2011-10-03T13:14:37-05:00 2010-12-31 ERNST & YOUNG US LLP 55 MERCHANT ST SUITE 1900 C-120 HONOLULU HI 96813 990 2010-01-01 990107971 HAWAII DENTAL SERVICE HAWA 8085211431 700 Bishop Street Honolulu HI 96813 FAYE KURREN 2011-09-30 8085312037 2010 2016-03-07 17:11:31Z Faye W Kurren PresidentCEO 700 BISHOP STREET HONOLULU HI 96813 243124393 false X www.deltadentalhi.org X 1962 HI PROMOTE AND ENCOURAGE THE BETTERMENT OF THE GENERAL MEDICAL AND DENTAL HEALTH OF THE PUBLIC FOR THE COMMON GOOD AND GENERAL WELFARE OF THE COMMUNITY. 13 3 100 0 38443 37020 1000 875 176777429 177962143 3086674 7700909 -123396 55014 179741707 185718941 1214354 2094869 157970028 157009216 9065510 8389671 0 0 0 5043018 4407625 173292910 171901381 6448797 13817560 120539345 132075695 18010038 18416409 102529307 113659286 SEE SCHEDULE O. false false 165319693 2094869 177978714 TO PROMOTE AND ENCOURAGE THE BETTERMENT OF THE GENERAL MEDICAL AND DENTAL HEALTH OF THE PUBLIC OF THE COMMON GOOD AND GENERAL WELFARE OF THE COMMUNITY. SEE SCHEDULE O - FORM 990, PART III, LINE 4A FOR PROGRAM SERVICE ACCOMPLISHMENTS. 165319693 false false false false false false false false false true false false false true false false true false false false false false false false false false true false true false false false false false true true true false false false false false true true true false true 2675 0 true 100 true true true false false false false false X 13 3 false false false false true true true true true false false true true true true true true true true false X CHERYL TAKITANI-SMITH 8085211431 700 BISHOP STREET SUITE 700 HONOLULU HI 96813 T Kimo Blaisdell 1.0 X 0 0 0 Paul Chang 1.0 X 0 0 0 Norman S Chun 1.0 X 0 0 0 Harold J Dias Jr 1.0 X 0 0 0 Clay R Hiramoto 1.0 X 0 0 0 John I Kotake 1.0 X 0 0 0 Kim James Lawler 1.0 X 0 0 0 Susan A Li 1.0 X 0 0 0 Jodi Nakayama 1.0 X 0 0 0 Gary K Nakata 1.0 X 0 0 0 Garrett B K Oka 1.0 X 0 0 0 Michael J O'Malley 1.0 X 0 0 0 Casey Z Tamashiro 1.0 X 0 0 0 Patrick K Loo 1.0 X 0 0 0 Faye W Kurren 40.0 X 538642 0 295057 Kathy Fay 40.0 X 204006 0 41011 Cheryl Takitani-Smith 40.0 X 204456 0 39108 Tom Delaney 40.0 X 144582 0 36489 Robert Sherman 40.0 X 149988 0 32416 Paul Amog 40.0 X 131398 0 19910 Jim Johnson 40.0 X 125761 0 32302 Roque Aranador 40.0 X 117966 0 31492 1616799 0 527785 9 false true false Ernst Young LLP 55 Merchant Street 1900 HONOLULU HI 96813 Accounting services 245120 Strategic Communications 46078 Emepela Place K105 HONOLULU HI 96744 Advertising 519273 Watson Wyatt Co 10 Universal City Plaza 3500 UNIVERSAL CITY CA 91608 Broker 101898 Benefit Plan Solutions 680 Iwilei Road 528 HONOLULU HI 96817 Broker 218816 4 875 875 SUBSCRIPTIONS EARNED 621300 177962143 177962143 177962143 2325684 2325684 0 0 62780677 57405452 5375225 5375225 5375225 0 0 0 PROFESSIONAL SERVICES 621300 38443 38443 FMG - VA HERO 900099 332 332 All other revenue 900099 16239 16239 55014 185718941 177978714 38443 7700909 2094869 2094869 0 0 157009216 157009216 1187197 1187197 0 0 5087316 2856578 2230738 994946 470133 524813 719310 402214 317096 400902 189435 211467 0 110280 110280 143637 143637 15707 15707 0 389067 389067 77560 77560 479397 479397 661332 515308 146024 130051 48571 81480 0 546299 209511 336788 118261 32413 85848 0 14947 2638 12309 0 0 227732 227732 215772 159313 56459 COMMISSION FEES 826996 826996 DUES & SUBSCRIPTIONS 282570 282570 BANK CHARGES 77786 77786 BUSINESS DEVELOPMENT 30171 6106 24065 GENERAL EXCISE TAX 5190 5190 54870 16995 37875 171901381 165319693 6581688 0 38927065 30596440 12269056 11369284 1364643 1262698 5542069 5162425 488378 379644 67490203 88467629 120539345 132075695 5812616 6022413 1704499 2088890 10492923 10305106 18010038 18416409 X 102529307 113659286 102529307 113659286 120539345 132075695 X 13817560 -2687581 X false true true X false 1363581 1239839 123742 3317851 3072474 245377 860637 850112 10525 379644 0 CLAIMS PAYABLE TO DENTISTS 5748000 REFUNDABLE GROUP SUBSCRIPTIONS 4557106 10305106 true Aloha United Way 200 North Vineyard Blvd Suite 700 Honolulu HI 96817 990073494 501(C)(3) 11000 General support American Red Cross HI State Chapter 4155 Diamond Head Road Honolulu HI 96816 530196605 501(C)(3) 6000 GENERAL SUPPORT Children's Discovery Center 111 Ohe Street Honolulu HI 96813 990241632 501(C)(3) 5352 Oral Health Education Hawaii Dental Service Foundation 700 Bishop Street Suite 700 Honolulu HI 96813 990246999 501(C)(4) 2022571 Support organization's programs 3 1 Description of Organization's Procedures for Monitoring the Use of Grants Form 990, Schedule I THE PURPOSE OF THE GRANTS AWARDED BY HAWAII DENTAL SERVICE (HDS) ARE REVIEWED AND APPROVED BY HDS CEO EXCEPT FOR GRANTS TO HDS FOUNDATION, WHICH ARE APPROVED BY THE HDS BOARD OF DIRECTORS. HDS FOUNDATION CHAIR REPORTS ON THE USE OF GRANTS TO HDS BOARD OF DIRECTORS. OTHER GRANTS ARE AWARDED TO VARIOUS PUBLIC CHARITABLE ORGANIZATIONS TO SUPPORT THE EXEMPT FUNCTIONS OF THE ORGANIZATIONS AND ARE NOT MONITORED. X X X true true X X X X X false true false false false false false true false Faye W Kurren 378701 0 144000 0 15941 0 277556 0 17501 0 833699 0 0 0 Kathy Fay 154006 0 50000 0 0 0 21996 0 19015 0 245017 0 0 0 Cheryl Takitani-Smith 153806 0 50000 0 650 0 12228 0 26880 0 243564 0 0 0 Tom Delaney 135502 0 9080 0 0 0 22000 0 14489 0 181071 0 0 0 Robert Sherman 142945 0 7043 0 0 0 22000 0 10416 0 182404 0 0 0 Paul Amog 119731 0 0 0 11667 0 5933 0 13977 0 151308 0 0 0 Jim Johnson 117866 0 7895 0 0 0 12576 0 19726 0 158063 0 0 0 Supplemental Compensation Information SCHEDULE J, PART I, LINE 1A: HDS HAS A CORPORATE MEMBERSHIP IN A SOCIAL CLUB IN WHICH THE CLUB REQUIREMENTS DICTATE THAT AN INDIVIDUAL BE IDENTIFIED TO AUTHORIZE TRANSACTIONS. AS SUCH, HDS'S CEO HAS BEEN DESIGNATED AS THE AUTHORIZED INDIVIDUAL. ONLY BUSINESS TRANSACTIONS ARE ALLOWED AND SUBSTANTIATED BY PROPER DOCUMENTATION. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: CEO RECEIVES GROSS UP PAYMENTS FOR LIFE INSURANCE PREMIUMS OVER $50,000 AND PARKING OVER INTERNAL REVENUE SERVICE LIMITS. VP FINANCIAL AFFAIRS RECEIVES GROSS UP PAYMENT FOR PARKING EXCEEDING INTERNAL REVENUE SERVICE LIMITS. DIRECTOR OF UNDERWRITING RECEIVES A HOUSING ALLOWANCE. THE PAYMENT TO THE INDIVIDUALS ABOVE ARE INCLUDED IN THEIR W-2S AS COMPENSATION. SCHEDULE J, PART I, LINE 4B: ON DECEMBER 31, 2009, THE BOARD OF DIRECTORS APPROVED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) FOR HDS'S PRESIDENT & CEO, FAYE KURREN. THE EXPENSE RECOGNIZED FOR THE SERP AMOUNTED TO $255,556 IN 2010 DUE TO INCREASE IN THE NET PRESENT VALUE OF THE PROJECTED BENEFIT OBLIGATION FROM 1/1/2010 TO 12/31/2010 AND INCREASES IN DEFINED PLAN BENEFITS BASED ON QUALIFIED ASSUMPTIONS AS REVIEWED BY THE ACTUARIES AND INCLUDED IN THE ACTUARIAL REPORT. SCHEDULE J, PART I, LINE 7: HDS HAS AN INCENTIVE BONUS PLAN DETAILING THE BONUS CALCULATION WHEN THE COMPANY ACHIEVES CERTAIN PERFORMANCE STANDARDS AND STRATEGIC GOALS. BONUS AMOUNT VARIES EACH YEAR DEPENDING ON PERFORMANCE AND ACHIEVEMENT OF STRATEGIC GOALS. BONUS AMOUNT FOR OFFICERS ARE PRESENTED TO AND APPROVED BY THE BOD COMPENSATION COMMITTEE WHICH IS DOCUMENTED IN MINUTES. BONUS PAYMENTS FOR MANAGEMENT AND STAFF ARE CALCULATED BY HUMAN RESOURCES AND APPROVED BY OFFICERS. BONUS AND INCENTIVE COMPENSATION WAS PAID TO: FAYE W. KURREN 144,000 KATHY FAY 50,000 CHERYL TAKITANI-SMITH 50,000 TOM DELANEY 9,080 ROBERT SHERMAN 7,043 JIM JOHNSON 7,895 ROQUE ARANADOR 7,425 NORMAN S CHUN Director 450426 DENTAL SVCS TO HDS SUBSCRIBERS false John I Kotake Director 368779 DENTAL SVCS TO HDS SUBSCRIBERS false Kim James Lawler Director 282929 DENTAL SVCS TO HDS SUBSCRIBERS false Garrett B K Oka Director 196123 DENTAL SVCS TO HDS SUBSCRIBERS false Casey Tamashiro Director 294430 DENTAL SVCS TO HDS SUBSCRIBERS false T Kimo Blaisdell Officer is Dir. of HDS 550341 PREMIUM FOR DENTAL PLAN false Harold J Dias Jr Officer is Dir. of HDS 218705 PREMIUM FOR DENTAL PLAN false Paul Chang Officer is Dir. of HDS 1727718 PREMIUM FOR DENTAL PLAN false Susan Li Officer is Dir. of HDS 2816274 PREMIUM FOR DENTAL PLAN false Clay Hiramoto Director 101582 DENTAL SVCS TO HDS SUBSCRIBERS false Patrick K Loo Officer is Dir of HDS 286752 PREMIUM FOR DENTAL PLAN false ORGANIZATION'S MISSION STATEMENT FORM 990, PART I & PART III, LINE 1 HAWAII DENTAL SERVICE OPERATES FOR THE PROMOTION OF THE COMMON GOOD AND GENERAL WELFARE OF THE PEOPLE. ITS GOAL IS TO INNOVATE AND CONDUCT PROGRAMS FOR DENTAL CARE AND TO MAKE AVAILABLE, IN A BROAD SCALE, THE BENEFITS OF THE SCIENCE OF DENTISTRY TO MEMBERS OF THE PUBLIC. DENTAL COVERAGE IS AVAILABLE TO THE GENERAL PUBLIC AS HAWAII DENTAL SERVICE MAINTAINS AN ENROLLMENT POLICY THAT IS OPEN TO INDIVIDUALS AND FAMILIES, AS WELL AS SMALL AND LARGE GROUPS. IN ADDITION, HAWAII DENTAL SERVICE PROVIDES FUNDING TO HAWAII DENTAL SERVICE FOUNDATION THAT GRANTS ORGANIZATIONS WHICH HAVE PROGRAMS IN PLACE TO SUPPORT ORAL HEALTH INITIATIVES IN THE COMMUNITY. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A HAWAII DENTAL SERVICE (HDS) OFFERS AND ADMINISTERS DENTAL CARE PROGRAMS TO SUBSCRIBER GROUPS AND INDIVIDUALS THROUGHOUT THE STATE OF HAWAII. THE TERMS OF THE AGREEMENTS GENERALLY PROVIDE THAT THE SUBSCRIBER GROUPS OR INDIVIDUALS PAY HDS A STIPULATED AMOUNT, INCLUDING AN ADMINISTRATIVE FEE, WHICH IS USED TO PAY FOR DENTAL SERVICES AND EXPENSES OF ADMINISTERING THE DENTAL SERVICE CONTRACTS. IN ADDITION, HDS FUNDED $2,022,571 TO HDS FOUNDATION IN 2010 TO SUPPORT ORAL HEALTH INITIATIVES IN THE COMMUNITY. AUDITED FINANCIAL STATEMENTS FORM 990, PART IV, LINE 12B THE ORGANIZATION IS INCLUDED IN THE COMBINED AUDITED FINANCIAL STATEMENTS AND OTHER FINANCIAL INFORMATION OF HAWAII DENTAL SERVICE AND HAWAII DENTAL SERVICE FOUNDATION. THE AUDIT COMMITTEE, WHICH CONSISTS OF BOARD MEMBERS, SELECTS THE AUDITORS AND REVIEWS THE COMBINED AUDITED FINANCIAL STATEMENTS GOVERNANCE, MANAGEMENT AND DISCLOSURE SECTION A. GOVERNING BODY AND MANAGEMENT FORM 990, PART VI, LINE 6 MEMBERSHIP IN THE CORPORATION IS COMPRISED OF DENTIST AND PUBLIC MEMBERS. DENTIST MEMBERSHIP IS AVAILABLE TO ALL DENTISTS AND DENTAL SURGEONS WHO HAVE BEEN DULY LICENSED TO PRACTICE IN THE STATE OF HAWAII BY THE BOARD OF DENTAL EXAMINERS OF THE STATE OF HAWAII. APPLICATION IS MADE IN WRITING AND APPROVED BY THE BOARD OF DIRECTORS. CERTAIN ORGANIZATIONS (COMPANIES, ORGANIZATIONS, OR ENTITIES CONTRACTING WITH HDS FOR DENTAL BENEFITS FOR AT LEAST 2 CONSECUTIVE YEARS WITH MORE THAN 100 OR MORE ELIGIBLE SUBSCRIBERS AT THE TIME OF SUCH DESIGNATION) ARE INVITED TO BECOME PUBLIC MEMBERS AND APPROVED BY THE BOARD OF DIRECTORS. BOTH MEMBERSHIPS OF THE CORPORATION MAY AT ANY TIME DEPOSE OR REMOVE FROM OFFICE ANY DIRECTOR, WITH OR WITHOUT CAUSE, EXCEPT AS SUCH REMOVAL WOULD BE CONTRARY TO LAW. ELECT BOARD MEMBERS FORM 990, PART VI, LINE 7A DENTISTS AND PUBLIC MEMBERS RESPECTIVELY ELECT DENTISTS AND PUBLIC DIRECTORS TO THE BOARD OF DIRECTORS FOR A THREE YEAR TERM. DUE TO STAGGERED TERMS 1/3 OF DIRECTORS ARE ELECTED ANNUALLY. APPROVAL OF DECISIONS FORM 990, PART VI, LINE 7B AMENDMENTS TO THE BYLAWS REQUIRE APPROVAL OF NOT LESS THAN A MAJORITY OF EACH CLASS OF MEMBERSHIP. SECTION B. POLICIES APPROVED COPY OF FORM 990 FORM 990, PART VI, LINE 11B THE RETURN IS THOROUGHLY REVIEWED BY THE CONTROLLER PRIOR TO FINAL REVIEW WITH THE VP-FINANCIAL AFFAIRS AND PRESIDENT. A COPY OF FORM 990 IS PROVIDED TO BOARD OF DIRECTORS PRIOR TO FILING. WRITTEN CONFLICT OF INTEREST POLICY FORM 990, PART VI, LINE 12C PURSUANT TO THE HDS CONFLICTS OF INTEREST POLICY, EMPLOYEES AND DIRECTORS OF HDS ARE PROVIDED WITH THE CONFLICTS OF INTEREST POLICY AND ARE REQUIRED TO SUBMIT A CONFLICTS OF INTEREST DISCLOSURE STATEMENT ANNUALLY. COMPLIANCE DEPARTMENT REVIEWS THE ANNUAL CONFLICTS OF INTEREST DISCLOSURE STATEMENTS AND REPORTS POTENTIAL CONFLICTS OF INTERESTS TO THE HDS BOARD OF DIRECTORS. THE BOARD OF DIRECTORS ARE NOT ALLOWED TO PARTICIPATE IN DELIBERATIONS OR VOTE ON ISSUES/TRANSACTIONS WHICH THEY HAVE A CONFLICT OF INTEREST. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, LINE 15A & 15B COMPENSATION FOR OFFICERS ARE DETERMINED BASED ON ADVICE FROM AN INDEPENDENT COMPENSATION CONSULTANT WHO USES DELTA DENTAL PLANS ASSOCIATION SURVEY AND THE HAWAII EMPLOYERS COUNCIL SURVEYS FOR COMPARABLE POSITIONS. THE INDEPENDENT CONSULTANT ALSO USES THEIR OWN COMPENSATION SURVEY AS APPROPRIATE TO PROVIDE ADVICE. OFFICER COMPENSATION IS PRESENTED TO AND APPROVED BY THE BOD COMPENSATION COMMITTEE. AMOUNTS ARE DOCUMENTED IN MINUTES AND HUMAN RESOURCE DEPARTMENT RECONCILES THE PAYMENT AT END OF EACH YEAR. COMPENSATION FOR MANAGEMENT AND STAFF POSITIONS ARE EVALUATED AND DETERMINED BASED ON HAWAII EMPLOYERS COUNCIL SURVEYS AND APPROVED BY THE PRESIDENT AND CEO ANNUALLY. SECTION C. DISCLOSURE PUBLIC DISCLOSURE OF ORGANIZATION GOVERNING DOCUMENTS FORM 990, PART VI, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 5 CHANGES IN FUND BALANCE NOT REPORTED ON FORM 990: PENSION ADJUSTMENT (285,795) UNREALIZED GAIN (1,892,052) EQUITY EARNINGS IN HEALTHENTIC (509,734) TOTAL (2,687,581) TIME DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII, SECTION A HAWAII DENTAL SERVICE FOUNDATION JOHN KOTAKE 1.0 HOUR JODI NAKAYAMA 1.0 HOUR GARRETT OKA 1.0 HOUR CHERYL TAKITANI-SMITH 1.0 HOUR FAYE KURREN 1.0 HOUR SUSAN LI 1.0 HOUR Hawaii Dental Service Foundation 700 Bishop Street Suite 700 Honolulu HI 96813 990246999 SUPPORT COMM. HI 501(c)(4) N/A NA false true false false false false false false false false false false false false true false false false HAWAII DENTAL SERVICE FOUNDATION B 2022571