Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Amended Explanation | SUPERSEDED/AMENDED RETURN WAS PREPARED TO TIMELY ATTACH DOCUMENT CORRECTION REQUIRED BY REVENUE NOTICE 2010-6.SEE ATTACHED NOTICE | |
| Form 990, Part VI, Line 19 | Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | ALL DOCUMENTS AND POLICIES ARE AVAILABLE UPON REQUEST. |
| Form 990, Part VI, Line 15b | Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | Delta 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 12c | Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | AT 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 11 | Form 990, Part VI, Line 11: Form 990 Review Process | AT 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 7a | Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | ALL MEMBER DENTISTS ARE INVITED TO THE ANNUAL MEETING AND IF PRESENT, HAVE ONE VOTE. |
| Form 990, Part VI, Line 6 | Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | DENTISTS LICENSED IN SOUTH DAKOTA THAT PAY A ONE-TIME MEMEBERSHIP DUES. |
| Client Note 2 - 409A DOCUMENT CORRECTION UNDER IV AND V OF NOTICE 2010-61. The name and taxpayer identification number of each service provider affected by the document failure: Scott Jones SSN: 504-68-50302. Identification of Nonqualified Deferred Compensation Plan: Amended Supplemental Employment Agreement with Scott Jones.3. The document failures are eligible for correction under the terms of Notice 2010-6. The document failures were corrected under IV and V of Notice of 2010-6. Delta Dental Plan of South Dakota has taken all actions required and otherwise met all requirements for such correction as of the last day of its taxable year in which the correction was made, and also as of the last day of any subsequent taxable year of Scott Jones during which an amount, if any, is required to be included in income under 409A by Scott Jones as part of the correction. The date of correction was December 30, 2010 and there was no event causing the inclusion of an amount in income under 409A.4. Scott Jones has not included any income under 409A as part of this correction. The amount involved in each document failure was $534,898.00.DELTA DENTAL PLAN OFSOUTH DAKOTAEIN: 46-0309258 | ||
| Client Note 1 - PAGE 10PART IX STATEMENT OF FUNCTIONAL EXPENSESLINE 22 DEPRECIATION (A)TOTAL (C)MANAGEMENT AND GENERALBUILDINGS STRAIGHT-LINE 28 YEARS $103,736 $103,736 MACHINERY & EQUIPMENT STRAIGHT-LINE 5-10 YEARS 180,788 180,788FURNITURE & FIXTURES STRAIGHT-LINE 5-10 YEARS 57,104 57,104TOTAL DEPRECIATION $341,628 $341,628PAGE 9PART VIII STATEMENT OF REVENUELINE 6B RENTAL EXPENSES DEPRECIATION BUILDINGS AND IMPROVEMENTS $31,949 |
| Software ID: | 10000105 |
| Software Version: | 2010v3.2 |