DELTA DENTAL OF MISSOURI: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- DELTA DENTAL OF MISSOURI (EIN 43-0908349)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-14
- IRS object ID
- 202203189349302460
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-14T07:56:32-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 312 WALNUT STREET SUITE 3000 | AddressLine1Txt |
| City | CINCINNATI | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 430908349 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF MISSOURI | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % BARBARA C BENTRUP | InCareOfNm |
| Business Name Control | DELT | BusinessNameControlTxt |
| Phone | 3146563000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12399 GRAVOIS ROAD | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 631271702 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BARBARA C BENTRUP | PersonNm |
| Person Title | CFO AND CORP COUNSEL | PersonTitleTxt |
| Phone | 3146563000 | PhoneNum |
| Signature | 2022-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | BARBARA C | PersonFirstNm |
| Person Last | BENTRUP | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Aaron Hershberger | PreparerPersonNm |
| PTIN | P00961884 | PTIN |
| Phone | 5136218300 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | E B ROB GOREN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12399 GRAVOIS ROAD | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 631271702 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $677,009,686 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.DELTADENTALMO.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1958 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | OUR PURPOSE IS TO IMPROVE THE DENTAL HEALTH OF THE PUBLIC BY PROMOTING PREVENTIVE DENTISTRY AND PROVIDING COMPREHENSIVE DENTAL CARE AND MAINTENANCE ON A PREPAID BASIS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 266 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $551,877,993 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $670,952,587 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,537,176 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,188,318 | CYInvestmentIncomeAmt |
| PY Other Revenue | $857,230 | PYOtherRevenueAmt |
| CY Other Revenue | $868,781 | CYOtherRevenueAmt |
| PY Total Revenue | $556,272,399 | PYTotalRevenueAmt |
| CY Total Revenue | $677,009,686 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,970,018 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,596,408 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $490,430,889 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $609,744,540 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $34,856,897 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $36,173,740 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $20,427,542 | PYOtherExpensesAmt |
| CY Other Expenses | $19,631,526 | CYOtherExpensesAmt |
| PY Total Expenses | $547,685,346 | PYTotalExpensesAmt |
| CY Total Expenses | $667,146,214 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $8,587,053 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $9,863,472 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $193,102,771 | TotalAssetsBOYAmt |
| Total Assets EOY | $206,764,296 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $30,918,722 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $34,125,285 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $162,184,049 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $172,639,011 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE ORGANIZATION'S PRIMARY PURPOSE IS TO IMPROVE THE DENTAL HEALTH OF THE PUBLIC BY PROMOTING PREVENTIVE DENTISTRY AND PROVIDING COMPREHENSIVE DENTAL CARE AND MAINTENANCE ON A PREPAID BASIS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $655,189,633 | ExpenseAmt |
| Revenue | $670,952,587 | RevenueAmt |
| Desc | DELTA DENTAL OF MISSOURI IS A PREPAID DENTAL INSURANCE COMPANY. IN 2021, DELTA DENTAL PROCESSED 3,565,893 CLAIMS FOR DENTAL SERVICES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,397,363 | ExpenseAmt |
| Grant | $1,397,363 | GrantAmt |
| Desc | ORAL HEALTH GRANT PROGRAM PROGRAM DESCRIPTION: DELTA DENTAL OF MISSOURI'S ORAL HEALTH GRANT PROGRAM HELPS REDUCE DENTAL DISEASE THROUGH EDUCATION, PREVENTION AND TREATMENT; ENSURE ACCESS TO AFFORDABLE, TIMELY AND HIGH-QUALITY DENTAL CARE; AND ENHANCE AWARENESS OF GOOD ORAL HEALTH WITH A FOCUS ON CHILDREN AND UNDERSERVED INDIVDUALS. IN 2021, DELTA DENTAL OF MISSOURI AWARDED MORE THAN $1.3 MILLION IN GRANTS TO 35 MISSOURI AND SOUTH CAROLINA ORGANIZATIONS, WHICH ALIGN WITH ITS NON-PROFIT MISSION TO IMPROVE ORAL HEALTH. FUNDING INCLUDED DIRECT CARE GRANTS; EQUIPMENT/CAPITAL GRANTS; EDUCATIONAL GRANTS; AND LOAN REPAYMENT GRANTS FOR DENTISTS WHO COMMIT TO SERVING IN A DENTAL HEALTH PROFESSIONAL SHORTAGE AREA. THE COMPANY ACCEPTS GRANT APPLICATIONS IN TWO GRANT CYCLES ANNUALLY. TO BE ELIGIBLE FOR AN ORAL HEALTH GRANT, APPLICANTS IN BOTH STATES MUST FIRST COMPLETE A LETTER OF INTENT THROUGH THE ONLINE GRANT APPLICATION SYSTEM. APPLICANTS MUST BE CONSIDERED TAX-EXEMPT UNDER 501(C)(3) OF THE INTERNAL REVENUE SERVICE CODE, OR BE A PUBLIC OR GOVERNMENTAL ENTITY, SUCH AS A PUBLIC SCHOOL OR HEALTH DEPARTMENT, AND SERVE THE PEOPLE OF MISSOURI OR SOUTH CAROLINA. THE MINIMUM GRANT AMOUNT IS $5,000. ORAL HEALTH GRANTS GREATER THAN $5,000 ARE INCLUDED IN SCHEDULE I. DELTA DENTAL OF MISSOURI BEGAN ADMINISTERING THIS ORAL HEALTH GRANT PROGRAM ONLINE IN 2017. DURING 2021, DELTA DENTAL OF MISSOURI'S TOTAL CHARITABLE CONTRIBUTIONS ALSO INCLUDED MORE THAN $149,000 IN FLUORIDATION GRANTS FOR 15 MISSOURI COUNTIES IN NEED OF NEW OR REPLACEMENT EQUIPMENT TO START OR CONTINUE COMMUNITY WATER FLUORIDATION. THIS FUNDING IS HELPING TO PROTECT THE ORAL HEALTH OF NEARLY 120,000 MISSOURIANS WHO LIVE IN THE IMPACTED COMMUNITIES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $216,200 | ExpenseAmt |
| Desc | LAND OF SMILES PROGRAM PROGRAM DESCRIPTION: DELTA DENTAL OF MISSOURI'S LAND OF SMILES IS AN EDUCATIONAL PROGRAM THAT FEATURES CAPTIVATING CHARACTERS , WHO TEACH GRADESCHOOLERS GOOD DENTAL HEALTH HABITS. IN 2020, THE COVID-19 PANDEMIC PREVENTED THE PROGRAM FROM VISITING ELEMENTARY SCHOOLS AS USUAL. DELTA DENTAL OF MISSOURI LAUNCHED AN INNOVATIVE VIRTUAL EXPERIENCE, FEATURING A VIBRANT VIDEO WITH NEW SUPERHERO CHARACTERS, USED FOR STUDENTS IN THE CLASSROOM AND FOR THOSE INVOLVED IN PARTIAL OR FULL-TIME VIRTUAL LEARNING. IN 2021, THE PROGRAM REACHED MORE THAN 105,000 MISSOURI AND SOUTH CAROLINA KINDERGARTEN-THROUGH-3RD-GRADE STUDENTS THROUGH 441 ONLINE PERFORMANCES. STUDENTS LEARN THE IMPORTANCE OF BRUSHING TEETH TWICE A DAY, FLOSSING, EATING HEALTHY FOODS AND VISITING THE DENTIST REGULARLY. DELTA DENTAL OF MISSOURI OFFERS FREE "SMILE BAGS" TO SCHOOLS FOR STUDENTS WHO PARTICIPATE IN THE PROGRAM. EACH BAG INCLUDES A TOOTHBRUSH, TOOTHPASTE AND DENTAL FLOSS TO HELP STUDENTS PRACTICE THE GOOD ORAL HEALTH HABITS THAT THEY LEARN. EACH SCHOOL IS RESPONSIBLE FOR DISTRIBUTING THE BAGS TO PARTICIPATING STUDENTS WHO ATTEND SCHOOL IN PERSON OR VIRTUALLY. A SURVEY OF SCHOOL NURSES SHOWED THAT 100% RATED THE PROGRAM'S EDUCATIONAL VALUE AS EXCELLENT OR GOOD. PRE- AND POST-TEST DATA ALSO SHOWED AN INCREASE IN CHILDREN'S ORAL HEALTH KNOWLEDGE AFTER VIEWING THE PROGRAM. LONGEVITY: THIS PROGRAM HAS BEEN IN PLACE IN MISSOURI SINCE 2002, AND IN SOUTH CAROLINA SINCE 2014. LINE 4D, PROGRAM SERVICE ------------------------- COMMUNITY GIVING PROGRAM PROGRAM DESCRIPTION: THROUGH DELTA DENTAL OF MISSOURI'S COMMMUNITY GIVING PROGRAM, THE COMPANY SUPPORTS CHARITABLE ORGANIZATIONS AND PROGRAMS THAT ARE WORKING TO MAKE A DIFFERENCE IN MISSOURI AND SOUTH CAROLINA COMMUNITIES. DELTA DENTAL OF MISSOURI CONSIDERS COMMUNITY GIVING REQUESTS EACH QUARTER FROM REGISTERED 501(C)(3) CHARITABLE ORGANIZATIONS, WHICH SERVE INDIVIDUALS IN MISSOURI OR SOUTH CAROLINA, AND SUPPORT THE OVERALL HEALTH AND WELL-BEING OF THE COMMUNITY WITH A FOCUS ON AT-RISK POPULATIONS. ORGANIZATIONS MAY APPLY FOR FUNDING ONCE PER YEAR. DELTA DENTAL OF MISSOURI'S COMMUNITY GIVING INCLUDES ORAL HEALTH SUPPLY DONATIONS OF TOOTHBRUSHES AND DENTAL FLOSS TO ORGANIZATIONS TO HELP INDIVIDUALS MAINTAIN GOOD ORAL HYGIENE FOR BETTER DENTAL HEALTH. Community Giving greater than $5,000 is included in Schedule I. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $199,045 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $189,827 | TotalOtherProgSrvcGrantAmt |
| Total Program Service Expenses | $657,002,241 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | false | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (true) | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (true) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 59233 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 266 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | Yes (true) | LocalChaptersInd |
| Policies Reference Chapters | Yes (true) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BARBARA C BENTRUP | PersonNm |
| Phone | 3146563000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12399 GRAVOIS ROAD | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 631271702 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| E B ROB GOREN | |||||||||
| President & CEO | 60.0 | 0.0 | Yes (X) | $928,817 | $0 | $102,943 | |||
| BARBARA C BENTRUP | |||||||||
| CFO & CORPORATE COUNSEL | 60.0 | 0.0 | Yes (X) | $719,082 | $0 | $130,379 | |||
| RONALD E INGE | |||||||||
| Chief Dental Officer & COO | 60.0 | 0.0 | Yes (X) | $581,885 | $0 | $67,801 | |||
| JAMES J BARONE | |||||||||
| Chief Sales & Mktg Officer | 60.0 | 0.0 | Yes (X) | $498,350 | $0 | $68,527 | |||
| JONATHAN R JENNINGS | |||||||||
| Chief Actuary & VP UW & PM | 60.0 | 0.0 | Yes (X) | $437,772 | $0 | $75,788 | |||
| HENRY S LAFFITTE | |||||||||
| VP, Sales & Account Management | 40.0 | 0.0 | $434,130 | $0 | $72,900 | Yes (X) | |||
| Vicki L Katzfey | |||||||||
| National Account Exec | 60.0 | 0.0 | $370,284 | $0 | $74,206 | Yes (X) | |||
| KARL A MUDRA | |||||||||
| Chief Information Officer | 60.0 | 0.0 | Yes (X) | $367,058 | $0 | $76,391 | |||
| ERIC W MANN | |||||||||
| Director of Operations | 40.0 | 0.0 | $269,082 | $0 | $78,128 | Yes (X) | |||
| JANE STANHAUS | |||||||||
| Chief HR Officer | 40.0 | 0.0 | Yes (X) | $258,493 | $0 | $68,662 | |||
| ELLEN R SAMUELS | |||||||||
| Director of Compliance | 40.0 | 0.0 | $229,632 | $0 | $82,317 | Yes (X) | |||
| ALLISON M IZSAK | |||||||||
| Director of Mktg & Comm | 60.0 | 0.0 | $203,440 | $0 | $78,014 | Yes (X) | |||
| EDWARD A PATTAROZZI | |||||||||
| Chief Sales & Mktg - RETIRED | 60.0 | 0.0 | $277,201 | $0 | $0 | Yes (X) | |||
| JAMES W RHEA | |||||||||
| Board Chairman/Director | 2.0 | 0.0 | Yes (X) | $55,800 | $0 | $0 | Yes (X) | ||
| MARK ZUST | |||||||||
| First Vice Chairman/Director | 2.0 | 0.0 | Yes (X) | $43,250 | $0 | $0 | Yes (X) | ||
| GARY WILLIAMS | |||||||||
| DIRECTOR | 2.0 | 0.0 | $41,100 | $0 | $0 | Yes (X) | |||
| ROSEMARY BISHOP | |||||||||
| Secretary/Director | 2.0 | 0.0 | Yes (X) | $38,200 | $0 | $0 | Yes (X) | ||
| WILLIAM J BENDER | |||||||||
| Treasurer/Director | 2.0 | 0.0 | Yes (X) | $34,750 | $0 | $0 | Yes (X) | ||
| WILLIAM EDWARDS - TERM ENDED | |||||||||
| 2nd Vice Chairman/Director | 2.0 | 0.0 | Yes (X) | $33,550 | $0 | $0 | Yes (X) | ||
| DEBORAH PATTERSON | |||||||||
| DIRECTOR | 2.0 | 0.0 | $31,450 | $0 | $0 | Yes (X) | |||
| TIMOTHY TAYLOR | |||||||||
| DIRECTOR | 2.0 | 0.0 | $30,900 | $0 | $0 | Yes (X) | |||
| STEVEN HARRIS | |||||||||
| DIRECTOR | 2.0 | 0.0 | $30,300 | $0 | $0 | Yes (X) | |||
| WILLIAM GRAY | |||||||||
| 2ND VICE CHAIRMAN/DIRECTOR | 2.0 | 0.0 | Yes (X) | $30,300 | $0 | $0 | Yes (X) | ||
| OLADIPUPO ADEFALA | |||||||||
| DIRECTOR | 2.0 | 0.0 | $29,350 | $0 | $0 | Yes (X) | |||
| JOHN R LANDGRAF JR | |||||||||
| DIRECTOR | 2.0 | 0.0 | $28,800 | $0 | $0 | Yes (X) | |||
| JOHNNY CUSTARDO | |||||||||
| DIRECTOR | 2.0 | 0.0 | $28,800 | $0 | $0 | Yes (X) | |||
| MARK MANCIN | |||||||||
| DIRECTOR | 2.0 | 0.0 | $28,200 | $0 | $0 | Yes (X) | |||
| KATHLEEN TUCKER | |||||||||
| DIRECTOR | 2.0 | 0.0 | $27,850 | $0 | $0 | Yes (X) | |||
| NOBLE COOPER JR | |||||||||
| DIRECTOR | 2.0 | 0.0 | $2,100 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $6,002,976 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $976,056 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 63 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MISSOURI DENTAL PROFESSIONALS | |||||
| 1100 SPUR DR STE 30 | MARSHFIELD | MO | 65706 | DENTAL SERVICES | $6,984,854 |
| JAY F HAUSER DDS PC | |||||
| PO BOX 503094 | SAINT LOUIS | MO | 63150 | DENTAL SERVICES | $3,215,241 |
| M FERNANDEZ DDS E BROWN DDS J OSDIE | |||||
| 3555 SUNSET OFFICE DR STE 210 | SAINT LOUIS | MO | 63127 | DENTAL SERVICES | $2,902,116 |
| MICHAEL K PARSONS DDS PC | |||||
| 6 MCBRIDE AND SON CENTER DR STE 20 | CHESTERFIELD | MO | 63005 | DENTAL SERVICES | $2,839,361 |
| ST LOUIS PEDIATRIC DENTISTRY LLC | |||||
| 4142 KEATON CROSSING BLVD 102 | O FALLON | MO | 63368 | DENTAL SERVICES | $2,576,734 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 991 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DENTAL PREMIUMS | Desc |
| Business | 524114 | BusinessCd |
| Total Revenue Column | $670,952,587 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $670,952,587 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $670,952,587 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,854,748 | TotalRevenueColumnAmt |
| Exclusion | $2,854,748 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,333,570 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,333,570 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,333,570 | TotalRevenueColumnAmt |
| Exclusion | $2,333,570 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MISCELLANEOUS INCOME | 900099 | $397,632 | $397,632 |
| INVESTMENT IN SUBSIDIARY | 900003 | $471,149 | $471,149 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $868,781 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $677,009,686 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $670,952,587 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $6,057,099 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,596,408 | TotalAmt |
| Program Services | $1,596,408 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $609,744,540 | TotalAmt |
| Program Services | $609,744,540 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,896,648 | TotalAmt |
| Management And General | $4,896,648 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,763,604 | TotalAmt |
| Program Services | $21,073,923 | ProgramServicesAmt |
| Management And General | $1,689,681 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,162,322 | TotalAmt |
| Program Services | $2,827,760 | ProgramServicesAmt |
| Management And General | $334,562 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,823,665 | TotalAmt |
| Program Services | $3,539,845 | ProgramServicesAmt |
| Management And General | $283,820 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,527,501 | TotalAmt |
| Program Services | $1,414,118 | ProgramServicesAmt |
| Management And General | $113,383 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $257,829 | TotalAmt |
| Program Services | $203,617 | ProgramServicesAmt |
| Management And General | $54,212 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $194,017 | TotalAmt |
| Program Services | $153,222 | ProgramServicesAmt |
| Management And General | $40,795 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $293,270 | TotalAmt |
| Management And General | $293,270 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,568,452 | TotalAmt |
| Program Services | $2,818,129 | ProgramServicesAmt |
| Management And General | $750,323 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,504,425 | TotalAmt |
| Program Services | $1,392,755 | ProgramServicesAmt |
| Management And General | $111,670 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,248,592 | TotalAmt |
| Program Services | $3,007,458 | ProgramServicesAmt |
| Management And General | $241,134 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,183 | TotalAmt |
| Program Services | $159,402 | ProgramServicesAmt |
| Management And General | $12,781 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $647,006 | TotalAmt |
| Program Services | $598,980 | ProgramServicesAmt |
| Management And General | $48,026 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $283,352 | TotalAmt |
| Program Services | $262,320 | ProgramServicesAmt |
| Management And General | $21,032 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,002 | TotalAmt |
| Program Services | $72,213 | ProgramServicesAmt |
| Management And General | $5,789 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,611,103 | TotalAmt |
| Program Services | $1,491,515 | ProgramServicesAmt |
| Management And General | $119,588 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $594,391 | TotalAmt |
| Management And General | $594,391 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BOARD AND BUREAU DUES | $821,759 | $760,762 | $60,997 |
| SERVICE BUREAU FEES | $3,076,650 | $2,848,278 | $228,372 |
| PUBLIC RELATIONS | $338,078 | $312,984 | $25,094 |
| SERVICE AGREEMENTS | $2,462,386 | $2,279,610 | $182,776 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $480,031 | TotalAmt |
| Program Services | $444,402 | ProgramServicesAmt |
| Management And General | $35,629 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $667,146,214 | TotalAmt |
| Program Services | $657,002,241 | ProgramServicesAmt |
| Management And General | $10,143,973 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,465,117 | BOYAmt |
| EOY | $31,835,963 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,807,157 | BOYAmt |
| EOY | $10,745,287 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,053,987 | BOYAmt |
| EOY | $1,043,334 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $27,761,089 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $18,415,327 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,903,912 | BOYAmt |
| EOY | $9,345,762 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $119,177,138 | BOYAmt |
| EOY | $135,498,879 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,531,329 | BOYAmt |
| EOY | $16,002,478 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,164,131 | BOYAmt |
| EOY | $2,292,593 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,102,771 | BOYAmt |
| EOY | $206,764,296 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,173,757 | BOYAmt |
| EOY | $16,719,136 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,744,965 | BOYAmt |
| EOY | $17,406,149 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,918,722 | BOYAmt |
| EOY | $34,125,285 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $162,184,049 | BOYAmt |
| EOY | $172,639,011 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $162,184,049 | BOYAmt |
| EOY | $172,639,011 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,102,771 | BOYAmt |
| EOY | $206,764,296 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $9,863,472 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $591,490 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,350,000 | OtherCostOrOtherBasisAmt |
| Book Value | $1,350,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,630,866 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,875,103 | DepreciationAmt |
| Book Value | $3,755,763 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,145,351 | OtherCostOrOtherBasisAmt |
| Depreciation | $995,060 | DepreciationAmt |
| Book Value | $150,291 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,730,740 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,315,295 | DepreciationAmt |
| Book Value | $1,415,445 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,904,132 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,229,869 | DepreciationAmt |
| Book Value | $2,674,263 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,345,762 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVEST. IN ADVANTICA HLDG CO | Desc |
| Book Value | $16,002,478 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $16,002,478 | TotalBookValueProgramRltdAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| INCURRED BUT UNREPORTED CLAIMS | $6,892,104 |
| ESTIMATE UNPAID CLAIM PROCESS | $1,175,782 |
| UNEARNED PREMIUMS | $8,290,783 |
| EXPERIENCE RATED CREDIT LIAB | $176,479 |
| ADVANCE DEPOSITS | $871,001 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $17,406,149 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | FIN 48 FOOTNOTE THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. ADVANTICA ADMINISTRATIVE SERVICES, INC. AND ITS WHOLLY-OWNED SUBSIDIARIES ARE SUBJECT TO BOTH FEDERAL AND STATE INCOME TAXES AND ACCOUNT FOR INCOME TAXES IN ACCORDANCE WITH INCOME TAX ACCOUNTING GUIDANCE (ASC 740 INCOME TAXES). THE INCOME TAX ACCOUNTING GUIDANCE RESULTS IN TWO COMPONENTS OF INCOME TAX EXPENSE: CURRENT AND DEFERRED. CURRENT INCOME TAX EXPENSE REFLECTS TAXES TO BE PAID OR REFUNDED FOR THE CURRENT PERIOD BY APPLYING THE PROVISIONS OF THE ENACTED TAX LAW TO THE TAXABLE INCOME OR EXCESS OF DEDUCTIONS OVER REVENUES. THE COMPANY DETERMINES DEFERRED INCOME TAXES USING THE LIABILITY (OR BALANCE SHEET) METHOD. UNDER THIS METHOD, THE NET DEFERRED TAX ASSET OR LIABILITY IS BASED ON THE TAX EFFECTS OF THE DIFFERENCES BETWEEN THE BOOK AND TAX BASES OF ASSETS AND LIABILITIES, AND ENACTED CHANGES IN TAX RATES AND LAWS ARE RECOGNIZED IN THE PERIOD IN WHICH THEY OCCUR. DEFERRED INCOME TAX EXPENSE RESULTS FROM CHANGES IN DEFERRED TAX ASSETS AND LIABILITIES BETWEEN PERIODS. DEFERRED TAX ASSETS ARE REDUCED BY A VALUATION ALLOWANCE IF, BASED ON THE WEIGHT OF EVIDENCE AVAILABLE, IT IS MORE LIKELY THAN NOT THAT SOME PORTION OR ALL OF A DEFERRED TAX ASSET WILL NOT BE REALIZED. UNCERTAIN TAX POSITIONS ARE RECOGNIZED IF IT IS MORE LIKELY THAN NOT, BASED ON THE TECHNICAL MERITS, THAT THE TAX POSITION WILL BE REALIZED OR SUSTAINED UPON EXAMINATION. THE TERM MORE LIKELY THAN NOT MEANS A LIKELIHOOD OF MORE THAN 50 PERCENT; THE TERMS EXAMINED AND UPON EXAMINATION ALSO INCLUDE RESOLUTION OF THE RELATED APPEALS OR LITIGATION PROCESSES, IF ANY. A TAX POSITION THAT MEETS THE MORE LIKELY-THAN-NOT RECOGNITION THRESHOLD IS INITIALLY AND SUBSEQUENTLY MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT HAS A GREATER THAN 50 PERCENT LIKELIHOOD OF BEING REALIZED UPON SETTLEMENT WITH A TAXING AUTHORITY THAT HAS FULL KNOWLEDGE OF ALL RELEVANT INFORMATION. THE DETERMINATION OF WHETHER OR NOT A TAX POSITION HAS MET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD CONSIDERS THE FACTS, CIRCUMSTANCES AND INFORMATION AVAILABLE AT THE REPORTING DATE AND IS SUBJECT TO MANAGEMENT'S JUDGMENT. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES ON INCOME TAXES AS A COMPONENT OF INCOME TAX EXPENSE. ON A CONSOLIDATED BASIS, ADVANTICA ADMINISTRATIVE SERVICES, INC. AND ITS SUBSIDIARIES HAD AN OPERATING GAIN TOTALING $456,351 AND $480,022 AS OF DECEMBER 31, 2021 AND 2020, RESPECTIVELY. AT DECEMBER 31, 2021 AND 2020, ADVANTICA ADMINISTRATIVE HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $20,941,000 AND $21,426,000, RESPECTIVELY. ADVANTICA ADMINISTRATIVE AND ITS SUBSIDIARIES HAD DEFERRED TAX ASSETS OF APPROXIMATELY $4,414,000 AND $4,408,000 AT DECEMBER 31, 2021 AND 2020, RESPECTIVELY, NEARLY ALL OF WHICH ARISE FROM THESE NET OPERATING LOSS CARRYFORWARDS. DUE TO THE REMAINING UNCERTAINTY REGARDING WHETHER THESE WILL BE REALIZED, A FULL VALUATION ALLOWANCE HAS BEEN RECORDED AGAINST THESE DEFERRED TAX ASSETS AT DECEMBER 31, 2021 AND 2020. THE ORGANIZATION AND ITS SUBSIDIARIES ARE CURRENTLY OPEN TO EXAMINATION UNDER THE STATUTE OF LIMITATIONS BY THE INTERNAL REVENUE SERVICE AND STATES IN WHICH IT FILES FOR THE YEARS ENDED DECEMBER 31, 2018 THROUGH 2021. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (43 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|
| Healthworks Kids Museum St Louis | ||||||||
| 1100 Macklind Ave | St Louis | MO | 63110 | 753018876 | 501(C)(3) | $150,000 | General Support | |
| Gateway to Oral Health Foundation | ||||||||
| 2211 Olive Street | St Louis | MO | 63103 | 113664960 | 501(C)(3) | $100,000 | General Support | |
| Delta Area Economic Opp Corp | ||||||||
| 99 Skyview Road | Portageville | MO | 63873 | 430834206 | 501(C)(3) | $75,000 | General Support | |
| Truman Medical Center Charitable Foundation | ||||||||
| 2310 Holmes Street | Kansas City | MO | 64108 | 431194064 | 501(C)(3) | $70,000 | General Support | SUITE 505 |
| Upward Smiles Inc | ||||||||
| 2820 Anchor Drive | Farmington | MO | 63640 | 452780221 | 501(C)(3) | $70,000 | General Support | |
| Little River Medical Center Inc | ||||||||
| PO Box 547 | Little River | SC | 29566 | 570672117 | 501(C)(3) | $63,000 | General Support | |
| Give Kids a Smile | ||||||||
| 10 Worthington Dr | MD Heights | MO | 63043 | 201287939 | 501(C)(3) | $50,000 | General Support | |
| Greenville Tech Foundation Inc | ||||||||
| 556 Perry Avenue | Greenville | SC | 29611 | 570565961 | 501(C)(3) | $50,000 | General Support | |
| Missouri Dental Assocation Foundation | ||||||||
| 3340 American Ave | Jefferson City | MO | 65109 | 431133855 | 501(C)(3) | $50,000 | General Support | |
| Healthy Smiles of Spartanburg Inc | ||||||||
| PO Box 1441 | Spartanburg | SC | 29304 | 030529473 | 501(C)(3) | $50,000 | General Support | |
| Healthy Learners | ||||||||
| 2749 Laurel St | Columbia | SC | 29204 | 571127197 | 501(C)(3) | $50,000 | General Support | |
| AIDS Resource Center of Wisconsin Inc | ||||||||
| 648 N Plankinton Ave | Milwaukee | WI | 53203 | 391534049 | 501(C)(3) | $50,000 | General Support | |
| Medical University of South Carolina | ||||||||
| 1 South Park Circle | Charleston | SC | 29425 | 576000722 | 501(C)(3) | $50,000 | General Support | |
| Samuel U Rodgers Health Center Inc | ||||||||
| 825 Euclid Avenue | Kansas City | MO | 64124 | 430899356 | 501(C)(3) | $42,267 | General Support | |
| East Cooper Community Outreach | ||||||||
| 1145 Six Mile Rd | Mount Pleasant | MO | 29466 | 570939280 | 501(C)(3) | $40,000 | General Support | |
| Heartland Outreach Providers | ||||||||
| 1215 NW State Rte 7 | Blue Springs | SC | 64014 | 274387842 | 501(C)(3) | $35,000 | General Support | |
| HNC Living Foundation | ||||||||
| 6240 W 135th St | Overland Park | MO | 66223 | 464214254 | 501(C)(3) | $25,000 | General Support | |
| Our Lady of Mercy Community Outreach | ||||||||
| PO Box 607 | Johns Island | SC | 29457 | 570905488 | 501(C)(3) | $25,000 | General Support | |
| Missouri Dept of Health & Senior Service | ||||||||
| PO Box 570 | Jefferson City | MO | 65102 | 446000987 | Gov't | $25,000 | General Support | Ste 130 |
| Jefferson County Water Authority | ||||||||
| 711 West Main Street | Festus | MO | 63028 | 030407826 | Gov't | $25,000 | General Support | |
| Public Water Supply District 1 Cole Co Mo | ||||||||
| 4346 Rainbow Dr | Jefferson City | MO | 65109 | 430861043 | Gov't | $25,000 | General Support | Ste 100 |
| St Louis Children's Hospital Foundation | ||||||||
| 1001 Highlands Plaza | St Louis | MO | 63110 | 431626863 | 501(C)(3) | $25,000 | General Support | |
| Children's Smile Center | ||||||||
| 601 N 21st Street | Ozark | MO | 65721 | 571196229 | 501(C)(3) | $25,000 | General Support | |
| City Utilities of Springfield MO | ||||||||
| 301 E Central | Springfield | MO | 65801 | 440553154 | Gov't | $20,864 | General Support | |
| Volunteers In Medicine Clinic | ||||||||
| 15 Northridge | Hilton Head Island | SC | 29926 | 570959206 | 501(C)(3) | $20,000 | General Support | |
| Health Outreach Foundation 180 Hever Knoll | ||||||||
| Village of | Loch Lloyd | MO | 64012 | 202367620 | 501(C)(3) | $15,000 | General Support | |
| Mercy Medicine Free Clinic | ||||||||
| 500 S Colt Street | Florence | SC | 29501 | 311693093 | 501(C)(3) | $15,000 | General Support | |
| Community Clinic of Southwest Missouri | ||||||||
| 701 S Joplin Ave | Joplin | MO | 64801 | 431643962 | 501(C)(3) | $15,000 | General Support | |
| Ronald McDonald House of the Ozarks | ||||||||
| 949 E Primrose St | Springfield | MO | 65807 | 431371143 | 501(C)(3) | $15,000 | General Support | |
| Cass Community Health Foundation | ||||||||
| 2316 E Meyer Blvd | Kansas City | MO | 64132 | 431349495 | 501(C)(3) | $12,564 | General Support | |
| Midlands Technical College Foundation Inc | ||||||||
| 7300 College Street | Irmo | SC | 29063 | 237085753 | 501(C)(3) | $12,500 | General Support | |
| St Louis Community College Foundation | ||||||||
| 3221 McKelvey Rd | Bridgeton | MO | 63044 | 431374500 | 501(C)(3) | $14,500 | General Support | |
| City of Monroe City | ||||||||
| 109 Second Street | Monroe City | MO | 63456 | 436002353 | Gov't | $11,645 | General Support | |
| City of Osage Beach | ||||||||
| 1000 City Parkway | Osage Beach | MO | 65065 | 430887515 | Gov't | $11,062 | General Support | |
| City of Dexter | ||||||||
| 301 E Stoddard St | Dexter | MO | 63841 | 436001012 | Gov't | $10,927 | General Support | |
| City of Glasgow | ||||||||
| 100 Market Street | Glasgow | MO | 65254 | 436001425 | Gov't | $10,685 | General Support | |
| City of Slater | ||||||||
| 232 N Main | Slater | MO | 65349 | 446000264 | Gov't | $10,395 | General Support | |
| RURAL PARISH CLINIC ARCHDIOCESE ST LOUIS | ||||||||
| 20 Archbishop May Drive | St Louis | MO | 63119 | 843396327 | 501(C)(3) | $10,000 | General Support | |
| LevelUp Kids Inc | ||||||||
| 5416 NE Antioch Road | Kansas City | MO | 64119 | 203664224 | 501(C)(3) | $10,000 | General Support | |
| YWCA Metro St Louis | ||||||||
| 3820 West Pine Blvd | St Louis | MO | 63108 | 430653618 | 501(C)(3) | $10,000 | General Support | |
| Dental Lifeline Network | ||||||||
| 1800 15th Street | Denver | CO | 80202 | 846129064 | 501(C)(3) | $8,000 | General Support | |
| City of Kahoka | ||||||||
| 250 N Morgan | Kahoka | MO | 63445 | 436001872 | Gov't | $5,672 | General Support | |
| American Lung Association | ||||||||
| 55 W Wacker Dr | Chicago | IL | 60601 | 131632524 | 501(c)(3) | $10,000 | General Support | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 43 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S. DELTA DENTAL MAINTAINS RECORDS TO SUBSTANTIATE THE AMOUNT OF ASSISTANCE THAT IT PROVIDES TO THE COMMUNITY ORGANIZATIONS. DELTA DENTAL WORKS WITH THE INDIVIDUAL ORGANIZATIONS TO UNDERSTAND THEIR MISSIONS AND TO DETERMINE THE BENEFITS OF DELTA DENTAL'S PARTICIPATION. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BARBARA C BENTRUP | |||||||||||||
| CFO & CORPORATE COUNSEL | $528,551 | $0 | $133,176 | $0 | $57,355 | $0 | $105,109 | $0 | $25,270 | $0 | $849,461 | $0 | $44,272 |
| E B ROB GOREN | |||||||||||||
| President & CEO | $672,059 | $0 | $190,480 | $0 | $66,278 | $0 | $70,137 | $0 | $32,806 | $0 | $1,031,760 | $0 | $65,310 |
| EDWARD A PATTAROZZI | |||||||||||||
| Chief Sales & Mktg - RETIRED | $0 | $0 | $0 | $0 | $277,201 | $0 | $0 | $0 | $0 | $0 | $277,201 | $0 | $18,139 |
| JONATHAN R JENNINGS | |||||||||||||
| Chief Actuary & VP UW & PM | $305,887 | $0 | $112,420 | $0 | $19,465 | $0 | $44,536 | $0 | $31,252 | $0 | $513,560 | $0 | $12,891 |
| KARL A MUDRA | |||||||||||||
| Chief Information Officer | $281,198 | $0 | $69,181 | $0 | $16,679 | $0 | $42,585 | $0 | $33,806 | $0 | $443,449 | $0 | $9,415 |
| JAMES J BARONE | |||||||||||||
| Chief Sales & Mktg Officer | $406,656 | $0 | $81,975 | $0 | $9,719 | $0 | $43,500 | $0 | $25,027 | $0 | $566,877 | $0 | |
| RONALD E INGE | |||||||||||||
| Chief Dental Officer & COO | $423,504 | $0 | $106,724 | $0 | $51,657 | $0 | $45,347 | $0 | $22,454 | $0 | $649,686 | $0 | $31,881 |
| ALLISON M IZSAK | |||||||||||||
| Director of Mktg & Comm | $163,440 | $0 | $39,463 | $0 | $537 | $0 | $44,952 | $0 | $33,062 | $0 | $281,454 | $0 | |
| Vicki L Katzfey | |||||||||||||
| National Account Exec | $101,466 | $0 | $268,005 | $0 | $813 | $0 | $43,500 | $0 | $30,706 | $0 | $444,490 | $0 | |
| ELLEN R SAMUELS | |||||||||||||
| Director of Compliance | $185,488 | $0 | $42,993 | $0 | $1,151 | $0 | $54,180 | $0 | $28,137 | $0 | $311,949 | $0 | |
| HENRY S LAFFITTE | |||||||||||||
| VP, Sales & Account Management | $230,613 | $0 | $202,858 | $0 | $659 | $0 | $39,595 | $0 | $33,305 | $0 | $507,030 | $0 | |
| ERIC W MANN | |||||||||||||
| Director of Operations | $212,262 | $0 | $47,791 | $0 | $9,029 | $0 | $56,339 | $0 | $21,789 | $0 | $347,210 | $0 | |
| JANE STANHAUS | |||||||||||||
| Chief HR Officer | $204,139 | $0 | $44,838 | $0 | $9,516 | $0 | $38,021 | $0 | $30,641 | $0 | $327,155 | $0 | |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 4A | SEVERANCE DURING THE TAX YEAR ENDED DECEMBER 31, 2021, EDWARD PATTAROZZI RECEIVED SEVERENCE PAYMENTS IN THE AMOUNT OF 259,062. |
| SCHEDULE J, PART I, LINE 4B | NAMES, AMOUNTS, AND DETAILS OF ARRANGEMENTS THE ORGANIZATION HAS A NONQUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR THE BENEFIT OF CERTAIN EMPLOYEES TO RECEIVE CONTRIBUTIONS IN EXCESS OF THE LIMITATIONS IMPOSED BY THE INTERNAL REVENUE CODE ON STANDARD EMPLOYEE PENSION PLANS. AMOUNTS PAID DURING 2021 FOR THE FOLLOWING INDIVIDUALS WERE: BARBARA BENTRUP - $44,272 E.B. ROB GOREN - $65,310 KARL MUDRA - $9,415 RONALD INGE - $31,881 JONATHAN JENNINGS - $12,891 THE ORGANIZATION HAS AN UNFUNDED NONQUALIFIED, DEFINED BENEFIT DEFERRED COMPENSATION PLAN (DBDCP) FOR ITS SENIOR LEVEL EXECUTIVES, WITH VESTING AT AGE 60 AND 10 YEARS OF SERVICE FOR EARLY RETIREMENT OR AGE 65 AND FIVE YEARS OF SERVICE FOR NORMAL RETIREMENT. THE PLAN WAS AMENDED TO CURTAIL BENEFITS ACCRUED AS OF DECEMBER 31, 2020 SUBJECT TO THE CONTINUING VESTING PROVISIONS IN THE DBDCP. THE ACTUARIALLY DETERMINED LIABILITY IS BASED UPON ASSUMPTIONS FOR REMAINING YEARS OF SERVICE UNTIL RETIREMENT, PROJECTED SALARIES FOR THE FINAL THREE YEARS OF SERVICE BUT IN NO CASE CONSIDERING ANY SALARY AFTER DECEMBER 31, 2020, AND A PREDETERMINED BENEFIT PERCENTAGE BASED UPON THE PARTICIPANT'S POSITION. INDIVIDUALS WHO PARTICIPATED IN THIS PLAN DURING 2021 WERE THE FOLLOWING: BARBARA BENTRUP, E. B. ROB GOREN, JONATHAN JENNINGS, RONALD INGE AND KARL MUDRA. ALL INCREASES IN THE PROJECTED BENEFIT ACCRUALS FOR THIS DBDCP ARE REPORTED ANNUALLY IN THE FORM 990 FOR EACH PARTICIPANT. IT IS IMPORTANT TO NOTE THAT SEVERAL PARTICIPANTS IN THIS PROGRAM ARE NOT YET VESTED, YET THE INCREASE IN THE VALUE OF THE COMPANY'S ACCRUAL HAS TO BE REPORTED ANNUALLY AS COMPENSATION ON THE FORM 990 FOR EACH OF THE PARTICIPANTS WHEN THERE WAS NO BENEFIT VALUE TO THEM PERSONALLY - IF PARTICIPANTS LEAVE THE COMPANY PRIOR TO MEETING THE AGE AND SERVICE REQUIREMENTS, THERE IS NO BENEFIT PAYABLE. SCHEDULE J, PART II, COLUMN C INCLUDES THESE AMOUNTS FOR THE INCREASES IN THE COMPANY'S ACCRUAL. THE AMOUNTS PER PARTICIPANT ARE: BARBARA BENTRUP - $61,609 E.B. ROB GOREN - $26,637 KARL MUDRA - $(378) JONATHAN JENNINGS - $2,175 RONALD INGE - $1,847 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| MARK R ZUST DDS LTD | |||
| BOARD MEMBER AS OWNER | $278,254 | DENTAL SERVICES PROVIDED | false |
| WILLIAM A GRAY DMD LLC | |||
| BOARD MEMBER AS OWNER | $281,694 | DENTAL SERVICES PROVIDED | false |
| FLORISSANT DENTAL ASSOCIATES LLC | |||
| FAMILY OF BOARD MEMBER | $479,422 | DENTAL SERVICES PROVIDED | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV, LINE 1 | FormAndLineReferenceDesc |
| Explanation | BUSINESS TRANSACTIONS BOARD MEMBER MARK ZUST AND DANIELLE RIORDAN, DAUGHTER OF BOARD MEMBER MARK ZUST, HAVE A REPORTABLE INTEREST IN MARK R ZUST DDS LTD WHICH PROVIDES DENTAL SERVICES TO SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION. BOARD MEMBER WILLIAM GRAY HAS A REPORTABLE INTEREST IN WILLIAM A GRAY DMD LLC WHICH PROVIDES DENTAL SERVICES TO SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION. SEAN LANDGRAF, SON OF BOARD MEMBER JOHN R LANDGRAF JR, HAS A REPORTABLE INTEREST IN FLORISSANT DENTAL ASSOCIATES LLC WHICH PROVIDES DENTAL SERVICES TO THE SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | CLASSES OF MEMBERS OR STOCKHOLDERS THE MEMBERS OF THE ORGANIZATION ARE COMPRISED OF LICENSED DENTISTS IN THE STATES OF MISSOURI AND SOUTH CAROLINA WHO HAVE AN EFFECTIVE SIGNED AND ACCEPTED PARTICIPATING DENTIST AGREEMENT WITH THE ORGANIZATION. THE MEMBERS MEET ANNUALLY. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBERS OR STOCKHOLDERS WHO CAN ELECT MEMBERS OF THE GOVERNING BODY THE ORGANIZATION HAS MEMBERS WHO ELECT THE INDIVIDUALS TO SERVE ON THE ORGANIZATION'S BOARD OF DIRECTORS. THE MEMBERS OF THE ORGANIZATION ARE COMPRISED OF LICENSED DENTISTS IN THE STATES OF MISSOURI AND SOUTH CAROLINA WHO HAVE AN EFFECTIVE SIGNED AND ACCEPTED PARTICIPATING DENTIST AGREEMENT WITH THE ORGANIZATION. THE MEMBERS MEET ANNUALLY. |
| FORM 990, PART VI, SECTION A, LINE 7B | GOVERNANCE DECISIONS CHANGES TO THE CORPORATE BYLAWS BY THE BOARD ARE SUBJECT TO APPROVAL BY THE MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | PROCESS TO REVIEW THE FORM 990 THE FORM 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. THE FORM 990 IS THEN REVIEWED IN DETAIL BY THE ORGANIZATION'S CFO AND PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE ELECTRONIC FILING OF THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY DELTA DENTAL OF MISSOURI REGULARLY REQUIRES ITS OFFICERS, DIRECTORS, AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST STATEMENT. THE REVIEW OF THE STATEMENTS IS PART OF THE FINANCE AND AUDIT COMMITTEE'S RESPONSIBILITIES. |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B | COMPENSATION APPROVAL PROCESS DELTA DENTAL OF MISSOURI HAS ESTABLISHED A COMPENSATION COMMITTEE (A SUBSET OF THE BOARD OF DIRECTORS) COMPOSED ENTIRELY OF PERSONS WITH NO CONFLICT OF INTEREST THAT REVIEWS AND SETS OFFICER COMPENSATION IN ACCORDANCE WITH THE PROCESS OUTLINED IN TREASURY REGULATION SECTION 53.4958-6 FOR ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS OF THE COMPENSATION OF THE CEO AND ALL OTHER OFFICERS. THIS PROCESS INCLUDES EMPLOYING INDEPENDENT COMPENSATION CONSULTANTS, UTILIZING RELEVANT COMPENSATION SURVEYS AND STUDIES, CONTEMPORANEOUSLY DOCUMENTING AND RECORDING THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT, AND SEEKING APPROVAL ON FINALIZED COMPENSATION PROPOSALS BY THE COMPENSATION COMMITTEE. REVIEWS ARE CONDUCTED AND APPROVED BY THE COMPENSATION COMMITTEE ON AN ANNUAL BASIS. THE ANNUAL COMPENSATION FOR 2021 WAS REVIEWED BY A THIRD PARTY COMPENSATION CONSULTANT AND THEN REVIEWED BY THE COMPENSATION COMMITTEE (SUBSECTION OF THE COMPANY'S BOARD OF DIRECTORS) IN MARCH, 2021. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS THE ORGANIZATION'S CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADVANTICA ADMINISTRATIVE SERVICES INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12399 GRAVOIS ROAD | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63127 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431826684 | EIN |
| Primary Activities | THIRD PARTY ADMIN | PrimaryActivitiesTxt |
| Legal Domicile State | MO | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C-CORP | EntityTypeTxt |
| Share Of Total Income | $3,358,941 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $16,457,757 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADVANTICA ADMINISTRATIVE SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | M | TransactionTypeTxt |
| Involved | $166,224 | InvolvedAmt |
| Method Of Amount Determination | ALLOCATIONS | MethodOfAmountDeterminationTxt |
Comments