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Nonprofiteer
← DELTA DENTAL PLAN OF INDIANA INC

Form 990 for tax year 2023

Filed by DELTA DENTAL PLAN OF INDIANA INC.

Totals

Total revenue
$153,563,516
Total expenses
$153,130,099
Contributions and grants received
$0
Grants paid
$606,707
Program service revenue
$150,467,799
Investment income
$3,094,592
Other revenue
$1,125
Total assets, end of year
$136,567,253
Total liabilities, end of year
$15,946,951
Net assets or fund balances, end of year
$120,620,302
Program services expenses (Part IX)
$144,308,848
Management and general expenses
$8,821,251
Fundraising expenses
$0
Program service expenses (Part III)
$144,308,848

Program services were 94.2% 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 CARE REVENUE

    total $148,297,336 · related or exempt $148,297,336

  • 2b · Program service revenue: VISION CARE REVENUE

    total $2,170,463 · unrelated business $2,170,463

  • 3 · Investment income

    total $3,764,767 · excluded $3,764,767

  • 7a · Gross sales of assets other than inventory

    securities $44,573,673

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

    securities $45,243,848

  • 7c · Gain or loss

    securities -$670,175

  • 7d · Net gain or loss

    total -$670,175 · excluded -$670,175

  • 11a · Other revenue: MISCELLANEOUS INCOME

    total $1,125 · related or exempt $1,125

  • 11e · Other revenue, total

    $1,125

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $606,707 · program services $606,707

  • 11b · Fees: legal

    total $391,186 · management and general $391,186

  • 11c · Fees: accounting

    total $63,658 · management and general $63,658

  • 11f · Fees: investment management

    total $340,880 · management and general $340,880

  • 11g · Fees: other

    total $123,516,076 · program services $123,313,162 · management and general $202,914

  • 12 · Advertising and promotion

    total $38,900 · program services $37,500 · management and general $1,400

  • 13 · Office expenses

    total $180,319 · management and general $180,319

  • 16 · Occupancy

    total $102,643 · management and general $102,643

  • 24a · Other expenses: TAX EXPENSE

    total $2,184 · management and general $2,184

  • 24b · Other expenses: ADMIN/OH

    total $19,706,656 · program services $12,697,948 · management and general $7,008,708

  • 24c · Other expenses: COMMISSIONS

    total $7,383,587 · program services $7,383,587

  • 24d · Other expenses: MEMBERSHIP DUES

    total $492,868 · management and general $492,868

  • 24e · All other expenses

    total $304,435 · program services $269,944 · management and general $34,491

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $1,298,771 · end of year $2,210,407

  • 2 · Savings and temporary cash investments

    beginning of year $7,894,556 · end of year $8,412,802

  • 4 · Accounts receivable

    beginning of year $5,881,967 · end of year $8,345,559

  • 7 · Other notes and loans receivable

    beginning of year $218,865 · end of year $282,538

  • 9 · Prepaid expenses and deferred charges

    end of year $8,292

  • 11 · Investments: publicly traded securities

    beginning of year $95,656,449 · end of year $106,051,989

  • 12 · Investments: other securities

    beginning of year $10,592,589 · end of year $10,862,638

  • 15 · Other assets

    beginning of year $488,646 · end of year $393,028

  • 17 · Accounts payable and accrued expenses

    beginning of year $3,333,627 · end of year $4,823,951

  • 19 · Deferred revenue

    beginning of year $3,247,324 · end of year $3,844,706

  • 25 · Other liabilities

    beginning of year $5,484,865 · end of year $7,278,294

  • 29 · Capital stock, trust principal or current funds

    beginning of year $0 · end of year $0

  • 30 · Paid-in or capital surplus, or land, building or equipment fund

    beginning of year $14,546,833 · end of year $14,546,833

  • 31 · Retained earnings, endowment or other funds

    beginning of year $95,419,194 · end of year $106,073,469

Listed in Part VII

  • GORAN M JURKOVIC CPA

    PRESIDENT & CEO

    Total calculated
    $11,833,525
    From this org
    $0
    From related orgs
    $9,219,805
    Other
    $2,613,720
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,474,566 related
    Bonus
    $0 + $3,570,478 related
    Other
    $0 + $4,174,761 related
    Deferred
    $0 + $2,588,461 related
    Nontaxable benefits
    $0 + $25,259 related
    Filer's total
    $0 + $11,833,525 related

  • AMY L BASEL CPA

    EVP/CFO & CRO/TREASURER

    Total calculated
    $3,025,568
    From this org
    $0
    From related orgs
    $2,381,009
    Other
    $644,559
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $528,195 related
    Bonus
    $0 + $886,909 related
    Other
    $0 + $965,905 related
    Deferred
    $0 + $619,300 related
    Nontaxable benefits
    $0 + $25,259 related
    Filer's total
    $0 + $3,025,568 related

  • SUE ELLEN JENKINS

    EVP, CHIEF LEGAL OFF, CAO & SEC.

    Total calculated
    $2,058,864
    From this org
    $0
    From related orgs
    $1,632,671
    Other
    $426,193
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $542,025 related
    Bonus
    $0 + $949,448 related
    Other
    $0 + $141,198 related
    Deferred
    $0 + $419,012 related
    Nontaxable benefits
    $0 + $7,181 related
    Filer's total
    $0 + $2,058,864 related

  • JEREMY J NELSON

    DIRECTOR

    Total calculated
    $499,638
    From this org
    $0
    From related orgs
    $434,608
    Other
    $65,030
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $194,658 related
    Bonus
    $0 + $235,469 related
    Other
    $0 + $4,481 related
    Deferred
    $0 + $49,022 related
    Nontaxable benefits
    $0 + $16,008 related
    Filer's total
    $0 + $499,638 related

  • ANTHONY D ROBINSON

    EVP, CMO & CRO

    Total calculated
    $3,068,485
    From this org
    $0
    From related orgs
    $2,349,997
    Other
    $718,488
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $604,517 related
    Bonus
    $0 + $886,686 related
    Other
    $0 + $858,794 related
    Deferred
    $0 + $693,229 related
    Nontaxable benefits
    $0 + $25,259 related
    Filer's total
    $0 + $3,068,485 related

  • JEFFERY W JOHNSTON DDS MS

    SR VP & CHIEF SCIENCE OFFICER

    Total calculated
    $614,101
    From this org
    $0
    From related orgs
    $498,455
    Other
    $115,646
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $339,270 related
    Bonus
    $0 + $154,289 related
    Other
    $0 + $4,896 related
    Deferred
    $0 + $97,956 related
    Nontaxable benefits
    $0 + $17,690 related
    Filer's total
    $0 + $614,101 related

  • MICHAEL GILMORE

    FORMER CHIEF INVESTMENT OFFICER

    Total calculated
    $889,741
    From this org
    $0
    From related orgs
    $775,688
    Other
    $114,053
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $509,237 related
    Bonus
    $0 + $249,775 related
    Other
    $0 + $16,676 related
    Deferred
    $0 + $88,796 related
    Nontaxable benefits
    $0 + $25,257 related
    Filer's total
    $0 + $889,741 related

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

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 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
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
THE CEO IS A W-2 EMPLOYEE OF A RELATED ORGANIZATION, DELTA DENTAL PLAN OF MICHIGAN, INC. COMPENSATION IS DETERMINED BY THAT ENTITY. THE DELTA DENTAL PLAN OF MICHIGAN, INC. COMPENSATION COMMITTEE REVIEWS PERFORMANCE AND SETS TOTAL COMPENSATION. EVERY TWO YEARS, A STUDY IS PERFORMED BY TOWERS WATSON AND THE DATA IS USED IN COMPENSATION DECISIONS. THE INDEPENDENT CONSULTANT PROVIDES AN OPINION AS TO THE REASONABLENESS AND APPROPRIATENESS OF THE TOTAL COMPENSATION, INCLUDING BASE PAY, INCENTIVE, BENEFITS AND RETIREMENT BENEFITS.
PART I, LINE 4B
THE RELATED ORGANIZATION, DELTA DENTAL PLAN OF MICHIGAN, HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). IN ORDER TO BE ELIGIBLE FOR THE SERP, AN EMPLOYEE MUST BE AN EXECUTIVE VICE PRESIDENT OR HIGHER AND ADDED TO THE PLAN BY THE BOARD OF DIRECTORS. THE SERP BENEFITS ARE REVIEWED AS PART OF THE TOTAL COMPENSATION BY AN INDEPENDENT CONSULTANT; TOWERS WATSON. IN 2023, GORAN JURKOVIC, AMY BASEL, ANTHONY ROBINSON, AND SUE ELLEN JENKINS ACCRUED BENEFITS AS PARTICIPANTS IN THE SERP PLANS. GORAN JURKOVIC, AMY BASEL AND ANTHONY ROBINSON BECAME VESTED IN A PORTION OF THEIR ACCRUED BENEFITS AND, AS REQUIRED BY THE IRS, THE VESTED PORTION WAS TREATED AS TAXABLE WAGES DURING 2023. THESE WAGES WERE ALSO REPORTED ON SCHEDULE J AS COMPENSATION THAT HAS BEEN REPORTED AS DEFFERED ON PRIOR FORM 990S.

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.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

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

Provenance

Return type
form_990
Tax year
2023
Filed
11 November 2024
IRS schema version
2023v5.1
Source object
202413189349308446

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