Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 01-01-2014 , and ending 12-31-2014
BCheck if applicable:
CName of organization
DENTAL SERVICE OF MASSACHUSETTS INC
 
Doing business as
DELTA DENTAL OF MASSACHUSETTS
 
Number and street (or P.O. box if mail is not delivered to street address)
465 MEDFORD STREET
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
BOSTON, MA02129
D Employer identification number

04-6143185
E Telephone number

G Gross receipts $ 390,280,866
F Name and address of principal officer:
STEVEN J POLLOCK
465 MEDFORD STREET
BOSTON,MA02129
I
Tax-exempt status: ( 4 ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.DELTADENTALMA.COM
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1966
M State of legal domicile: MA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO IMPROVE THE ORAL HEALTH OF ALL.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 11
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 9
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 0
6 Total number of volunteers (estimate if necessary) ............. 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 15,763
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 14,763
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 293,998,057 300,336,361
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 585,184 10,004,150
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 294,583,241 310,340,511
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 3,700,000 5,000,000
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 179,087,254 185,806,976
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 396,500 389,414
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 78,125,805 91,575,105
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 261,309,559 282,771,495
19 Revenue less expenses. Subtract line 18 from line 12....... 33,273,682 27,569,016
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 563,233,177 614,422,026
21 Total liabilities (Part X, line 26)............. 108,196,256 104,665,753
22 Net assets or fund balances. Subtract line 21 from line 20..... 455,036,921 509,756,273
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2014)
Form 990 (2014)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: IMPROVE THE ORAL HEALTH OF ALL.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 260,721,362 including grants of $ 5,000,000 ) (Revenue $ 300,336,361 )
DENTAL SERVICE OF MASSACHUSETTS, INC. (DSM) D/B/A DELTA DENTAL OF MASSACHUSETTS IS A NOT-FOR-PROFIT DENTAL SERVICE ORGANIZATION WITH A MISSION TO IMPROVE THE ORAL HEALTH OF ALL. DSM AND ITS SUBSIDIARIES' ACTIVITIES INCLUDE, BUT ARE NOT LIMITED TO, SECURING DENTAL SERVICES FOR EMPLOYEE GROUPS, INDIVIDUALS AND THEIR FAMILIES; PROVIDING INNOVATIVE PRODUCTS AND SERVICES; FINANCE AND DEVELOP PROFESSIONAL AND SCIENTIFIC STUDY AND RESEARCH; AND EDUCATE THE PUBLIC CONCERNING THE IMPORTANCE OF ORAL HEALTH. SEE SCHEDULE O
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet260,721,362
Form 990 (2014)
Form 990 (2014)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A........................
1
 
No
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II........
4
 
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2014)
Form 990 (2014)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I.... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................ Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
Yes
 
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV..................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
57,221
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
0
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
 
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
 
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
 
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2014)
Form 990 (2014)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
11
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
9
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
 
No
14
Did the organization have a written document retention and destruction policy? .........
14
 
No
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
MA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletJAMES E COLLINS
465 MEDFORD STREET
BOSTON,MA02129 (617) 886-1000
Form 990 (2014)
Form 990 (2014)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Edward A Hjerpe III........................................................................
Chairman / Director
 5.0
.......................0.0 		X           72,000 0 0
(2) Pamela DA Reeve........................................................................
Vice Chair (3/14-12/14)/DIR.
 3.5
.......................0.5 		X           35,500 8,000 0
(3) Anne Page Palmer........................................................................
Vice Chair (1/14-3/14)/DIR.
 3.5
.......................0.5 		X           39,584 0 0
(4) Colleen D Baldwin........................................................................
Director (3/14-12/14)
 3.5
.......................0.5 		X           23,891 0 0
(5) Thomas J Galligan III........................................................................
Director
 3.5
.......................1.0 		X           31,084 12,000 0
(6) Raul I Garcia........................................................................
Director
 3.5
.......................0.0 		X           33,822 0 0
(7) Linda J Hall........................................................................
Director (3/14-12/14)
 3.5
.......................0.5 		X           22,391 0 0
(8) Karen Kaplan........................................................................
Director (1/14-3/14)
 3.5
.......................0.5 		X           3,000 0 0
(9) Donald J Kenney........................................................................
Director
 3.5
.......................0.5 		X           46,072 0 0
(10) Roderick K King........................................................................
Director
 3.5
.......................0.5 		X           25,822 8,000 0
(11) Donald R LeClair........................................................................
Director
 3.5
.......................0.5 		X           41,663 8,689 0
(12) Linda C Niessen........................................................................
Director (1/14-2/14)
 3.5
.......................0.0 		X           0 0 0
(13) Robert J Weyant........................................................................
Director (3/14-12/14)
 3.5
.......................0.0 		X           14,584 6,000 0
(14) Fay Donohue........................................................................
President
 9.0
.......................31.0 		X   X       0 3,250,994 3,560,314
(15) James E Collins........................................................................
Treasurer
 9.0
.......................31.0 		    X       0 936,603 721,533
(16) David Abelman........................................................................
Clerk
 9.0
.......................31.0 		    X       0 463,282 217,944
(17) Gregory P Winn........................................................................
Assistant Treasurer - DSM
 9.0
.......................31.0 		    X       0 255,303 106,574
Form 990 (2014)
Form 990 (2014)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Steven J Pollock........................................................................
COO - DENTAQUEST
 9.0
.......................31.0 		      X     0 1,776,091 1,116,324
(19) Dennis Leonard........................................................................
SVP - DentaQuest
 9.0
.......................31.0 		      X     0 1,083,919 731,955
(20) Robert D Compton........................................................................
EXEC.DIR. - DQ ORAL HEALTH CTR
 9.0
.......................31.0 		        X   0 1,067,636 346,234
(21) Robert E Lynn........................................................................
SVP - DentaQuest
 9.0
.......................31.0 		        X   0 895,577 517,348
(22) Sheryl Traylor........................................................................
SVP - HUMAN RES. DENTAQUEST
 9.0
.......................31.0 		        X   0 489,049 749,819
(23) Kenneth P Erdelt........................................................................
SVP - OPERATIONS DENTAQUEST
 9.0
.......................31.0 		        X   0 550,979 659,967
(24) John Luther........................................................................
SVP - CHIEF DENTAL OFFICER
 9.0
.......................31.0 		        X   0 539,440 260,607
(25) James Hawkins FMR CLK........................................................................
CURR. VP & DEP. GEN. COUNSEL
 9.0
.......................31.0 		          X 0 322,740 204,215
(26) Margaret AWingFMR CLK........................................................................
CURR. DIR. OF GOVERNANCE
 9.0
.......................31.0 		          X 0 286,599 161,217








1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 389,413 11,960,901 9,354,051
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet0
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
Gentle Dental Associates LLC,
200 5th Ave 3rd Floor
WALTHAM,MA02451 		DENTAL SERVICES 10,772,383
Great Hill Dental Partners,
1610 Tremont Street
BOSTON,MA02120 		DENTAL SERVICES 4,567,509
Chestnut Dental Associates PC,
87 Chestnut Street
NEEDHAM,MA02492 		DENTAL SERVICES 4,101,909
President and Fellows of Harvard Co,
188 Longwood Avenue
BOSTON,MA02115 		DENTAL SERVICES 3,740,450
Mass General Physician Organization,
MGH DENTAL GROUP 165 Cambridge Str
BOSTON,MA02114 		DENTAL SERVICES 2,714,596
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet870
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 0
Program Service RevenueAmt Business Code
2a REVENUE FROM DENTAL SERVICE PLAN 900099 243,948,648 243,948,648    
b ASO ADMINISTRATIVE SERVICE 900099 56,387,713 56,387,713    
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 300,336,361
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 3,319,302   15,763 3,303,539
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss) 0 0
d Net rental income or (loss).......MediumBullet 0      
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 86,460,424 164,779
b Less: cost or other basis and sales expenses 79,940,355  
c Gain or (loss) 6,520,069 164,779
d Net gain or (loss)..........MediumBullet 6,684,848     6,684,848
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 0
12 Total revenue. See Instructions......MediumBullet 310,340,511 300,336,361 15,763 9,988,387
Form 990 (2014)
Form 990 (2014)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 5,000,000 5,000,000
2 Grants and other assistance to domestic individuals. See Part IV, line 22 .... 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............ 0  
4 Benefits paid to or for members .... 185,806,976 185,806,976
5 Compensation of current officers, directors, trustees, and key employees .... 389,414 389,414    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages .... 0      
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 0      
9 Other employee benefits ....... 0      
10 Payroll taxes ........... 0      
11 Fees for services (non-employees):        
a Management ...... 52,719,453 43,388,794 9,330,659  
b Legal ......... 0      
c Accounting ........... 170,004   170,004  
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 1,083,892   1,083,892  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 306,750 122,700 184,050  
12 Advertising and promotion .... 5,474 2,190 3,284  
13 Office expenses ....... 119 48 71  
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 0      
17 Travel ............ 17,893 7,157 10,736  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 115,374 46,150 69,224  
20 Interest ........... 142,443 56,976 85,467  
21 Payments to affiliates ....... 12,495,630 6,675,062 5,820,568  
22 Depreciation, depletion, and amortization ..... 8,247,315 3,298,926 4,948,389  
23 Insurance .............. 0      
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a Commissions 11,316,776 11,316,776   0
b Subscriptions and Dues 572,982 229,193 343,789  
c PREMIUM TAXES 3,792,883 3,792,883 0  
d ACA FEE & OTHER 588,117 588,117 0 0
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 282,771,495 260,721,362 22,050,133 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2014)
Form 990 (2014)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 0 1 0
2 Savings and temporary cash investments ......... 47,100,253 2 11,029,721
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 13,793,113 4 6,780,666
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 8,750,000 7 8,750,000
8 Inventories for sale or use .............. 0 8 0
9 Prepaid expenses and deferred charges .......... 142,016 9 263
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 77,517,336
b Less: accumulated depreciation ..... 10b 33,347,962 35,879,455 10c 44,169,374
11 Investments—publicly traded securities .......... 277,443,109 11 324,434,931
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 ..... 0 13 0
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 180,125,231 15 219,257,071
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 563,233,177 16 614,422,026
Liabilities 17 Accounts payable and accrued expenses ......... 4,886,075 17 12,088,406
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 0 19 0
20 Tax-exempt bond liabilities ............. 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 103,310,181 25 92,577,347
26 Total liabilities. Add lines 17 through 25......... 108,196,256 26 104,665,753
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 455,036,921 27 509,756,273
28 Temporarily restricted net assets ........... 0 28 0
29 Permanently restricted net assets ........... 0 29 0
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 455,036,921 33 509,756,273
34 Total liabilities and net assets/fund balances ........ 563,233,177 34 614,422,026
Form 990 (2014)
Form 990 (2014)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
310,340,511
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
282,771,495
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
27,569,016
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
455,036,921
5
Net unrealized gains (losses) on investments ...............
5
688,299
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
26,462,037
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
509,756,273
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? .................
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
DENTAL SERVICE OF MASSACHUSETTS INC
 
Employer identification number

04-6143185
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................        
c Leasehold improvements ............   9,054 8,299 755
d Equipment ................   9,476,101 2,141,159 7,334,942
e Other .................   68,032,181 31,198,504 36,833,677
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 44,169,374
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) INVESTMENT IN SUBSIDIARIES 154,951,234
(2) Cost Reimbursement 64,305,837







Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 219,257,071
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
Unpaid Claims 34,746,361
Group Experience Refunds 7,270,010
Unearned Premium 3,804,274
Advance Deposits 45,135,285
Payable for Open Trade 1,621,417




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 92,577,347
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
FIN 48/ASC 740 DISCLOSURE THERE IS NO FIN 48/ASC 740 FOOTNOTE. HOWEVER, THE FOLLOWING DISCLOSURE WAS MADE: THE COMPANY DETERMINES WHETHER A TAX POSITION OF THE COMPANY IS MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTION OF ANY RELATED APPEALS OF LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS OF THE POSITION. FOR TAX POSITIONS MEETING THE MORE LIKELY THAN NOT THRESHOLD, THE TAX AMOUNT RECOGNIZED IN THE FINANCIAL STATEMENTS IS REDUCED BY THE LARGEST BENEFIT THAT HAS A GREATER THAN FIFTY PERCENT LIKELIHOOD OF BEING REALIZED UPON THE ULTIMATE SETTLEMENT WITH THE RELEVANT TAXING AUTHORITY.
Schedule D (Form 990) 2014

Additional Data


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Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
DENTAL SERVICE OF MASSACHUSETTS INC
 
Employer identification number

04-6143185
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants
and other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria
used to award the grants or assistance? ...........................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total expenditures
for and investments
in region
Central America and the Caribbean 0 0 Investments   9,140,545
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 0 0 9,140,545
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b) 0 0 9,140,545
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (a)(c) Region (b)(d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
 
3
Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; do not file with Form 990)............................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)...............................................
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713; do not file with Form 990).....................................
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2014
Additional Data


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Software Version:  



Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
DENTAL SERVICE OF MASSACHUSETTS INC
 
Employer identification number
04-6143185
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) DentaQuest Foundation Inc
465 Medford Street
Boston,MA02129 		04-3265080 501(c)(3) 5,000,000       UNRESTRICTED ORAL HEALTH IMPROVEMENT






















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
2
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Description of Organization's Procedures for Monitoring the Use of Grants DSM PROVIDES GRANTS ONLY TO RELATED ORGANIZATIONS WHO ARE EXEMPT FROM UNDER INTERNAL REVENUE CODE SECTION 501(C)(3).
Schedule I (Form 990) 2014


Additional Data


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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
DENTAL SERVICE OF MASSACHUSETTS INC
 
Employer identification number

04-6143185
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
Yes
 
b
Any related organization? .........................
5b
Yes
 
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
Yes
 
b
Any related organization? .........................
6b
Yes
 
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1Fay DonohuePresident (i)
(ii)		 0
...............................
704,342 		0
...............................
614,000 		0
...............................
1,932,652 		0
...............................
3,546,924 		0
...............................
13,390 		0
...............................
6,811,308 		0
...............................
1,932,652
2James E CollinsTreasurer (i)
(ii)		 0
...............................
379,043 		0
...............................
198,135 		0
...............................
359,425 		0
...............................
702,911 		0
...............................
18,622 		0
...............................
1,658,136 		0
...............................
359,425
3David AbelmanClerk (i)
(ii)		 0
...............................
363,737 		0
...............................
52,935 		0
...............................
46,610 		0
...............................
199,357 		0
...............................
18,587 		0
...............................
681,226 		0
...............................
46,610
4Gregory P WinnAssistant Treasurer - DSM (i)
(ii)		 0
...............................
183,842 		0
...............................
54,359 		0
...............................
17,102 		0
...............................
88,361 		0
...............................
18,213 		0
...............................
361,877 		0
...............................
17,102
5Steven J PollockCOO - DENTAQUEST (i)
(ii)		 0
...............................
439,963 		0
...............................
256,865 		0
...............................
1,079,263 		0
...............................
1,097,587 		0
...............................
18,737 		0
...............................
2,892,415 		0
...............................
1,079,263
6Dennis LeonardSVP - DentaQuest (i)
(ii)		 0
...............................
315,164 		0
...............................
147,460 		0
...............................
621,295 		0
...............................
719,299 		0
...............................
12,656 		0
...............................
1,815,874 		0
...............................
621,295
7Robert D ComptonEXEC.DIR. - DQ ORAL HEALTH CTR (i)
(ii)		 0
...............................
246,350 		0
...............................
73,596 		0
...............................
747,690 		0
...............................
338,955 		0
...............................
7,279 		0
...............................
1,413,870 		0
...............................
747,690
8Robert E LynnSVP - DentaQuest (i)
(ii)		 0
...............................
344,453 		0
...............................
148,880 		0
...............................
402,244 		0
...............................
498,803 		0
...............................
18,545 		0
...............................
1,412,925 		0
...............................
402,244
9Sheryl TraylorSVP - HUMAN RES. DENTAQUEST (i)
(ii)		 0
...............................
290,301 		0
...............................
129,975 		0
...............................
68,773 		0
...............................
742,444 		0
...............................
7,375 		0
...............................
1,238,868 		0
...............................
68,773
10Kenneth P ErdeltSVP - OPERATIONS DENTAQUEST (i)
(ii)		 0
...............................
269,266 		0
...............................
118,160 		0
...............................
163,553 		0
...............................
641,579 		0
...............................
18,388 		0
...............................
1,210,946 		0
...............................
163,554
11John LutherSVP - CHIEF DENTAL OFFICER (i)
(ii)		 0
...............................
323,768 		0
...............................
136,390 		0
...............................
79,282 		0
...............................
242,108 		0
...............................
18,499 		0
...............................
800,047 		0
...............................
79,282
12James Hawkins FMR CLKCURR. VP & DEP. GEN. COUNSEL (i)
(ii)		 0
...............................
233,918 		0
...............................
71,720 		0
...............................
17,102 		0
...............................
185,896 		0
...............................
18,319 		0
...............................
526,955 		0
...............................
17,102
13Margaret AWingFMR CLKCURR. DIR. OF GOVERNANCE (i)
(ii)		 0
...............................
151,215 		0
...............................
34,949 		0
...............................
100,435 		0
...............................
143,059 		0
...............................
18,158 		0
...............................
447,816 		0
...............................
100,435
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, QUESTION 1A THE CHIEF EXECUTIVE OFFICER/PRESIDENT MAY TRAVEL FIRST CLASS FOR ALL BUSINESS FLIGHTS. ALL OTHER OFFICERS OF A SR. VICE PRESIDENT LEVEL OR GREATER MAY TRAVEL FIRST CLASS ON DOMESTIC FLIGHTS OF FOUR HOURS OR GREATER OF CONTINUOUS DURATION. ALL BUSINESS RELATED TRAVEL IS NOT TAXED. SOCIAL CLUB DUES, IF ANY, ARE BUSINESS IN NATURE. BECAUSE THESE DUES ARE BUSINESS RELATED, ANY DUES ARE NOT TREATED AS TAXABLE INCOME TO THE INDIVIDUAL. THE ABOVE ITEMS WERE PAID THROUGH DENTAQUEST, LLC, A RELATED ORGANIZATION. COMPENSATION CONTINGENT ON REVENUE SCHEDULE J, PART I, QUESTION 5 DENTAQUEST, LLC SPONSORS A TARGET INCENTIVE PLAN THAT ALLOWS PARTICIPANTS ANNUALLY TO EARN A THRESHOLD, TARGET OR SUPERIOR INCENTIVE (AS A PERCENT OF THEIR BASE SALARY). THE ACTUAL INCENTIVE TO BE AWARDED IS BASED ON THE ACHIEVEMENT OF PERFORMANCE GOALS THAT ARE SET AT THE BEGINNING OF THE YEAR BY THE COMPENSATION COMMITTEE AS PART OF THE ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY AND PAY-FOR-PERFORMANCE PHILOSOPHY. AMONG THE PERFORMANCE GOALS ARE A REVENUE GOAL, A NET INCOME GOAL AND A MEMBERSHIP GOAL. EACH PARTICIPANT IN THE TARGET INCENTIVE PLAN HAS A MAXIMUM INCENTIVE THAT CAN BE EARNED REGARDLESS OF THE ATTAINMENT OF THE REVENUE, NET INCOME AND/OR MEMBERSHIP GOALS. THE MAXIMUM INCENTIVE OPPORTUNITY FOR EACH PARTICIPANT IS SET SO THAT THE PARTICIPANT'S TOTAL POSSIBLE COMPENSATION IS REASONABLE FOR PURPOSES OF INTERMEDIATE SANCTIONS, SECTION 4958 OF THE INTERNAL REVENUE CODE. COMPENSATION CONTINGENT ON NET EARNINGS SCHEDULE J, PART I, QUESTION 6 & 7 NON-FIXED PAYMENTS: THE COMPANY PROVIDES ANNUAL INCENTIVE BONUSES TO MANAGEMENT EMPLOYEES THAT ARE CALCULATED BASED ON THE PERFORMANCE OF THE COMPANY AND THE INDIVIDUAL EMPLOYEE. THE PROCESS TO ESTABLISH THE PRESUMPTION THAT COMPENSATION PAID TO THE ORGANIZATION'S CEO AND OTHER TOP MANAGEMENT WAS REASONABLE AS DESCRIBED IN SECTION 4958. THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS APPROVES THE OVERALL ANNUAL INCENTIVE BONUS POOL AND REVIEWS AND APPROVES COMPENSATION RELEVANT TO EXECUTIVE OFFICERS REPORTING TO THE COMPANY'S CEO. THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS AND MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS ON COMPENSATION MATTERS FOR THE COMPANY'S CEO. THE BOARD OF DIRECTORS APPROVES THE COMPENSATION OF THE COMPANY'S CEO. LONG-TERM INCENTIVE COMPENSATION: THE FOLLOWING DSM AND DENTAQUEST,LLC EMPLOYEES PARTICIPATE IN THE DENTAQUEST,LLC LONG-TERM INCENTIVE COMPENSATION PLAN AND RECEIVED THE PAYMENTS LISTED BELOW DURING 2014: FAY DONOHUE $1,932,652 JAMES E. COLLINS $359,425 DAVID ABELMAN $46,610 GREGORY P. WINN $17,102 STEVEN J. POLLOCK $1,079,263 DENNIS LEONARD $621,295 ROBERT D. COMPTON $747,690 ROBERT E. LYNN $402,244 SHERYL TRAYLOR $68,773 KENNETH P. ERDELT $163,554 JOHN LUTHER $79,282 JAMES HAWKINS $17,102 MARGARET A. WING $100,435 LONG-TERM INCENTIVE COMPENSATION PLAN PAYMENTS ARE BASED ON THE VALUATION OF THE COMPANY, DENTAQUEST, LLC, AND ARE PAID OUT OVER A FIVE YEAR PERIOD. PAYMENTS ARE MADE ANNUALLY AND PARTICIPANTS RECEIVE PAYOUTS FOR ALL VESTED BALANCES. THE ELIGIBLE LISTED EMPLOYEES OVER $250,000 AS OF 12/31/2014 PARTICIPATE IN A 457(B) SUPPLEMENTAL RETIREMENT PLAN. OF THOSE ELIGIBLE EMPLOYEES, NO ONE RECEIVED ANY PAYMENTS IN 2014. SCHEDULE J, PART II COMPENSATION PAID BY RELATED ORGANIZATION: SCHEDULE J, PART II INCLUDES INDIVIDUALS THAT ARE PAID BY DENTAQUEST, LLC, A RELATED ORGANIZATION, BUT PERFORM SERVICES FOR BOTH DENTAQUEST, LLC AND DENTAL SERVICE OF MASSACHUSETTS, INC., THE FILING ORGANIZATION. BONUS PAYMENTS SCHEDULE J, PART II, COLUMN B(II) COLUMN B(II) ON SCHEDULE J PART II INCLUDES BONUSES EARNED AND ACCRUED DURING 2013, BUT PAID IN 2014. OTHER REPORTABLE COMPENSATION SCHEDULE J, PART II, COLUMN B(III) COLUMN B(III) OTHER REPORTABLE COMPENSATION REPRESENTS LONG-TERM INCENTIVE COMPENSATION EXPENSE EARNED PRIOR TO 2014, BUT PAID DURING 2014. DEFERRED COMPENSATION SCHEDULE J, PART II, COLUMN C COLUMN C ON SCHEDULE J PART II INCLUDES LONG-TERM INCENTIVE COMPENSATION AND PENSION AMOUNTS EARNED DURING 2014 BUT PAID IN FUTURE YEARS.
Schedule J (Form 990) 2014

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
DENTAL SERVICE OF MASSACHUSETTS INC
 
Employer identification number

04-6143185
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2014
Schedule L (Form 990 or 990-EZ) 2014
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) DONALD LECLAIR DIRECTOR 204,383 DENTAL CLAIMS   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
DENTAL SERVICE OF MASSACHUSETTS INC
 
Employer identification number

04-6143185
Return Reference Explanation
ORGANIZATION'S MISSION FORM 990, PART III, LINE 4A DELTA DENTAL OF MASSACHUSETTS IS A MEMBER OF THE DELTA DENTAL PLANS ASSOCIATION. DELTA DENTAL IS AMERICA'S LARGEST AND MOST TRUSTED DENTAL BENEFITS CARRIER, COVERING MORE AMERICANS THAN ANY OTHER DENTAL BENEFITS PROVIDER AND STRIVES DAILY TO MAKE DENTAL COVERAGE MORE ACCESSIBLE AND AFFORDABLE TO A WIDE VARIETY OF EMPLOYERS, GROUPS AND INDIVIDUALS. EXECUTIVE COMMITTEE PART VI, QUESTION 1A THE BOARD OF DIRECTORS FOR DENTAL SERVICE OF MASSACHUSETTS HAS AN EXECUTIVE COMMITTEE THAT IS AUTHORIZED TO ACT ON BEHALF OF THE BOARD ON ANY MATTERS REQUIRING PROMPT ACTION DURING ANY PERIOD WHEN IT IS IMPRACTICABLE TO CALL A MEETING OF THE BOARD OR A QUORUM OF THE BOARD IS NOT AVAILABLE. BUSINESS RELATIONSHIPS FORM 990, PART VI, LINE 2 FAY DONOHUE, JAMES E. COLLINS, DAVID ABELMAN, GREGORY P. WINN, STEVEN J. POLLOCK, DENNIS LEONARD, PAMELA D.A. REEVE, THOMAS J. GALLIGAN III, RODERICK K. KING, DONALD R. LECLAIR AND ROBERT J. WEYANT HAVE A BUSINESS RELATIONSHIP SINCE THEY JOINTLY SERVE AS OFFICERS OR DIRECTORS OF THE ORGANIZATION AND ONE OR MORE ITS SUBSIDIARIES. DELEGATE CONTROL OVER MANAGEMENT DUTIES FORM 990, PART VI, LINE 3 THE COMPANY HIRES DENTAQUEST, LLC (A RELATED PARTY) TO PROVIDE MANAGEMENT SERVICES. SIGNIFICANT CHANGES TO THE ORGANIZATION'S GOVERNING DOCUMENTS FORM 990, PART VI, LINE 4 DENTAL SERVICE OF MASSACHUSETTS, INC. AMENDED ITS BYLAWS DURING THE YEAR TO REMOVE THE REQUIREMENT THAT AT LEAST ONE-THIRD BUT LESS THAN ONE-HALF OF THE BOARD OF DIRECTORS SHALL BE MADE UP OF DENTISTS REGISTERED TO PRACTICE DENTISTRY IN THE COMMONWEALTH OF MASSACHUSETTS. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 6 THE ORGANIZATION HAS MEMBERS, THE MAJORITY OF WHICH ARE PERSONS WHO ARE NOT PROVIDERS OF HEALTH SERVICES LICENSED UNDER THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS. MEMBERSHIP RIGHTS FORM 990, PART VI, LINE 7A THE MEMBERS OF THE ORGANIZATION ELECT THE DIRECTORS AT THE ANNUAL MEETING OF THE ORGANIZATION. GOVERNANCE FORM 990, PART VI, QUESTION 7B A QUORUM OF THE ORGANIZATION'S MEMBERS MAY VOTE TO AMEND OR REPEAL THE BY-LAWS. REVIEW PROCESS FORM 990, PART VI, QUESTION 11B THE AUDIT COMMITTEE, A COMMITTEE OF THE DSM BOARD OF DIRECTORS, REVIEWS A FINAL FORM OF THE FORM 990 PRIOR TO ACTUAL FILING. MEMBERS OF THE EXTERNAL TAX FIRM (CURRENTLY ERNST & YOUNG U.S., LLP) INITIALLY DISCUSS, PREPARE AND REVIEW THE RETURN WITH MANAGEMENT. MANAGEMENT AND STAFF REVIEW THE 990 FOR ACCURACY AND COMPLETENESS AND PROVIDE COMMENTS TO THE PREPARER. ONCE THE RETURN IS FULLY ANALYZED AND PREPARED, A PAPER COPY IS DISTRIBUTED TO THE AUDIT COMMITTEE MEMBERS IN ADVANCE OF A SPECIFIC MEETING. AUDIT COMMITTEE MEMBERS REVIEW THE DRAFT FORM 990 AND THEN SEND TO THE FULL BOARD. A COPY OF THE FINAL FORM 990 IS SENT TO THE FULL BOARD AND OFFICERS BEFORE IT IS FILED. CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12C MONITORING THE ORGANIZATION'S CONFLICT OF INTEREST POLICY PROVIDES THAT ANNUALLY, EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS SHALL SIGN A QUESTIONNAIRE AFFIRMING THAT SUCH PERSON RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, READ AND UNDERSTANDS THE POLICY AND AGREES TO COMPLY WITH THE POLICY. ADDITIONALLY, THE SIGNED QUESTIONNAIRE AFFIRMS THAT THE PERSON UNDERSTANDS DENTAL SERVICE OF MASSACHUSETTS, INC. IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, DENTAL SERVICE OF MASSACHUSETTS MUST ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. ENFORCEMENT IF THE GOVERNING BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE A BOARD OR COMMITTEE MEMBER ("MEMBER") HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE MEMBER'S RESPONSE AND AFTER MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, THE GOVERNING BOARD OR COMMITTEE DETERMINES THE MEMBER HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. WHO IS COVERED? THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBERS OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS. LEVEL OF DETERMINATION AND REVIEW OF CONFLICTS IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER PRESENTATION OF A POTENTIAL TRANSACTION OR ARRANGEMENT IS MADE BY AN INTERESTED PERSON, THE REMAINING DISINTERESTED BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. THE CHAIRPERSON OF THE GOVERNING BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE TRANSACTION OR ARRANGEMENT IN QUESTION. AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE IF DENTAL SERVICE OF MASSACHUSETTS CAN OBTAIN, WITH REASONABLE EFFORTS, A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST, FOR ITS OWN BENEFIT AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION, THE GOVERNING BOARD OR COMMITTEE SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. RESTRICTIONS PLACED ON CONFLICTED PERSONS IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. WHISTLEBLOWER AND DOCUMENT RETENTION POLICIES PART VI, LINES 13 & 14 THE BOARD OF DENTAL SERVICE OF MASSACHUSETTS, INC. HAS NOT FORMALLY ADOPTED WHISTLEBLOWER OR DOCUMENT RETENTION POLICIES. HOWEVER, DENTAL SERVICE OF MASSACHUSETTS, INC. FOLLOWS WHISTLEBLOWER AND DOCUMENT RETENTION POLICIES APPROVED BY THE DENTAL SERVICE OF MASSACHUSETTS, INC.'S EXECUTIVE AND COMPLIANCE COMMITTEES, NOT THE FULL BOARD OF DIRECTORS. THEREFORE, EVEN THOUGH DENTAL SERVICE OF MASSACHUSETTS, INC. HAS WHISTLEBLOWER AND DOCUMENT RETENTION POLICIES IN FULL EFFECT, IT MUST ANSWER NO TO PART VI, LINES 13 AND 14 BECAUSE THEY HAVE NOT BEEN FORMALLY ADOPTED BY THE DENTAL SERVICE OF MASSACHUSETTS, INC. BOARD OF DIRECTORS. COMPENSATION POLICY FORM 990, PART VI, QUESTION 15A & B THE PROCESS FOR DETERMINING COMPENSATION FOR THE ORGANIZATION'S CEO AND OTHER TOP MANAGEMENT IS MODELED AFTER THE REQUIREMENTS IN THE INTERNAL REVENUE CODE SECTION 4958 TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLE COMPENSATION. COMPENSATION IS REVIEWED AND APPROVED BY A COMPENSATION COMMITTEE ("THE COMMITTEE") OF THE BOARD, WHICH IS COMPRISED OF INDEPENDENT PERSONS, ON AN ANNUAL BASIS. THE COMMITTEE ENGAGED AN INDEPENDENT COMPENSATION CONSULTANT, WHICH PRESENTED TO THE COMMITTEE COMPARABLE MARKET DATA FROM PUBLISHED SURVEYS AND FORM 990S OF COMPARABLE ORGANIZATIONS TO ASSIST IN EVALUATING THE COMPENSATION FOR EACH INDIVIDUAL. THE COMMITTEE CONDUCTED A REVIEW OF THIS COMPARABILITY DATA AND DOCUMENTED ITS DELIBERATIONS AND DISCUSSIONS IN MINUTES THAT ARE RETAINED WITH OTHER GOVERNANCE RECORDS OF THE ORGANIZATION. THE COMMITTEE FOLLOWED THE PROCESS TO ESTABLISH THE PRESUMPTION THAT COMPENSATION PAID TO THE ORGANIZATION'S CEO AND OTHER TOP MANAGEMENT WAS REASONABLE FOR PURPOSES OF SECTION 4958 BY RELYING ON PROFESSIONAL ADVICE IN A WRITTEN OPINION OF REASONABLENESS FROM INDEPENDENT COMPENSATION CONSULTANT. THE COMMITTEE INFORMS THE BOARD OF ITS DECISIONS AT THE NEXT BOARD MEETING. PUBLIC DISCLOSURE FORM 990, PART VI, QUESTION 19 WE FILE A MASSACHUSETTS FORM PC WITH AN ATTACHED FORM 990. THE FORM PC IS FILED WITH THE ATTORNEY GENERAL'S OFFICE AND IS AVAILABLE FOR INSPECTION BY ANY OF THE INTERESTED PUBLIC. THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, ARTICLES OF INCORPORATION AND BYLAWS ARE MADE AVAILABLE UPON REQUEST. OTHER CHANGES IN NET ASSETS PART XI, LINE 9 EQUITY INCOME IN SUBSIDIARIES $2
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
DENTAL SERVICE OF MASSACHUSETTS INC
 
Employer identification number

04-6143185
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) DENTAQUEST FOUNDATION INC
465 MEDFORD STREET

BOSTON,MA02129
04-3265080 		ORAL HTH IMPR MA 501(c)(3) N/A DSM
 
Yes
 
(2) DENTAQUEST INSTITUTE INC
2400 COMPUTER DRIVE

WESTBOROUGH,MA01581
20-5312990 		ORAL HTH IMPR MA 501(c)(3) 11A DSM
 
Yes
 
(3) DENTAQUEST CARE GROUP INC
465 MEDFORD STREET

BOSTON,MA02129
46-3674034 		ORAL HTH IMPR MA 501(c)(3) 11A DSM
 
Yes
 
(4) DNTL HTH PROGS INC DBA COMM DNTL CARE
465 MEDFORD STREET

BOSTON,MA02129
75-1823660 		ORAL HTH IMPR TX 501(C)(3) 7 DQ CAREGROUP
 
Yes
 
(5) SARRELL REGNL DNTL CTR FOR PUB HTHINC
230 E 10TH STREET NO 106

ANNISTON,AL36207
20-0232609 		ORAL HTH IMPR AL 501(C)(3) 9 DQ CAREGROUP
 
Yes
 
(6) COMMUNITY CARE OF KENTUCKY INC
 
 
46-5159049 		ORAL HTH IMPR KY 501(C)(3) 7 DQ CAREGROUP
 
Yes
 
(7) COMMUNITY CARE OF NEW MEXICO INC
465 MEDFORD STREET

BOSTON,MA02129
47-1711799 		ORAL HTH IMPR NM 501(C)(3) 7 DQ CAREGROUP
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) DENTAQUEST GROUP INC

465 MEDFORD STREET
BOSTON,MA02129
20-4056199 		DENTAL SERVICE DE DSM
  		C CORP 31,251,645 386,488,000 100.000 % Yes  
(2) DSM MASSACHUSETTS INSURANCE COMPANYINC

465 MEDFORD STREET
BOSTON,MA02129
46-5661073 		INSURANCE MA DSM INVESTMENTS
  		C CORP 0 5,040,000 100.000 % Yes  
(3) DENTAQUEST OF ILLINOIS LLC

465 MEDFORD STREET
BOSTON,MA02129
42-1529687 		DENTAL SERVICE WI DENTAQUEST LLC
  		LLC 1,262,773 8,394,662 100.000 % Yes  
(4) DENTAQUEST OF MARYLAND LLC

465 MEDFORD STREET
BOSTON,MA02129
81-0567214 		DENTAL SERVICE WI DENTAQUEST LLC
  		LLC -1,068,226 -425,604 100.000 % Yes  
(5) DENTAQUEST ADMINISTRATIVE SERVICES LLC

465 MEDFORD STREET
BOSTON,MA02129
39-2041298 		DENTAL SERVICE CA DENTAQUEST LLC
  		LLC -64,587 387,485 100.000 % Yes  
(6) DENTAQUEST OF GEORGIA LLC

465 MEDFORD STREET
BOSTON,MA02129
14-1885493 		DENTAL SERVICE WI DENTAQUEST LLC
  		LLC 538 1,783,799 100.000 % Yes  
(7) DENTAQUEST OF ARIZONA LLC

465 MEDFORD STREET
BOSTON,MA02129
11-3692025 		DENTAL SERVICE WI DENTAQUEST LLC
  		LLC 302,934 687,354 100.000 % Yes  
(8) DENTAQUEST OF TENNESSEE LLC

465 MEDFORD STREET
BOSTON,MA02129
35-2177954 		DENTAL SERVICE WI DENTAQUEST LLC
  		LLC -7,881 8,302,725 100.000 % Yes  
(9) DENTAQUEST OF KENTUCKY LLC

465 MEDFORD STREET
BOSTON,MA02129
14-1885490 		DENTAL SERVICE WI DENTAQUEST LLC
  		LLC 0 4,424,273 100.000 % Yes  
(10) DENTAQUEST IPA OF NEW YORK LLC

465 MEDFORD STREET
BOSTON,MA02129
81-0616910 		DENTAL SERVICE WI DENTAQUEST LLC
  		LLC 8,093,743 -5,137,034 100.000 % Yes  
(11) DENTAQUEST USA INSURANCE COMPANY INC

465 MEDFORD STREET
BOSTON,MA02129
20-2970185 		INSURANCE TX DENTAQUEST LLC
  		C CORP 24,440,721 156,796,348 100.000 % Yes  
(12) DSM INVESTMENTS INC

465 MEDFORD STREET
BOSTON,MA02129
04-3428012 		DENTAL SERVICE MA DSM
  		C CORP -213,858 6,202,962 100.000 % Yes  
(13) DENTAQUEST OF NEW JERSEY LLC

465 MEDFORD STREET
BOSTON,MA02129
56-2356433 		DENTAL SERVICE WI DENTAQUEST LLC
  		LLC -200,072 989,322 100.000 % Yes  
(14) DENTAQUEST OF NEW YORK LLC

465 MEDFORD STREET
BOSTON,MA02129
14-1885500 		DENTAL SERVICE WI DENTAQUEST LLC
  		LLC -1,689,289 15,148,484 100.000 % Yes  
(15) DENTAQUEST OF MINNESOTA LLC

465 MEDFORD STREET
BOSTON,MA02129
56-2356445 		DENTAL SERVICE WI DENTAQUEST LLC
  		LLC 326,733 4,269,631 100.000 % Yes  
(16) DENTAQUEST OF NEW MEXICO LLC

465 MEDFORD STREET
BOSTON,MA02129
14-1885481 		DENTAL SERVICE WI DENTAQUEST LLC
  		LLC 526,136 2,045,513 100.000 % Yes  
(17) DENTAQUEST OF FLORIDA INC

465 MEDFORD STREET
BOSTON,MA02129
65-0743731 		INSURANCE FL DENTAQUEST LLC
  		C CORP 74,780 18,400,980 100.000 % Yes  
(18) DSM USA INSURANCE COMPANY INC

465 MEDFORD STREET
BOSTON,MA02129
59-0397210 		INSURANCE TX DENTAQUEST LLC
  		C CORP 175,578 7,847,979 100.000 % Yes  
(19) CALIFORNIA DENTAL NETWORK INC

465 MEDFORD STREET
BOSTON,MA02129
93-0954061 		INSURANCE CA DENTAQUEST LLC
  		C CORP 96,931 1,829,312 100.000 % Yes  
(20) PACIFIC DENTAL NETWORK INC

465 MEDFORD STREET
BOSTON,MA02129
33-0672992 		DENTAL SERVICE CA DENTAQUEST LLC
  		C CORP 148,144 1,033,059 100.000 % Yes  
(21) DENTAQUEST LLC

465 MEDFORD STREET
BOSTON,MA02129
20-0390099 		DENTAL SERVICE DE DQ MA BUS TRUST
  		LLC 32,375,727 368,244,000 100.000 % Yes  
(22) DENTAQUEST MID-ATLANTIC INC

465 MEDFORD STREET
BOSTON,MA02129
52-2006071 		INSURANCE MD DQ MANAGEMENT
  		C CORP 842,736 11,850,494 100.000 % Yes  
(23) DENTAQUEST VIRGINIA INC

 
 
52-2016912 		INSURANCE VA DQ MANAGEMENT
  		C CORP 926,501 3,831,500 100.000 % Yes  
(24) DENTAQUEST MANAGEMENT INC

 
 
52-1908785 		DENTAL SERVICE MD DQ GROUP
  		C CORP 31,251,645 138,357,326 100.000 % Yes  
(25) DSM INSURANCE SERVICES INC

 
 
04-3172335 		INSURANCE MA DSM INVESTMENTS
  		C CORP -60,032 -83,315 100.000 % Yes  
(26) DENTAQUEST ORAL HEALTH CENTER INC

 
 
04-3434787 		ORAL HEALTH CTR MA DSM INVESTMENTS
  		C CORP -153,826 1,246,277 100.000 % Yes  
(27) DQ MASSACHUSETTS BUSINESS TRUST

 
 
20-4056067 		DENTAL SERVICE MA DQ MANAGEMENT
  		TRUST 32,375,727 124,064,166 100.000 % Yes  
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
 
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) DENTAQUEST FOUNDATION INC

 B 5,000,000 FMV
(2) DENTAQUEST FOUNDATION INC

 O 480,738 FMV
(3) DENTAQUEST INSTITUTE INC

 B 300,000 FMV
(4) DENTAQUEST GROUP INC & SUBSIDIARIES

 P 62,035,063 FMV
(5) DENTAQUEST INSTITUTE INC

 O 459,837 FMV
(6) DENTAQUEST INSTITUTE INC

 Q 240,017 FMV
(7) DENTAQUEST GROUP INC & SUBSIDIARIES

 G 6,411,116 FMV
(8) DENTAQUEST CARE GROUP INC

 B 3,905,000 FMV
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2014
Additional Data


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