Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Members and Stockholders | Part VI, Sec A, Lines 6-7 | The organization's directors act as the organization's one class of members, designated Members, and elect new members who automatically become directors. The Members also must approve any changes to specified Bylaws provisions. |
| Process used to review Form 990 | Part VI, Sec B, Line 11 | The organization's CFO and legal counsel oversee the completion of the Form 990, and review it prior to filing with the President/CEO and with the Delta Dental of Pennsylvania Audit Committee to which such duties have been delegated. |
| Compliance with conflict of interest policy | Part VI, Sec B, Line 12c | Each director is required to complete a Conflict of Interest Disclosure Statement annually, and between annual statements is required to disclose any new position or relationship formed that potentially raises a conflict of interest. Legal counsel reviews these disclosures and reports the information to the full board of directors. |
| Written documentation and destruction policy | Part VI, Sec B, Line 14 | A draft document retention and destruction policy is under consideration pending the testing of associated software being installed for management of electronic records. |
| Process for determining compensation | Part VI, Sec B, Lines 15a and b | Compensation paid to the CEO, which is paid through a contractual agreement with Dentegra Group, Inc. ("DGI"), is reviewed and approved by the DGI directors. Vice presidents' compensation is either approved by the President or in accordance with the procedure of Delta Dental of California by whom they are employed. All compensation for the ensuing year is only approved after reviewing comparability data presented by an outside compensation consultant, an assessment of each officer's performance over the preceding year and the organization's program accomplishments for the year. This process was followed for 2010 compensation. |
| Process for making documents available to the public | Part VI, Sec C, Line 19 | The organization annually includes major portions of its financial statement in a published annual report that is made available to persons or entities known to have an interest in the organization, and is available to the larger public upon request. Statutory financial statements are included in quarterly and annual returns to state Departments of Insurance regulating the organization which returns are available to the public. The organization does not make its governing documents or conflict of interest policy available to the public. |
| Delta Dental Enterprise | Form 990, Part VII; Schedule J; Schedule R | The organization, regulated by the West Virginia Offices of the Insurance Commissioner, is a member of the Delta Dental of California enterprise companies, which include Delta Dental of California, Delta Dental of Pennsylvania and affiliated companies operating in 15 states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands. The enterprise companies comprise one of the nation's largest dental benefits delivery systems covering 24.2 million enrollees and handling 36 million claims. Total revenue for the enterprise exceeded $6.3 billion in 2010. The organization represents less than 1% of total enterprise revenues. |
| Other Changes in Net Assets | Part XI, Line 5 | Net unrealized gains (losses) on investments. |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Gary D. Radine TITLE:President HOURS:59 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Anthony S. Barth TITLE:Chief Operating Officer HOURS:49 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Roy M. Hilliard TITLE:VP, Sales HOURS:49 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Renee A. Fisher TITLE:VP, Quality Assurance & Train. HOURS:49 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Philip N. Engle TITLE:V.P., Information Tech. HOURS:49 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Michael J. Castro TITLE:Chief Financial Officer HOURS:49 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Jeanne M. Foster TITLE:Vice President, Finance HOURS:49 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Richard C. Graybill TITLE:V.P. Underwriting & Actuarial HOURS:49 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Charles Lamont, Esq. TITLE:Chief Legal Officer HOURS:49 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Karen L. Robinson TITLE:Assistant Secretary HOURS:49 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Whitney H. Sherbocker TITLE:Assistant Secretary HOURS:49 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Alicia F. Weber TITLE:Sr. VP/Controller HOURS:49 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Patrick S. Steele TITLE:Chief Information Officer HOURS:49 |
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