2023-11-02T13:23:37-05:00 2022-12-31 341851358 CBIZ MHM LLC 530 HOWELL ROAD SUITE 209 GREENVILLE SC 29615 990 2022-01-01 941461312 DELTA DENTAL OF CALIFORNIA DELT 4159728300 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 ALICIA F WEBER CFO 4159748577 2023-11-01 1 ALICIA WEBER 999009999 0 KELLIE A LANFORD P00538614 8642412001 2023-11-02 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ALICIA F WEBER 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 6075740574 0 X WWW.DELTADENTALINS.COM X 1954 CA TO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS, SERVICE, TECHNOLOGY AND PROFESSIONAL SUPPORT. 12 11 2364 0 1086857 26603 0 0 5350531255 5728676235 52604149 53932315 7764997 53359488 5410900401 5835968038 26921485 27456765 4507201237 4794058788 368483279 404208374 0 0 0 248733408 291003273 5151339409 5516727200 259560992 319240838 3350387641 3585172780 1091250193 1112823411 2259137448 2472349369 TO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS, SERVICE, TECHNOLOGY AND PROFESSIONAL SUPPORT. 0 0 5403635566 5834881181 THE ORGANIZATION PROVIDED DENTAL BENEFIT COVERAGE FOR 27,778,000 BENEFICIARIES IN 2022, PRIMARILY THROUGH CONTRACTS WITH INDEPENDENT DENTISTS. INCLUDED WERE PUBLICLY SPONSORED DENTAL BENEFIT PROGRAMS ADMINISTERED BY THE ORGANIZATION, AS WELL AS 1,183,000 ENROLLED IN THE FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM (FEDVIP).THE ORGANIZATION PAID MORE THAN $4.8 BILLION FOR DENTAL CARE DURING 2022. 27456765 27456765 THE ORGANIZATION MADE GRANTS DURING 2022 TO FOSTER IMPROVED ACCESS TO DENTAL HEALTH CARE TREATMENT, TO SUPPORT PROFESSIONAL DENTAL EDUCATION, AND TO PROVIDE ORAL HEALTH INSTRUCTION FOR PATIENTS. 5431092331 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 1 0 1 112534 0 1 2364 1 1 1 0 0 0 0 0 1 0 X 12 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X ALICIA F WEBER CFO 4159748577 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 X CASTRO MICHAEL J CHIEF EXECUTIVE OFFICER 40.00 10.00 X 5009544 0 222178 GILBERT LEROY R JR EXECUTIVE VICE PRESIDENT/CHIEF OPERATIONS OFFICER 40.00 10.00 X 3118124 0 13644 WEBER ALICIA F EXECUTIVE VICE PRESIDENT CHIEF FINANCIAL OFFICER 40.00 10.00 X 3009258 0 48312 CHAVARRIA SARAH PRESIDENT 40.00 10.00 X 2805685 0 62579 HANKINSON MICHAEL G EXECUTIVE VICE PRESIDENT CHIEF LEGAL OFFICER 40.00 10.00 X 2509654 0 52087 JACKSON KEVIN L EXECUTIVE VICE PRESIDENT/CHIEF GROWTH OFFICER 40.00 10.00 X 2317629 0 39631 TITCOMBE DOMINIC EXECUTIVE VICE PRESIDENT/CHIEF INFORMATION OFFICER 40.00 10.00 X 2103812 0 62579 NAVID MOHAMMADREZA SENIOR VICE PRESIDENT CHIEF RELATIONSHIP AND BUSIN 40.00 10.00 X 1089901 0 71839 LEIBOWITZ THOMAS J SENIOR VICE PRESIDENT CHIEF ACTUARY. 40.00 10.00 X 995498 0 52230 RUIZ JOSEPH F GROUP VICE PRESIDENT GROWTH STRATEGY BUSINESS DEVE 40.00 10.00 X 889746 0 51869 MANOWSKI MICHAEL SENIOR VICE PRESIDENT CHIEF TECHNOLOGY OFFICER 40.00 10.00 X 870135 0 48899 SHERMAN BRIAN SENIOR VICE PRESIDENT CHIEF PEOPLE OFFICER 40.00 10.00 X 830743 0 56093 CROLEY DANIEL W VICE PRESIDENT CHIEF DENTAL OFFICER 40.00 10.00 X 764982 0 74637 BALTIS THOMAS VICE PRESIDENT CHIEF INFORMATION SECURITY OFFICER 40.00 10.00 X 791138 0 42155 FEGLEY ANDREA M SENIOR VICE PRESIDENT DEPUTY GENERAL COUNSEL 40.00 10.00 X 777866 0 50763 THOMPSON JENNIFER L SALES ACCOUNT EXECUTIVE 40.00 10.00 X 745241 0 70113 NAKAHARA EARL VICE PRESIDENT RISK, ETHICS & COMPLIANCE AND CHIEF 40.00 10.00 X 740198 0 57827 MANER MICHAEL VICE PRESIDENT SALES 10.00 40.00 X 0 706296 56155 SCHROEDER KURT GRAY SENIOR VICE PRESIDENT CHIEF MARKETING & COMMUNICAT 40.00 10.00 X 710271 0 48332 PARKER EARL JR SENIOR VICE PRESIDENT CUSTOMER OPERATIONS 10.00 40.00 X 0 691339 52652 NASR JAMAL L VICE PRESIDENT BUSINESS PROCESS MANAGEMENT 40.00 10.00 X 693802 0 49636 ALBUM JEFFREY M VICE PRESIDENT PUBLIC & GOVERNMENT AFFAIRS 40.00 10.00 X 694716 0 46518 MARTEL LORI ANN VICE PRESIDENT OF PRODUCT MANAGEMENT 40.00 10.00 X 703660 0 19282 THOLIA ASHISH SENIOR DIRECTOR STRATEGY BUSINESS DEVELOPMENT 40.00 10.00 X 675073 0 43145 SBRAGIA RICHARD J VICE PRESIDENT FINANCE - FINANCIAL OPERATIONS 40.00 10.00 X 664715 0 49685 SHEETZ MARTY A VICE PRESIDENT, CUSTOMER ONBOARDING AND OPERATIONS 40.00 10.00 X 656125 0 47111 TODI HEMANT VICE PRESIDENT DATA ANALYTICS AND INSIGHTS 40.00 10.00 X 644807 0 57797 GOLDMAN EDWARD L JR VICE PRESIDENT INFRASTRUCTURE ENGINEERING 40.00 10.00 X 645076 0 53177 CEMBROLA MICHAEL VICE PRESIDENT SALES 10.00 40.00 X 0 638317 55974 SWAMINATHAN SHANMUGA S VICE PRESIDENT ENTERPRISE ARCHITECTURE 40.00 10.00 X 625139 0 61190 SANCHEZ WALTER VICE PRESIDENT INTERNAL AUDIT & CHIEF AUDIT EXECUT 40.00 10.00 X 616289 0 67507 PARTHASARATHY SRIPADH VICE PRESIDENT IT DEVELOPMENT 40.00 10.00 X 614349 0 62162 YODOWITZ HEIDI E CHAIR 5.00 0.00 X X 234975 0 0 BERGERT GLEN F SECOND VICE CHAIR 5.00 2.00 X X 181604 35218 0 O'TOOLE TERRY A DIRECTOR 5.00 0.00 X 179000 0 0 MCCANN STEVEN F DIRECTOR 5.00 0.00 X 158574 0 0 GONELLA ROY A FIRST VICE CHAIR 5.00 0.00 X X 146274 0 0 REID ANDREW J DIRECTOR 5.00 0.00 X 140274 0 0 FRANZOI LYNN L DIRECTOR 5.00 0.00 X 125274 0 0 LAMB JAY C DMD DIRECTOR 5.00 0.00 X 117708 0 0 LAW IAN DIRECTOR 5.00 0.00 X 111000 0 0 PICKERING STEPHEN R DDS DIRECTOR 5.00 0.00 X 110274 0 0 KAPLAN GREGORY D DDS DIRECTOR 5.00 0.00 X 108313 0 0 ALLFORD ROBERT ALLAN DIRECTOR 5.00 0.00 X 108000 0 0 WIDMANN JANET DIRECTOR 5.00 0.00 X 107274 0 0 39141720 2071170 1847758 997 0 1 0 ELEVATED RESOURCES INC 3990 WESTERLY PL STE 270 NEWPORT BEACH CA 92660 CONSULTING SERVICES 42294632 ENTISYS SOLUTIONS INC PO BOX 889426 LOS ANGELES CA 90088 CONSULTING SERVICES 9530178 ELIXIRR LLC 605 GUADALAJARA CIRCLE IRVING TX 75062 CONSULTING SERVICES 8483653 CATALYST360 LLC 11000 OPTUM CIRCLE EDEN PRAIRIE MN 55344 CONSULTING SERVICES 7237654 QUALFON DATA SERVICES GROUP LLC 13700 OAKLAND AVE HIGHLAND PARK MI 48203 CONSULTING SERVICES 6686671 127 PROFESSIONAL SERVICES 524114 5055827224 5055827224 FEES & CONTRACTS FROM GOVERNMENT 524114 672849011 672849011 5728676235 56236955 56236955 237467896 239772536 -2304640 -2304640 -2304640 INCOME/LOSS FROM SUBSIDIARIES 524298 53651685 52564828 1086857 OTHER REVENUE 524298 124451 124451 MISC EXPENSES 524298 -6260213 -6260213 5843565 5843565 53359488 5835968038 5834881181 1086857 0 27456765 27456765 4794058788 4794058788 39141720 39141720 282006857 258135292 23871565 21694450 19368346 2326104 46159416 41870372 4289044 15205931 13687191 1518740 20218099 20218099 1860847 858421 1002426 1594426 1594426 9056855 9056855 20728984 20535707 193277 49712005 48351362 1360643 16969431 16969431 18136031 16418050 1717981 3198425 2252832 945593 1164086 970572 193514 4708630 4708630 29853968 28969929 884039 3588756 3440740 148016 BROKER FEES 55651953 55651953 OUTSIDE SERVICES 30559383 29349421 1209962 CONSULTANT FEES 21392639 18369990 3022649 2608755 -1200841 3809596 5516727200 5431092331 85634869 0 -113513700 -64632111 735581353 267261493 353641351 403715672 185556316 176973163 59458926 63267093 309810347 161528196 130746140 148282151 1193629615 1681390167 790956584 864371501 14331056 44543651 3350387641 3585172780 524730427 564836255 52585385 47189751 513934381 500797405 1091250193 1112823411 X 0 0 0 0 2259137448 2472349369 2259137448 2472349369 3350387641 3585172780 X 319240838 -85019904 -21009013 X 0 1 X 1 0 53623767 24237992 29385775 61727837 41341446 20386391 194458743 95948758 98509985 148282151 INVESTMENT - OTHER SECURITIES 864371501 F 864371501 ACCRUED RETIREMENT BENEFITS 25860008 DEFERRED COMPENSATION PLANS 10580956 GROUP PREFUNDING DEPOSITS 13583477 REFUNDABLE BALANCES 376690190 DUE TO AFFILIATES 27894011 LONG-TERM LEASE LIABILITY 46188763 500797405 X 3013110417 -85019904 -85019904 3098130321 2737837716 2737837716 5835968037 2778949124 0 2778949124 2737778076 2737778076 5516727200 PART X, LINE 2: THE COMPANY IS A TAX-EXEMPT ORGANIZATION ORGANIZED UNDER SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE AND, AS SUCH, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE FINANCIAL STATEMENTS. CURRENT ACCOUNTING GUIDANCE CLARIFIES HOW UNCERTAINTIES IN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. POSITIONS INCLUDE THOSE WITH RESPECT TO THE COMPANY'S TAX EXEMPT STATUS AND WITH RESPECT TO INCOME TAXES ON UNRELATED BUSINESS INCOME. THE COMPANY HAS DETERMINED THAT SUCH TAX POSITIONS DO NOT RESULT IN UNCERTAINTIES REQUIRING RECOGNITION. PART XI, LINE 4B - OTHER ADJUSTMENTS: ADMINISTRATIVE SERVICE CONTRACTS CLAIM REIMBURSEMENT REVENUE INVESTMENT EXPENSES UNRELATED BUSINESS INCOME PART XII, LINE 4B - OTHER ADJUSTMENTS: CLAIMS INCURRED FOR ADMINISTRATIVE SERVICE CONTRACTS INVESTMENT EXPENSES UNRELATED BUSINESS EXPENSE PART X, LINE 1, (5) REFUNDABLE BALANCES: ON MARCH 11, 2020, THE WORLD HEALTH ORGANIZATION DECLARED A NOVEL STRAIN OF CORONAVIRUS (COVID-19) AS A GLOBAL PANDEMIC. THE COVID-19 OUTBREAK HAS CAUSED BUSINESS DISRUPTION THROUGH MANDATED AND VOLUNTARY CLOSINGS OF BUSINESSES AND SHELTER IN PLACE ORDERS. THESE DISRUPTIONS IMPACTED THE ORGANIZATION'S CUSTOMERS' ABILITY TO OBTAIN DENTAL SERVICES. THE ORGANIZATION HAS TAKEN A POSITION AND COMMITTED TO ITS CUSTOMERS, PROVIDERS, AND REGULATORS TO NOT EXCESSIVELY PROFIT FROM THE PANDEMIC. TO THIS END, IN 2020, THE ORGANIZATION ESTABLISHED ESTIMATED RESERVES REPRESENTING EXCESS UNDERWRITING GAINS IN THE AMOUNT OF $231.3 MILLION. DURING 2022, RESERVE AMOUNTS WERE USED TO SUPPORT CUSTOMERS THROUGH ONGOING PAYMENT RELIEF AND OTHER PROGRAMS RESULTING IN A REMAINING BALANCE OF $50.2 MILLION AT DECEMBER 31, 2022. IN ADDITION, CERTAIN CONTRACTS PROVIDE THAT PREMIUMS RECEIVED IN EXCESS OF CLAIMS INCURRED AND ADMINISTRATIVE FEES ARE EITHER REFUNDABLE TO THE GROUPS AT THE EXPIRATION OF THE AGREEMENTS OR APPLIED AGAINST FUTURE PREMIUM PAYMENTS. 1 ALAMEDA COUNTY COMMUNITY FOOD BANK 7900 EDGWATER DR OAKLAND CA 94621 942960297 501 (C) (3) 10000 0 2022 CORPORATE GIVING AMERICAN ONLINE GIVING FOUNDATION INC PO BOX 645725 PITTSBURGH PA 152645255 810739440 501 (C) (3) 293124 0 DDC MATCHING GIFTS AMERICAN RED CROSS INC 1663 MARKET ST SAN FRANCISCO CA 94103 530196605 501 (C) (3) 25000 0 2022 RED CROSS GALA- HEROES UNMASQUED ASIAN ART MUSEUM FOUNDATION 200 LARKIN ST SAN FRANCISCO CA 94102 941704765 501 (C) (3) 6000 0 2022 CORPORATE MEMBERSHIP BAY AREA COUNCIL 353 SACRAMENTO ST 10TH FL SAN FRANCISCO CA 94111 237325853 501 (C) (4) 10000 0 77TH ANNUAL DINNER - SILVER SPONSORSHIP BLUE STAR FAMILIES INC 515 VERBENA CT ENCINITAS CA 92024 800369895 501 (C) (3) 12000 0 2022 CONTRIBUTION IN SUPPORT OF BLUE STAR FAMILIES CAREER PROGRAM CALIFORNIA ACADEMY OF GENERAL DENTISTRY PO BOX 22417 SACRAMENTO CA 95822 237178502 501 (C) (6) 20000 0 2022 ANNUAL MTG W/ DR. SCOTT CLYNCH CARROLL COLLEGE ATHLETICS 1601 NORTH BENTON HELENA MT 59625 810231774 501 (C) (3) 5000 0 2022 CORPORATE SPONSORSHIP CHOC FOUNDATION C/O GLASS SLIPPER GUILD 1201 WEST LA VETA AVE ORANGE CA 92868 956097416 501 (C) (3) 5000 0 GLASS SLIPPER GUILD'S 28TH ANNUAL GALA COLUMBIA UNIVERSITY COLLEGE OF DENTAL MEDICINE 630 WEST 168 ST PH 7 WEST 318 NEW YORK NY 10032 135598093 501 (C) (3) 10000 0 2022 CONTRIBUTION CONSERVATION SOCIETY OF CALIFORNIA DBA OAKLAND ZOO PO BOX 5238 OAKLAND CA 94605 941687847 501 (C) (3) 15000 0 WALK IN THE WILD CORPORATION OF THE FINE ARTS MUSEUMS 50 HAGIWARA TEA GARDEN DR SAN FRANCISCO CA 94118 943045948 501 (C) (3) 5000 0 2022 CONTRIBUTION CURE TAY-SACHS FOUNDATION INC 2409 E LUKE AVE PHOENIX MARICOPA AZ 85016 260256621 501 (C) (3) 5000 0 2022 TAKE A HIKE TAY-SACHS VIRTUAL 5K DELTA DENTAL COMMUNITY CARE FOUNDATION 560 MISSION ST STE 1300 SAN FRANCISCO CA 94105 371570764 501 (C) (3) 26750000 0 ENTERPRISE CONTRIBUTION TO DDCCF DISABLED AMERICAN VETERANS DBA DAV 860 DOLWICK DR ERLANGER ERLANGER KY 41018 310263158 501 (C) (4) 7500 0 2022 NATIONAL DAV WINTER SPORTS CLINIC EQUAL RIGHTS ADVOCATES INC 611 MISSION ST 4TH FL SAN FRANCISCO CA 94105 237217027 501 (C) (3) 5000 0 2022 CONTRIBUTION GOLD STAR WIVES OF AMERICA INC PO BOX 361986 BIRMINGHAM AL 35236 436050359 501 (C) (4) 5000 0 2022 ANNUAL CONFERENCE CONTRIBUTION HEALTH CAREER CONNECTION INC 300 FRANK H OGAWA PLAZA STE 243 OAKLAND CA 94612 251904312 501 (C) (3) 5000 0 ANNUAL CELEBRATION CONNECTING GENERATIONS OF HEALTH LEADERS HENRY M JACKSON FOUNDATION ADVANCEMENT OF MILITARY MEDICINE INC 6720 A ROCKLEDGE DR STE 100 BETHESDA MD 20817 521317896 501 (C) (3) 5000 0 2022 HEROES OF MILITARY MEDICINE CONTRIBUTION LA CLINICA DE LA RAZA INC 1450 FRUITVALE AVE OAKLAND CA 94601 941744108 501 (C) (3) 5000 0 2022 CONTRIBUTION LAPS FOR LEXI INC 12926 OLIVINE WAY SILVER SPRING MD 20904 462160960 501 (C) (3) 12000 0 2022 CONTRIBUTION LOVEALL FOUNDATION FOR CHILDREN 4120 DOUGLAS BLVD 306-304 GRANITE BAY CA 95746 680435070 501 (C) (3) 6000 0 2022 CONTRIBUTION MILITARY OFFICERS ASSOCIATION OF AMERICA DBA MOAA FOUNDATION 201 N WASHINGTON ST ALEXANDRIA VA 223142539 464219250 501 (C) (3) 10000 0 2022 CONTRIBUTION NATIONAL MILITARY FAMILY ASSOCIATION 2800 EISENHOWER AVE STE 250 ALEXANDRIA VA 22314 520899384 501 (C) (3) 15000 0 CONTRIBUTION - OPERATION PURPLE CAMP RAPHAEL HOUSE OF SAN FRANCISCO INC 1065 SUTTER ST SAN FRANCISCO CA 94109 943141608 501 (C) (3) 15000 0 50TH ANNIVERSARY CELEBRATION EVENT RICHMONDERMET AID FOUNDATION 942 DIVISADERO ST STE 201 SAN FRANCISCO CA 94115 943232222 501 (C) (3) 25000 0 2022 CONTRIBUTION SACRAMENTO FOOD BANK & FAMILY SERVICES 3333 3RD AVE SACRAMENTO CA 95817 943315566 501 (C) (3) 22500 0 2022 RUN TO FEED THE HUNGRY SPONSORSHIP SAN FRANCISCO MUSEUM OF MODERN ART 151 THIRD ST SAN FRANCISCO CA 941033159 941156300 501 (C) (3) 5000 0 2022 CONTRIBUTION SAN FRANCISCO SYMPHONY 201 VAN NESS AVE SAN FRANCISCO CA 941024585 941156284 501 (C) (3) 5000 0 DECK THE HALL CONCERT SF MARIN FOOD BANK 900 PENNSYLVANIA AVE SAN FRANCISCO CA 94107 943041517 501 (C) (3) 12500 0 2022 CONTRIBUTION SHRINERS HOSPITALS FOR CHILDREN - PHILADELPHIA 3551 NORTH BROAD STREET PHILADELPHIA PA 19140 362193608 501 (C) (3) 6000 0 2022 CONTRIBUTION ST VINCENT SENIOR CITIZEN NUTRITION PROGRAM INC DBA ST VINCENT MEALS ON WHE 2303 MIRMAR ST LOS ANGELES CA 90057 953696693 501 (C) (3) 15000 0 2022 CONTRIBUTION STUDENT HEALTH SERVICES SUPPORT FUND 333 S BEAUDRY AVE LOS ANGELES CA 90017 954262448 501 (C) (3) 5000 0 SALUTE TO STUDENT HEALTH TRAGEDY ASSISTANCE PROGRAM FOR SURVIVORS 3033 WILSON BLVD ARLINGTON VA 22201 920152268 501 (C) (3) 5000 0 2022 SPONSORSHIP OF TABS HONOR GALA TRIUMPH CANCER FOUNDATION 947 ENTERPRISE DR LOFT B SACRAMENTO CA 95825 453968833 501 (C) (3) 20000 0 TRIUMPH UNCORKED ANNUAL FUNDRAISER WARRIOR EXPEDITIONS 6621 FAIRWAY VIEW TR ROANOKE VA 24018 465201997 501 (C) (3) 5000 0 2022 CONTRIBUTION 32 4 PART I, LINE 2: THE ORGANIZATION AWARDS GRANTS AND PROVIDES OTHER ASSISTANCE THROUGH CONTRIBUTIONS AND/OR SPONSORSHIPS FOR PROGRAMS THAT FOSTER DENTAL HEALTH AND EDUCATION, AS WELL AS COMMUNITY SUPPORT. THROUGH THESE GRANTS, CONTRIBUTIONS AND SPONSORSHIPS, THE ORGANIZATION HELPS FINANCE HEALTH, EDUCATION, AND RESEARCH PROJECTS IN DENTISTRY, HEALTH AND HUMAN SERVICES, AND CIVIC AND/OR COMMUNITY ACTIVITIES. INDIVIDUAL GRANTS, CONTRIBUTIONS AND/OR SPONSORSHIPS WILL GENERALLY NOT EXCEED $100,000 WITH EXCEPTION OF THE CONTRIBUTION MADE TO THE DELTA DENTAL COMMUNITY CARE FOUNDATION. GRANTS WILL BE LIMITED TO ONE-YEAR PROJECTS, SUBJECT TO RENEWAL. EXCEPT IN SPECIAL CASES, AN ORGANIZATION/ENTITY WILL NOT BE ELIGIBLE FOR MORE THAN ONE GRANT DURING ANY YEAR. X X X 1 1 X X X X 1 0 0 0 0 0 0 1 0 CASTRO MICHAEL J CHIEF EXECUTIVE OFFICER 1198364 0 3612501 0 198679 0 191624 0 30554 0 5231722 0 0 0 GILBERT LEROY R JR EXECUTIVE VICE PRESIDENT/CHIEF OPERA 106043 0 1194486 0 1817595 0 9150 0 4494 0 3131768 0 0 0 WEBER ALICIA F EXECUTIVE VICE PRESIDENT CHIEF FINAN 774996 0 2112618 0 121644 0 29618 0 18694 0 3057570 0 0 0 CHAVARRIA SARAH PRESIDENT 772692 0 1963784 0 69209 0 32025 0 30554 0 2868264 0 0 0 HANKINSON MICHAEL G EXECUTIVE VICE PRESIDENT CHIEF LEGAL 624038 0 1782943 0 102673 0 32025 0 20062 0 2561741 0 0 0 JACKSON KEVIN L EXECUTIVE VICE PRESIDENT/CHIEF GROWT 638460 0 1493182 0 185987 0 9077 0 30554 0 2357260 0 0 0 TITCOMBE DOMINIC EXECUTIVE VICE PRESIDENT/CHIEF INFOR 549045 0 1487229 0 67538 0 32025 0 30554 0 2166391 0 0 0 NAVID MOHAMMADREZA SENIOR VICE PRESIDENT CHIEF RELATION 444548 0 582538 0 62815 0 47237 0 24602 0 1161740 0 0 0 LEIBOWITZ THOMAS J SENIOR VICE PRESIDENT CHIEF ACTUARY. 384365 0 550046 0 61087 0 34881 0 17349 0 1047728 0 0 0 RUIZ JOSEPH F GROUP VICE PRESIDENT GROWTH STRATEGY 388976 0 449380 0 51390 0 32025 0 19844 0 941615 0 0 0 MANOWSKI MICHAEL SENIOR VICE PRESIDENT CHIEF TECHNOLO 407622 0 422607 0 39906 0 32025 0 16874 0 919034 0 0 0 SHERMAN BRIAN SENIOR VICE PRESIDENT CHIEF PEOPLE O 400669 0 385202 0 44872 0 32025 0 24068 0 886836 0 0 0 CROLEY DANIEL W VICE PRESIDENT CHIEF DENTAL OFFICER 347014 0 384249 0 33719 0 44407 0 30230 0 839619 0 0 0 BALTIS THOMAS VICE PRESIDENT CHIEF INFORMATION SEC 337143 0 418141 0 35854 0 32025 0 10130 0 833293 0 0 0 FEGLEY ANDREA M SENIOR VICE PRESIDENT DEPUTY GENERAL 357654 0 371326 0 48886 0 33923 0 16840 0 828629 0 0 0 THOMPSON JENNIFER L SALES ACCOUNT EXECUTIVE 89515 0 637891 0 17835 0 44412 0 25701 0 815354 0 0 0 NAKAHARA EARL VICE PRESIDENT RISK, ETHICS & COMPLI 332932 0 360970 0 46296 0 32025 0 25802 0 798025 0 0 0 MANER MICHAEL VICE PRESIDENT SALES 0 263843 0 414589 0 27864 0 31112 0 25043 0 762451 0 0 SCHROEDER KURT GRAY SENIOR VICE PRESIDENT CHIEF MARKETIN 354180 0 333891 0 22200 0 32025 0 16307 0 758603 0 0 0 PARKER EARL JR SENIOR VICE PRESIDENT CUSTOMER OPERA 0 336563 0 341596 0 13180 0 32025 0 20627 0 743991 0 0 NASR JAMAL L VICE PRESIDENT BUSINESS PROCESS MANA 318639 0 349793 0 25370 0 29891 0 19745 0 743438 0 0 0 ALBUM JEFFREY M VICE PRESIDENT PUBLIC & GOVERNMENT A 315949 0 347808 0 30959 0 29698 0 16820 0 741234 0 0 0 MARTEL LORI ANN VICE PRESIDENT OF PRODUCT MANAGEMENT 317041 0 330229 0 56390 0 9150 0 10132 0 722942 0 0 0 THOLIA ASHISH SENIOR DIRECTOR STRATEGY BUSINESS DE 357044 0 289472 0 28557 0 32025 0 11120 0 718218 0 0 0 SBRAGIA RICHARD J VICE PRESIDENT FINANCE - FINANCIAL O 315442 0 329595 0 19678 0 32025 0 17660 0 714400 0 0 0 SHEETZ MARTY A VICE PRESIDENT, CUSTOMER ONBOARDING 313793 0 323083 0 19249 0 32025 0 15086 0 703236 0 0 0 TODI HEMANT VICE PRESIDENT DATA ANALYTICS AND IN 324615 0 305892 0 14300 0 32025 0 25772 0 702604 0 0 0 GOLDMAN EDWARD L JR VICE PRESIDENT INFRASTRUCTURE ENGINE 326513 0 304119 0 14444 0 32025 0 21152 0 698253 0 0 0 CEMBROLA MICHAEL VICE PRESIDENT SALES 0 268763 0 356954 0 12600 0 32025 0 23949 0 694291 0 0 SWAMINATHAN SHANMUGA S VICE PRESIDENT ENTERPRISE ARCHITECTU 303923 0 278516 0 42700 0 35433 0 25757 0 686329 0 0 0 SANCHEZ WALTER VICE PRESIDENT INTERNAL AUDIT & CHIE 290200 0 297098 0 28991 0 37329 0 30178 0 683796 0 0 0 PARTHASARATHY SRIPADH VICE PRESIDENT IT DEVELOPMENT 291814 0 293227 0 29308 0 38176 0 23986 0 676511 0 0 0 YODOWITZ HEIDI E CHAIR 234975 0 0 0 0 0 0 0 0 0 234975 0 0 0 BERGERT GLEN F SECOND VICE CHAIR 181604 35218 0 0 0 0 0 0 0 0 181604 35218 0 0 O'TOOLE TERRY A DIRECTOR 179000 0 0 0 0 0 0 0 0 0 179000 0 0 0 MCCANN STEVEN F DIRECTOR 158574 0 0 0 0 0 0 0 0 0 158574 0 0 0 PART I, LINE 1A FIRST CLASS BUSINESS TRAVEL IS REIMBURSED TO THE CEO, EXECUTIVE VICE PRESIDENTS, SENIOR VICE PRESIDENTS, AND GROUP VICE PRESIDENTS. FIRST CLASS BUSINESS TRAVEL IS NOT TREATED AS TAXABLE COMPENSATION. TRAVEL FOR COMPANIONS WAS PROVIDED TO THREE BOARD MEMBERS, ONE OFFICER, AND ONE HIGHEST COMPENSATED EMPLOYEE. THE COST OF THIS BENEFIT WAS INCLUDED IN TAXABLE COMPENSATION. FINANCIAL AND TAX PLANNING EXPENSES ARE REIMBURSED TO EMPLOYEES AT THE DIRECTOR OR ABOVE LEVELS OF MANAGEMENT. A COMPANY POLICY OUTLINES THE MAXIMUM REIMBURSEMENT ALLOWED FOR EACH MANAGEMENT LEVEL. THIRTEEN OFFICERS RECEIVED REIMBURSEMENT IN 2022. THESE REIMBURSEMENTS ARE INCLUDED IN THE TAXABLE COMPENSATION OF THE REIMBURSED EMPLOYEES. PART I, LINE 4A DURING 2022, ONE EXECUTIVE, LEROY R. GILBERT, JR. RECEIVED A SEVERANCE PAYMENT UPON SEPARATION FROM THE ORGANIZATION. THESE PAYMENTS ARE INCLUDED ON SCHEDULE J AND REPORTED IN PART II, COLUMN(B)(III). PART I, LINE 7: THE CEO OF THE ORGANIZATION, WITH BOARD OF DIRECTORS APPROVAL, MAY GRANT AN ANNUAL BONUS TO ALL MANAGEMENT EMPLOYEES. THESE AMOUNTS ARE INCLUDED IN TAXABLE COMPENSATION. PART II, ROW (II): SOME OF THE ORGANIZATION'S OFFICERS ARE PAID BY A RELATED ORGANIZATION. ACCORDINGLY, THEIR COMPENSATION IS REPORTED ON ROW (II). GREGORY D KAPLAN DDS PARTICIPATING PROVIDER 690109 DENTAL CLAIM PAYMENTS 0 BRENT KAPLAN FAMILY MEMBER OF A CURRENT DIRECTOR 306914 ADMINISTRATIVE MANAGEMENT AND ADVISORY SERVICES 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S BYLAWS NAME TWO CLASSES OF "MEMBERS," "CORPORATE MEMBERS AND "DENTIST MEMBERS." ALL CORPORATE MEMBERS ARE ALSO DIRECTORS OF THE ORGANIZATION AND SO ARE NOT "MEMBERS" AS DEFINED IN THE INSTRUCTIONS TO FORM 990, PART VI, QUESTION 6. HOWEVER, THE ORGANIZATION'S DIRECTORS ARE ELECTED BY ITS PARENT HOLDING COMPANY BOARD OF DIRECTORS, TWO OF WHOM ARE NOT ALSO DIRECTORS OF THE ORGANIZATION AND THUS MAY BE CONSIDERED "MEMBERS" PURSUANT TO THE INSTRUCTIONS. THE DENTIST MEMBERS HAVE A RIGHT TO VOTE UPON PROPOSED CHANGES TO THE PROPORTION OF THE DENTISTS SERVING AS DIRECTORS AND CORPORATE MEMBERS, AND SO MAY BE CONSIDERED "MEMBERS" UNDER THE INSTRUCTIONS. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S DIRECTORS ARE ELECTED BY THE PARENT HOLDING COMPANY BOARD OF DIRECTORS, WHICH INCLUDES TWO PERSONS WHO ARE NOT ALSO DIRECTORS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B THE DENTIST MEMBERS HAVE A RIGHT TO VOTE ONLY UPON PROPOSED CHANGES TO THE BYLAWS PROVISIONS THAT SPECIFY THE PROPORTION OF DENTISTS AND LAY PERSONS SERVING AS DIRECTORS AND CORPORATE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S CFO AND LEGAL COUNSEL OVERSEE THE COMPLETION OF THE FORM 990, AND, PRIOR TO FILING, REVIEW IT WITH THE PRESIDENT/CEO AND WITH THE ORGANIZATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY, AND BETWEEN ANNUAL STATEMENTS IS REQUIRED TO DISCLOSE ANY NEW POSITION OR RELATIONSHIP FORMED THAT POTENTIALLY RAISES A CONFLICT OF INTEREST. LEGAL COUNSEL REVIEWS THESE DISCLOSURES AND REPORTS THE INFORMATION TO THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PAID TO THE CEO AND EXECUTIVE VICE PRESIDENTS IS APPROVED BY THE COMPENSATION COMMITTEE OF THE ORGANIZATION. THE COMPENSATION COMMITTEE APPROVES COMPENSATION FOR THE ENSUING YEAR AFTER REVIEWING COMPARABILITY DATA PRESENTED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT, AN ASSESSMENT OF EACH OFFICER'S PERFORMANCE OVER THE PRECEDING YEAR, AND THE ORGANIZATION'S PROGRAM ACCOMPLISHMENTS FOR THE PRIOR YEAR. COMPENSATION PAID TO DIRECTORS IS ALSO APPROVED BY THE COMPENSATION COMMITTEE AFTER REVIEWING COMPARABILITY DATA IN A BENCHMARKING STUDY PREPARED AND PRESENTED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT RETAINED BY THE BOARD OF DIRECTORS. THESE PROCESSES WERE FOLLOWED FOR 2022 COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION ANNUALLY INCLUDES MAJOR PORTIONS OF ITS FINANCIAL STATEMENT IN A PUBLISHED ANNUAL REPORT THAT IS MADE AVAILABLE TO PERSONS OR ENTITIES KNOWN TO HAVE AN INTEREST IN THE ORGANIZATION, AND IS AVAILABLE TO THE LARGER PUBLIC UPON REQUEST. STATUTORY FINANCIAL STATEMENTS FOR SUBSIDIARY COMPANIES ARE INCLUDED IN QUARTERLY AND ANNUAL RETURNS TO STATE DEPARTMENTS OF INSURANCE REGULATING THE ORGANIZATION WHICH RETURNS ARE AVAILABLE TO THE PUBLIC. THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. FORM 990, PART VII; SCHEDULE J; SCHEDULE R THE ORGANIZATION, REGULATED BY THE CALIFORNIA DEPARTMENT OF MANAGED HEALTH CARE, IS A MEMBER OF THE DELTA DENTAL OF CALIFORNIA ENTERPRISE COMPANIES, WHICH INCLUDE DELTA DENTAL OF CALIFORNIA, DELTA DENTAL OF PENNSYLVANIA AND AFFILIATED COMPANIES. THE ENTERPRISE OFFERS DENTAL COVERAGE IN ALL 50 STATES, THE DISTRICT OF COLUMBIA, PUERTO RICO, AND THE U.S. VIRGIN ISLANDS, WITH A LOCAL PRESENCE IN COMMUNITIES ACROSS THE COUNTRY, PROVIDING GROUPS AND INDIVIDUALS WITH QUALITY, COST-EFFECTIVE DENTAL INSURANCE, AND SUPERIOR CUSTOMER SERVICE. THE ENTERPRISE COMPANIES COMPRISE ONE OF THE NATION'S LARGEST DENTAL BENEFITS DELIVERY SYSTEMS COVERING 45 MILLION ENROLLEES AND HANDLING 57 MILLION CLAIMS. TOTAL REVENUE FOR THE ENTERPRISE EXCEEDED $9.8 BILLION IN 2022. THE ORGANIZATION REPRESENTS APPROXIMATELY 59% OF TOTAL ENTERPRISE REVENUES. FORM 990, PART XI, LINE 9: PENSION LIABILITY AND POST-RETIREMENT ADJUSTMENTS -20,949,384. NET INCOME FROM DISREGARDED ENTITY -59,629. 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