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Nonprofiteer
← DELTA DENTAL PLAN OF MICHIGAN

Form 990 for tax year 2022

Filed by DELTA DENTAL PLAN OF MICHIGAN.

Totals

Total revenue
$1,131,603,192
Total expenses
$1,118,877,669
Contributions and grants received
$0
Grants paid
$7,363,710
Program services expenses (Part IX)
$990,072,627
Management and general expenses
$128,805,042
Fundraising expenses
$0
Program service expenses (Part III)
$990,072,627

Program services were 88.5% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • LAURA DICKERSON

    DIRECTOR

    Total calculated
    $0
    Hours/week
    5

  • BLAKE LIVINGSTON DDS

    DIRECTOR

    Total calculated
    $65,000
    From this org
    $65,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • SUNCICA TRAVAN DDS MS

    DIRECTOR

    Total calculated
    $60,000
    From this org
    $60,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • STEVEN M TACK

    DIRECTOR

    Total calculated
    $68,750
    From this org
    $68,750
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • ANTHONY O WILLIAMS JD

    DIRECTOR

    Total calculated
    $60,000
    From this org
    $60,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • PATRICK K GILLESPIE

    DIRECTOR

    Total calculated
    $60,000
    From this org
    $60,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • ANDREW KOTARBA

    DIRECTOR

    Total calculated
    $71,563
    From this org
    $68,750
    From related orgs
    $2,813
    Other
    $0
    Hours/week
    5

  • LARRY DEGROAT

    DIRECTOR

    Total calculated
    $60,000
    From this org
    $60,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • RAYMOND F GIST DDS

    DIRECTOR

    Total calculated
    $61,500
    From this org
    $60,000
    From related orgs
    $1,500
    Other
    $0
    Hours/week
    5 + 1 related

  • MELISSA STOLICKER

    VICE CHAIR

    Total calculated
    $136,926
    From this org
    $72,750
    From related orgs
    $64,176
    Other
    $0
    Hours/week
    5 + 5 related

  • SARA DOLAN

    CHAIR

    Total calculated
    $139,176
    From this org
    $70,000
    From related orgs
    $69,176
    Other
    $0
    Hours/week
    5 + 5 related

  • KURT D GALLINGER

    DIRECTOR - PART YEAR

    Total calculated
    $35,415
    From this org
    $25,000
    From related orgs
    $10,415
    Other
    $0
    Hours/week
    5 + 5 related

  • STEVEN M DATER DDS

    DIRECTOR

    Total calculated
    $60,000
    From this org
    $60,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • CHRISTOPHER T FISHER

    DIRECTOR

    Total calculated
    $167,004
    From this org
    $60,000
    From related orgs
    $107,004
    Other
    $0
    Hours/week
    5 + 10 related

    Schedule J breakdown matched by us

    Base
    $60,000 + $107,004 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $60,000 + $107,004 related

  • KELLY JUBB SCHEIDERER

    DIRECTOR

    Total calculated
    $94,081
    From this org
    $44,500
    From related orgs
    $29,081
    Other
    $20,500
    Hours/week
    5 + 6 related

  • STEPHEN A EKLUND DDH MHSA DRPH

    DIRECTOR

    Total calculated
    $90,296
    From this org
    $60,000
    From related orgs
    $30,296
    Other
    $0
    Hours/week
    5 + 6 related

  • POE A TIMMONS

    DIRECTOR (ROOSEVELT INNOV. ONLY)

    Total calculated
    $50,750
    From this org
    $8,750
    From related orgs
    $42,000
    Other
    $0
    Hours/week
    5 + 5 related

  • GORAN JURKOVIC CPA

    CEO, PRESIDENT

    Total calculated
    $8,489,708
    From this org
    $6,178,337
    From related orgs
    $0
    Other
    $2,311,371
    Hours/week
    35 + 15 related

    Schedule J breakdown matched by us

    Base
    $1,403,355
    Bonus
    $3,094,090
    Other
    $1,680,892
    Deferred
    $2,287,652
    Nontaxable benefits
    $23,719
    Filer's total
    $8,489,708

  • AMY BASEL CPA

    SVP, CFO, CRO & TREASURER

    Total calculated
    $1,948,645
    From this org
    $1,462,790
    From related orgs
    $0
    Other
    $485,855
    Hours/week
    35 + 15 related

    Schedule J breakdown matched by us

    Base
    $507,383
    Bonus
    $561,274
    Other
    $394,133
    Deferred
    $462,136
    Nontaxable benefits
    $23,719
    Filer's total
    $1,948,645

  • ANTHONY ROBINSON

    SVP & CHIEF MARKETING OFFICER

    Total calculated
    $2,132,081
    From this org
    $1,599,799
    From related orgs
    $0
    Other
    $532,282
    Hours/week
    43 + 7 related

    Schedule J breakdown matched by us

    Base
    $527,061
    Bonus
    $579,003
    Other
    $493,735
    Deferred
    $508,563
    Nontaxable benefits
    $23,719
    Filer's total
    $2,132,081

  • TOBY HALL

    SVP, CHIEF ACTUARY & DATA OFFICER

    Total calculated
    $1,279,483
    From this org
    $896,076
    From related orgs
    $0
    Other
    $383,407
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $411,148
    Bonus
    $462,002
    Other
    $22,926
    Deferred
    $368,374
    Nontaxable benefits
    $15,033
    Filer's total
    $1,279,483

  • SUE ELLEN JENKINS

    SVP, CHIEF LEGAL OFF, CAO & SEC.

    Total calculated
    $1,437,848
    From this org
    $1,118,484
    From related orgs
    $0
    Other
    $319,364
    Hours/week
    37 + 13 related

    Schedule J breakdown matched by us

    Base
    $522,489
    Bonus
    $575,320
    Other
    $20,675
    Deferred
    $311,438
    Nontaxable benefits
    $7,926
    Filer's total
    $1,437,848

  • JEFF BOTKIN

    SVP, BUSINESS SERVICES

    Total calculated
    $901,713
    From this org
    $768,624
    From related orgs
    $0
    Other
    $133,089
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $357,774
    Bonus
    $389,836
    Other
    $21,014
    Deferred
    $116,477
    Nontaxable benefits
    $16,612
    Filer's total
    $901,713

  • MARK BAUGHMAN

    SVP & CIO

    Total calculated
    $864,957
    From this org
    $763,563
    From related orgs
    $0
    Other
    $101,394
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $357,427
    Bonus
    $389,470
    Other
    $16,666
    Deferred
    $84,782
    Nontaxable benefits
    $16,612
    Filer's total
    $864,957

  • JEFFERY JOHNSTON DDS MS

    SVP & CHIEF SCIENCE OFFICER

    Total calculated
    $594,762
    From this org
    $494,618
    From related orgs
    $0
    Other
    $100,144
    Hours/week
    43 + 7 related

    Schedule J breakdown matched by us

    Base
    $326,961
    Bonus
    $159,553
    Other
    $8,104
    Deferred
    $82,939
    Nontaxable benefits
    $17,205
    Filer's total
    $594,762

  • KUSHTRIM SHAQIRI

    VP GOVERMENT PROGRAMS

    Total calculated
    $684,657
    From this org
    $640,330
    From related orgs
    $0
    Other
    $44,327
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $360,789
    Bonus
    $274,795
    Other
    $4,746
    Deferred
    $20,608
    Nontaxable benefits
    $23,719
    Filer's total
    $684,657

  • MIKE BOBAK

    VP SALES & ACCT MGT

    Total calculated
    $666,363
    From this org
    $596,993
    From related orgs
    $0
    Other
    $69,370
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $233,436
    Bonus
    $362,023
    Other
    $1,534
    Deferred
    $45,651
    Nontaxable benefits
    $23,719
    Filer's total
    $666,363

  • EARL MAJOR

    VP HUMAN RESOURCES

    Total calculated
    $444,139
    From this org
    $378,506
    From related orgs
    $0
    Other
    $65,633
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $269,932
    Bonus
    $104,162
    Other
    $4,412
    Deferred
    $49,021
    Nontaxable benefits
    $16,612
    Filer's total
    $444,139

  • MARGARET TRIMER

    VP STRATEGIC PARTNERSHIPS

    Total calculated
    $438,818
    From this org
    $356,542
    From related orgs
    $0
    Other
    $82,276
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $246,088
    Bonus
    $95,657
    Other
    $14,797
    Deferred
    $58,557
    Nontaxable benefits
    $23,719
    Filer's total
    $438,818

  • DANIEL LOVEJOY

    VP, SALES AND ACCT MGT

    Total calculated
    $620,994
    From this org
    $572,193
    From related orgs
    $0
    Other
    $48,801
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $234,686
    Bonus
    $335,656
    Other
    $1,851
    Deferred
    $25,082
    Nontaxable benefits
    $23,719
    Filer's total
    $620,994

  • WALTER BUZANOWSKI

    VP & GENERAL COUNSEL

    Total calculated
    $452,407
    From this org
    $377,550
    From related orgs
    $0
    Other
    $74,857
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $272,235
    Bonus
    $104,775
    Other
    $540
    Deferred
    $51,138
    Nontaxable benefits
    $23,719
    Filer's total
    $452,407

  • MICHAEL GILMORE

    FORMER VP, CHIEF INVEST OFFICER

    Total calculated
    $869,408
    From this org
    $0
    From related orgs
    $783,761
    Other
    $85,647
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $507,598 related
    Bonus
    $0 + $257,500 related
    Other
    $0 + $18,663 related
    Deferred
    $0 + $61,928 related
    Nontaxable benefits
    $0 + $23,719 related
    Filer's total
    $0 + $869,408 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 — 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
  • 1a · Health or social club dues or initiation fees
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

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
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 1A
FIRST CLASS TRAVEL IS AVAILABLE TO SENIOR EXECUTIVES AND KEY EMPLOYEES. THIS AMOUNT WAS TREATED AS NONTAXABLE TO THESE INDIVIDUALS. TRAVEL MAY BE AVAILABLE TO SPOUSES ON OCCASION AND WOULD BE TREATED AS TAXABLE INCOME TO THE BOARD MEMBER OR EMPLOYEE AS APPROPRIATE. VARIOUS INDIVIDUALS ON SCHEDULE J ARE ELIGIBLE FOR REIMBURSEMENT OF SUBSTANTIATED HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES THAT HAVE A BUSINESS PURPOSE. THE PERSONAL PORTION OF THIS BENEFIT IS REPORTED ANNUALLY AND IS INCLUDED AS TAXABLE INCOME ON THE EMPLOYEE'S W-2.
PART I, LINE 3
THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS PERFORMANCE AND SETS TOTAL COMPENSATION FOR THE CEO WITHOUT THE PRESENCE OR INFLUENCE OF THE CEO. 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
DELTA DENTAL PLAN OF MICHIGAN, HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). IN ORDER TO BE ELIGIBLE FOR THE SERP, AN EMPLOYEE MUST BE A SENIOR 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 2022, GORAN JURKOVIC, AMY BASEL, TOBY HALL, SUE JENKINS, AND ANTHONY ROBINSON ACCRUED BENEFITS AS PARTICIPANTS IN THE SERP PLAN. 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 2022. THESE WAGES WERE ALSO REPORTED ON SCHEDULE J AS COMPENSATION THAT HAS BEEN REPORTED AS DEFFERED ON PRIOR FORM 990S.
PART I, LINE 7
AS INDICATED IN SCHEDULE J, PART II, TOP MANAGEMENT OFFICIALS RECEIVED A BONUS BASED UPON PERFORMANCE AND THE FINANCIAL RESULTS OF THE ORGANIZATION. THE BONUS WAS APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD.

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

The 10 largest by cash amount. The API serves every itemized grant.

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.

Provenance

Return type
form_990
Tax year
2022
Filed
10 November 2023
IRS schema version
2022v5.0
Source object
202313189349307811

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.