COMMISSIONS831308831308
MANAGEMENT SERVICE EXPENSE11104441110444
CLAIMS PAID/INCURRED8109234581092345

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total496799Total
Management And General496799ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total91439540Total
Program Services83184659ProgramServices
Management And General8254881ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY100EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY900735BOY
EOY1127342EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY7450829BOY
EOY7546524EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY18828BOY
EOY50792EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis6984037LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2203180LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4995096BOY
EOY4780857EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY18271895BOY
EOY17539055EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY5749033BOY
EOY6663768EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY264611BOY
EOY247864EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY37651027BOY
EOY37956302EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2622035BOY
EOY3029248EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4830594BOY
EOY4710243EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY7452629BOY
EOY7739491EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY30198398BOY
EOY30216811EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY30198398BOY
EOY30216811EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY37651027BOY
EOY37956302EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1180471ReconcilationRevenueExpenses
Reconcilation Other Changes-1162058ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis96552InvestmentCostOrOtherBasis
Other Cost Or Other Basis300819OtherCostOrOtherBasis
Book Value397371BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis855405InvestmentCostOrOtherBasis
Other Cost Or Other Basis3792143OtherCostOrOtherBasis
Depreciation854837Depreciation
Book Value3792711BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1354756OtherCostOrOtherBasis
Depreciation1117714Depreciation
Book Value237042BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis584362OtherCostOrOtherBasis
Depreciation230629Depreciation
Book Value353733BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4780857TotalOfBookValueLandBuildings
Total Of Book Value Securities6663768TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
DEFERRED PREMIUMS$715,387
COST PLUS GROUP DEPOSITS$74,100
CLAIMS PAYABLE, DENTAL ACCIDENT$31,920
UNPAID CLAIMS PROCESSING COSTS$300,000
REPORTED CLAIMS INCURRED, NOT REPORTED$3,588,836
FieldValueIRS element (for citing)
Total Of Amounts4710243TotalOfAmounts
Total Revenue92620011TotalRevenue
Total Expenses91439540TotalExpenses
Excess Or Deficit For Year1180471ExcessOrDeficitForYear
Net Unrealized GL On Investments-1162058NetUnrealizedGLOnInvestments
Total Adjustments-1162058TotalAdjustments
Excess Or Deficit Per FS18413ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt92612260TotRevenueEtcAuditedFinclStmt
Other Revenues46260OtherRevenues
Revenue Not Rptd F99046260RevenueNotRptdF990
Revenue Subtotal92566000RevenueSubtotal
Investment Expenses Not Included54011InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt54011RevenueNotRptdOnFinStmt
Total Revenue Per Form99092620011TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt91439540TotExpensesEtcAuditedFinclStmt
Expenses Subtotal91439540ExpensesSubtotal
Total Expenses Per Form99091439540TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XPart X : FIN48 FootnoteACCOUNTING STANDARDS PRESCRIBE A RECOGNITION THRESHOLD OF MORE LIKELY THAN NOT, AND A MEASUREMENT ATTRIBUTE FOR ALL TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN, IN ORDER FOR THOSE TAX POSITIONS TO BE RECOGNIZED IN THE FINANCIAL STATEMENTS. AT DECEMBER 31, 2011, THE CORPORATION BELIEVES THAT THERE ARE NO UNCERTAIN TAX POSITIONS OR LIABILITES, OR INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX POSITIONS. IF THE CORPORATION HAD INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IT WOULD BE ACCOUNTED FOR AS A COMPONENET OF INCOME TAX EXPENSE. IN ACCORDANCE WITH THE APPLICABLE STATUTE OF LIMITATIONS, THE CORPORATION'S TAX RETURNS COULD BE AUDITED BY THE INTERNAL REVENUE SERVICE FOR THE YEARS ENDED DECEMBER 31, 2008 TO 2011.
Part XII, Line 2dPart XII, Line 2d: Other revenue amounts included in F/S but not included on form 990RENTAL REAL ESTATE DEPRECIATION EXPENSE $31949 INSURANCE $5202 REAL ESTATE TAXES $9109

Schedule I IRS990ScheduleI

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistancePurpose Of GrantPurposeOfGrant
CAPITAL AREA UNITED WAY
221 SOUTH CENTRAL AVEPIERRESD57501460403398501(C)(3)325250DISTRIBUTING CHARITABLE DONATIONS
SO DAKOTA VOICES FOR CHILDREN
PO BOX 2196SIOUX FALLSSD57101460425502501(c)(3)250000TO IMPROVE LIVES OF SD CHILDREN
DELTA DENTAL PHILANTHROPIC FU
804 NORTH EUCLID SUITE 1PIERRESD57501911776857501(c)(3)20000000PROMOTE DENTAL HEALTH IN SOUTH DAK
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants3TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
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 PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonSCOTT JONESNamePerson
Base Compensation Filing Org350000BaseCompensationFilingOrg
Bonus Filing Org160000BonusFilingOrg
Other Compensation Filing Org4327OtherCompensationFilingOrg
Deferred Comp Filing Org226311DeferredCompFilingOrg
Total Compensation Filing Org740638TotalCompensationFilingOrg

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSch J, Part I, Line 1aIdentifier
Return ReferencePart I, Line 1a: Relevant information in regards to selections on 1a.ReturnReference

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableALL DOCUMENTS AND POLICIES ARE AVAILABLE UPON REQUEST.
Form 990, Part VI, Line 15bForm 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesDelta Dental of South DakotaCompensation Committee CharterPurposeThe purpose of the Compensation Committee is to review and report to the Board on compensation and personnel policies, programs and plans and to approve employee compensation and benefit plans.MembershipThe Compensation Committee shall be comprised of the DDSD Chair and vice-chair and at least two other board members.TermCommittee members are appointed to annual terms and may be reappointed to unlimited consecutive terms.Responsibilities1.Develop and recommend DDSD's compensation philosophy.2.Develop and recommend DDSD's compensation and benefits policies and programs including incentive plans, pension plan, and any perquisites.3.Periodically review DDSD's compensation and benefits policies/programs to determine whether they are properly coordinated and appropriate/competitive for like organizations.4.Annually review the CEO's performance and determine salary adjustments and incentive payments for CEO, ensuring compliance with the IRS "Rebuttable Presumption" safety zone for executive comp matters.5.Reviews CEO's recommendations as to salary adjustments and incentive payments for executive staff, ensuring compensation within the ranges of the executive compensation philosophy.MeetingsThe Compensation Committee shall meet at least annually and more often as determined necessary to fulfill its responsibilities.Reporting & AuthorityThe Compensation Committee may exercise all of the powers of the Board as authorized in concert with this charter. All actions taken by the Compensation Committee will be reported to the Board at its next regularly scheduled meeting.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsAT THE REGULARLY SCHEDULED BOARD MEETING TO ELECT BOD OFFICERS CONDUCTED IN MAY OF EACH YEAR, THE BOD AND OFFICERS OF DELTA DENTAL OF SOUTH DAKOTA ARE EACH GIVEN A CONFLICT OF INTEREST FORM TO FILL OUT. AT THE NEXT BOD MEETING EACH ONE IS READ AND ANY ACTION THAT NEEDS TO BE TAKEN IS DONE AT THAT TIME.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessAT THE REGULARLY SCHEDULED BOARD MEETING IN MAY OF EACH YEAR , THE FORM 990 IS GIVEN TO EACH BOARD MEMBER AND A REVIEW IS CONDUCTED BY THE CHAIRMAN OF THE AUDIT AND FINANCE COMMITTEE.
Form 990, Part VI, Line 7bForm 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or ShareholdersALL MEMBER DENTISTS PRESENT AT THE ANNUAL MEETING ARE EACH ALLOWED ONE VOTE ON ALL ITEMS.
Form 990, Part VI, Line 7aForm 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyALL MEMBER DENTISTS ARE INVITED TO THE ANNUAL MEETING AND IF PRESENT, HAVE ONE VOTE.
Form 990, Part VI, Line 6Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderDENTISTS LICENSED IN SOUTH DAKOTA THAT PAY A ONE-TIME MEMEBERSHIP DUES.
Client Note 1 - PAGE 10PART IX STATEMENT OF FUNCTIONAL EXPENSESLINE 22 DEPRECIATION (A)TOTAL (C)MANAGEMENT AND GENERALBUILDINGS STRAIGHT-LINE 28 YEARS $102,863 $102,863 MACHINERY & EQUIPMENT STRAIGHT-LINE 5-10 YEARS 162,781 162,781FURNITURE & FIXTURES STRAIGHT-LINE 5-10 YEARS 56,558 56,558TOTAL DEPRECIATION $322,202 $322,202PAGE 9PART VIII STATEMENT OF REVENUELINE 6B RENTAL EXPENSES DEPRECIATION BUILDINGS AND IMPROVEMENTS $31,949

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