Skip to content
Nonprofiteer
← ARIZONA DENTAL INSURANCE SERVICE

Form 990 for tax year 2023

Filed by ARIZONA DENTAL INSURANCE SERVICE.

Totals

Total revenue
$161,501,573
Total expenses
$153,677,278
Contributions and grants received
$0
Grants paid
$1,303,136
Program service revenue
$157,796,530
Investment income
$3,581,742
Other revenue
$123,301
Total assets, end of year
$150,102,052
Total liabilities, end of year
$16,340,104
Net assets or fund balances, end of year
$133,761,948
Program services expenses (Part IX)
$131,790,145
Management and general expenses
$21,887,133
Fundraising expenses
$0
Program service expenses (Part III)
$131,790,145

Program services were 85.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: DENTAL PREMIUMS

    total $141,878,043 · related or exempt $141,878,043

  • 2b · Program service revenue: REV - SELF INSUR GROUP

    total $10,604,782 · related or exempt $10,604,782

  • 2c · Program service revenue: VISION PREMIUMS

    total $5,313,705 · unrelated business $5,313,705

  • 3 · Investment income

    total $3,099,560 · unrelated business $132,481 · excluded $2,967,079

  • 7a · Gross sales of assets other than inventory

    securities $19,745,916

  • 7b · Less cost or other basis and sales expenses

    securities $19,263,734

  • 7c · Gain or loss

    securities $482,182

  • 7d · Net gain or loss

    total $482,182 · excluded $482,182

  • 11a · Other revenue: OTHER INCOME

    total $123,301 · related or exempt $123,301

  • 11e · Other revenue, total

    $123,301

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $1,303,136 · program services $1,303,136

  • 5 · Compensation of officers, directors and key employees

    total $4,022,390 · program services $2,802,485 · management and general $1,219,905

  • 7 · Other salaries and wages

    total $9,973,476 · program services $4,585,265 · management and general $5,388,211

  • 8 · Pension plan contributions

    total $505,700 · program services $352,332 · management and general $153,368

  • 9 · Other employee benefits

    total $1,715,052 · program services $914,769 · management and general $800,283

  • 10 · Payroll taxes

    total $824,662 · program services $420,881 · management and general $403,781

  • 11b · Fees: legal

    total $343,613 · management and general $343,613

  • 11c · Fees: accounting

    total $133,800 · management and general $133,800

  • 11f · Fees: investment management

    total $313,774 · management and general $313,774

  • 11g · Fees: other

    total $14,463,065 · program services $6,767,230 · management and general $7,695,835

  • 12 · Advertising and promotion

    total $1,280,912 · program services $22,107 · management and general $1,258,805

  • 13 · Office expenses

    total $96,951 · program services $45,995 · management and general $50,956

  • 14 · Information technology

    total $1,642,059 · program services $978,071 · management and general $663,988

  • 16 · Occupancy

    total $1,512,896 · program services $1,084,522 · management and general $428,374

  • 17 · Travel

    total $161,730 · program services $111,543 · management and general $50,187

  • 20 · Interest

    total $7,711 · program services $7,711

  • 22 · Depreciation, depletion and amortization

    total $388,664 · program services $270,790 · management and general $117,874

  • 23 · Insurance

    total $341,774 · program services $341,774

  • 24a · Other expenses: PROFESSIONAL DENTAL SVS

    total $109,075,923 · program services $109,075,923

  • 24b · Other expenses: PREMIUM TAX

    total $1,944,831 · management and general $1,944,831

  • 24c · Other expenses: PRINTING AND POSTAGE

    total $1,198,441 · program services $1,198,275 · management and general $166

  • 24d · Other expenses: UBIT

    total $759,818 · management and general $759,818

  • 24e · All other expenses

    total $1,666,900 · program services $1,507,336 · management and general $159,564

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $9,675,962 · end of year $11,926,899

  • 4 · Accounts receivable

    beginning of year $8,747,562 · end of year $9,375,797

  • 9 · Prepaid expenses and deferred charges

    beginning of year $1,208,403 · end of year $1,456,180

  • 10a · Land, buildings and equipment: cost or other basis

    $1,882,273

  • 10b · Land, buildings and equipment: accumulated depreciation

    $622,967

  • 10c · Land, buildings and equipment, net

    beginning of year $6,826,931 · end of year $1,259,306

  • 11 · Investments: publicly traded securities

    beginning of year $94,594,719 · end of year $106,854,568

  • 12 · Investments: other securities

    beginning of year $11,035,787 · end of year $12,529,233

  • 15 · Other assets

    beginning of year $1,696,839 · end of year $6,700,069

  • 17 · Accounts payable and accrued expenses

    beginning of year $11,797,248 · end of year $12,634,438

  • 19 · Deferred revenue

    beginning of year $1,242,277 · end of year $1,543,450

  • 23 · Secured mortgages and notes payable

    beginning of year $41,201 · end of year $107,338

  • 25 · Other liabilities

    beginning of year $2,212,571 · end of year $2,054,878

  • 27 · Net assets without donor restrictions

    beginning of year $118,492,906 · end of year $133,761,948

Mission and programs · 2023

Mission

THE CORPORATION EXISTS TO IMPROVE LIVES BY PROMOTING OPTIMAL ORAL HEALTH.

  • THE ORGANIZATION PROVIDED DENTAL BENEFIT COVERAGE FOR 473,430 BENEFICIARIES INCLUDED AMONG THESE BENEFICIARIES WERE I) 36,183 INDIVIDUAL ENROLLEES, MANY OF WHOM ARE HIGH-RISK INDIVIDUALS WHO MAY NOT OTHERWISE RECEIVE ACCESS TO AFFORDABLE DENTAL BENEFIT COVERAGE. THESE INDIVIDUALS OBTAINED COVERAGE AS A RESULT OF THE ORGANIZATION'S COLLABORATION WITH CHARITABLE AND GOVERNMENTAL ORGANIZATIONS; II) 53,990 ENROLLEES WHO ARE OR WERE EMPLOYED WITH THE STATE OF ARIZONA,; III) 58,871 ENROLLEES WHO ARE OR WERE EMPLOYED WITH THE ARIZONA STATE RETIREMENT SYSTEM, AND IV). THE ORGANIZATION EXPENDED MORE THAN $105 MILLION FOR DENTAL CARE DURING 2023, WITH DENTAL BENEFITS COVERAGE BEING PROVIDED THROUGH CONTRACTS WITH INDEPENDENT PROFESSIONAL DENTAL SERVICE PROVIDERS.

    Expenses $130,487,009 · Revenue $152,606,126

  • THE ORGANIZATION ALSO MAKES GRANTS AND DONATES FACILITIES, EQUIPMENT, AND EMPLOYEE TIME TO SUPPORT MANY CHARITABLE CAUSES. DURING 2023, THE ORGANIZATION PROVIDED OR SUPPORTED PREVENTATIVE DENTAL HEALTH SERVICES, CHILDREN'S ORAL HEALTH SERVICE, DENTAL CLINICS, IN-SCHOOL SCREENINGS, TOBACCO AND CHRONIC DISEASE PREVENTION PROGRAMS, EARLY CHILDHOOD PROGRAMS, PRENATAL AND POSTNATAL ORAL HEALTH, AND ACCESS TO DENTAL SERVICES.

    Expenses $1,303,136 · Grants $1,303,136

As filed on the 2023 return.

Listed in Part VII

  • Ronald V Davella

    BOARD CHAIR - BEG 4/23

    Total calculated
    $55,976
    From this org
    $55,976
    From related orgs
    $0
    Other
    $0
    Hours/week
    10

  • Richard B Higgs DDS

    BOARD CHAIR & BOARD MEMBER

    Total calculated
    $42,664
    From this org
    $42,664
    From related orgs
    $0
    Other
    $0
    Hours/week
    3

  • Michael A Warren

    SECRETARY/TREASURER

    Total calculated
    $38,432
    From this org
    $38,432
    From related orgs
    $0
    Other
    $0
    Hours/week
    3

  • Gerald E Loe

    BOARD MEMBER

    Total calculated
    $36,996
    From this org
    $36,996
    From related orgs
    $0
    Other
    $0
    Hours/week
    3

  • Brenda Schmidt

    BOARD VICE-CHAIR

    Total calculated
    $36,764
    From this org
    $36,764
    From related orgs
    $0
    Other
    $0
    Hours/week
    3

  • Bruce Allan Spigner DDS

    BOARD MEMBER

    Total calculated
    $36,332
    From this org
    $36,332
    From related orgs
    $0
    Other
    $0
    Hours/week
    3

  • Gary Owen Jones DDS

    BOARD MEMBER

    Total calculated
    $34,668
    From this org
    $34,668
    From related orgs
    $0
    Other
    $0
    Hours/week
    3

  • Shaharyar Ashraf

    BOARD MEMBER

    Total calculated
    $32,668
    From this org
    $32,668
    From related orgs
    $0
    Other
    $0
    Hours/week
    3 + 1 related

  • Stephen Meyer Houghton

    BOARD MEMBER

    Total calculated
    $30,336
    From this org
    $30,336
    From related orgs
    $0
    Other
    $0
    Hours/week
    3

  • Candace Hunter Wiest

    BOARD MEMBER

    Total calculated
    $30,336
    From this org
    $30,336
    From related orgs
    $0
    Other
    $0
    Hours/week
    3

  • Matthew Wandoloski

    BOARD MEMBER

    Total calculated
    $25,336
    From this org
    $25,336
    From related orgs
    $0
    Other
    $0
    Hours/week
    3

  • Michael Jones

    PRESIDENT/CEO

    Total calculated
    $1,122,019
    From this org
    $939,425
    From related orgs
    $0
    Other
    $182,594
    Hours/week
    40 + 2 related

    Schedule J breakdown matched by us

    Base
    $619,154
    Bonus
    $320,271
    Other
    $0
    Deferred
    $139,988
    Nontaxable benefits
    $42,606
    Filer's total
    $1,122,019

  • Mark Anderson

    SENIOR VICE PRESIDENT/CFO

    Total calculated
    $671,671
    From this org
    $554,494
    From related orgs
    $0
    Other
    $117,177
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $319,641
    Bonus
    $158,355
    Other
    $76,498
    Deferred
    $80,979
    Nontaxable benefits
    $36,198
    Filer's total
    $671,671

  • Leslie Hess

    GENERAL COUNSEL & CCO

    Total calculated
    $527,313
    From this org
    $438,824
    From related orgs
    $0
    Other
    $88,489
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $323,912
    Bonus
    $114,912
    Other
    $0
    Deferred
    $52,241
    Nontaxable benefits
    $36,248
    Filer's total
    $527,313

  • Craig Livesay

    SENIOR VICE PRESIDENT/COO

    Total calculated
    $532,984
    From this org
    $435,249
    From related orgs
    $0
    Other
    $97,735
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $317,031
    Bonus
    $118,218
    Other
    $0
    Deferred
    $51,181
    Nontaxable benefits
    $46,554
    Filer's total
    $532,984

  • Jolou Trujillo-Ottino

    SVP OF SALES - THRU 6/23

    Total calculated
    $329,739
    From this org
    $289,599
    From related orgs
    $0
    Other
    $40,140
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $259,370
    Bonus
    $30,229
    Other
    $0
    Deferred
    $20,386
    Nontaxable benefits
    $19,754
    Filer's total
    $329,739

  • Jason Greenwood

    SVP OF MARKETING AND COMMUNICATIONS

    Total calculated
    $363,649
    From this org
    $298,755
    From related orgs
    $0
    Other
    $64,894
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $238,755
    Bonus
    $60,000
    Other
    $0
    Deferred
    $29,843
    Nontaxable benefits
    $35,051
    Filer's total
    $363,649

  • Jolean Fleck

    VP, PEOPLE & ORG DEVELOPMENT

    Total calculated
    $404,244
    From this org
    $327,578
    From related orgs
    $0
    Other
    $76,666
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $228,290
    Bonus
    $99,288
    Other
    $0
    Deferred
    $38,931
    Nontaxable benefits
    $37,735
    Filer's total
    $404,244

  • Heather N Schneider

    DENTAL DIRECTOR

    Total calculated
    $249,342
    From this org
    $237,383
    From related orgs
    $0
    Other
    $11,959
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $200,383
    Bonus
    $37,000
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $11,959
    Filer's total
    $249,342

  • Joshua Cupero

    CONTROLLER

    Total calculated
    $235,175
    From this org
    $211,053
    From related orgs
    $0
    Other
    $24,122
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $182,953
    Bonus
    $28,100
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $24,122
    Filer's total
    $235,175

  • John Bruley

    DIRECTOR OF IT

    Total calculated
    $231,774
    From this org
    $195,687
    From related orgs
    $0
    Other
    $36,087
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $168,687
    Bonus
    $27,000
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $36,087
    Filer's total
    $231,774

  • Eric Skartveit

    SENIOR DIRECTOR OF UNDERWRITING

    Total calculated
    $234,361
    From this org
    $197,920
    From related orgs
    $0
    Other
    $36,441
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $164,920
    Bonus
    $33,000
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $36,441
    Filer's total
    $234,361

  • Tiffany Di Giacinto

    SENIOR DIRECTOR OF BRAND AND PRODUCT

    Total calculated
    $213,947
    From this org
    $191,076
    From related orgs
    $0
    Other
    $22,871
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $160,145
    Bonus
    $30,931
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $22,871
    Filer's total
    $213,947

  • Allan Allford

    FORMER CEO

    Total calculated
    $579,195
    From this org
    $579,195
    From related orgs
    $0
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $88
    Other
    $579,107
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $579,195

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 1a · First-class or charter travel
  • 1a · Travel for companions
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Form 990 of other organizations
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

Answered no

  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 1A
1. FIRST CLASS TRAVEL - THIS BENEFIT IS AVAILABLE TO ALL SENIOR EXECUTIVES FOR BUSINESS RELATED TRAVEL EXCEEDING 4 HOURS. IT IS NOT TREATED AS TAXABLE COMPENSATION. 2. TRAVEL FOR COMPANIONS - THIS BENEFIT IS AVAILABLE TO THE PRESIDENT/CEO. THE SPOUSAL PORTION IS TREATED AS TAXABLE INCOME TO THE PRESIDENT/CEO.
PART I, LINES 4A-B
4A: IN 2023, JOLOU TRUJILLO-OTTINO RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF 86,229. 4B: THE ORGANIZATION HAS NONQUALIFIED DEFERRED COMPENSATION PLANS FOR CERTAIN MEMBERS OF SENIOR MANAGEMENT AS DETERMINED BY THE DDAZ BOARD. PLAN BALANCES ARE CREDITED AT THE DISCRETION OF THE BOARD. IN 2023, THE FOLLOWING INDIVIDUALS RECEIVED DISTRIBUTIONS FROM THE NON-QUALIFIED DEFERRED COMPENSATION PLAN (457F): MARK ANDERSON RECEIVED 76,498 THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED DEFERRED COMPENSATION PLAN, BUT DID NOT RECEIVE A DISTRIBUTION IN 2023: JOLEAN FLECK, JASON GREENWOOD, LESLIE HESS, MICHAEL JONES, CRAIG LIVESAY AND JOLOU TRUJILLO-OTTINO
PART I, LINE 7
CONSISTENT WITH THE ORGANIZATION'S OVERALL COMPENSATION PHILOSOPHY, OFFICERS, HIGHLY COMPENSATED, AND OTHER DESIGNATED EMPLOYEES PARTICIPATE IN AN ORGANIZATION INCENTIVE COMPENSATION PLAN. THE PLAN CONTAINS METRICS WHICH REPRESENT STRATEGIC PLAN MEASURES THAT ARE DETERMINED ANNUALLY BY THE BOARD OF DIRECTORS. AN OVERALL WEIGHTED SCORE IS CALCULATED BASED ON ACHIEVING A RANGE OF PLAN MEASURES. THE GOALS INCLUDE PRESERVATION OF INCOME WHICH PROVIDES THE ORGANIZATION WITH THE RESOURCES NECESSARY TO ACCOMPLISH ITS CHARITABLE PURPOSES.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

  • ARIZONA DENTAL INSURANCE HOLDINGS LLC

    HOLDING COMPANY · AZ

    Directly controlled by ARIZONA DENTAL INSURANCE SERVICE INC

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • CANYON INSURANCE SERVICE INC

    C · INSURANCE · AZ · 100% owned · share of income $9,218 · share of assets $583,930 · controlled entity

    Directly controlled by AZ DENTAL

  • SOUTHWEST BENEFIT AMINISTRATORS LLC

    C · ADMIN SERVICES · AZ · 100% owned · share of income $16,803,910 · share of assets $122,680 · controlled entity

    Directly controlled by AZ DENTAL

Provenance

Return type
form_990
Tax year
2023
Filed
1 November 2024
IRS schema version
2023v5.1
Source object
202443139349302814

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.