DELTA DENTAL OF IOWA: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL OF IOWA (EIN 42-0959302)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-14
IRS object ID
202213189349303766
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

FieldValueIRS element (for citing)
Return2022-11-14T09:23:40-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN411431613PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BERGANKDV LTDBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line112100 MEREDITH DR SUITE 200AddressLine1Txt
CityURBANDALECityNm
State AbbreviationIAStateAbbreviationCd
ZIP50323ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN420959302EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF IOWABusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlDELTBusinessNameControlTxt
Phone5152615500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line19000 NORTHPARK DRIVEAddressLine1Txt
CityJOHNSTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50131ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSHERRY PERKINSPersonNm
Person TitleVICE PRES FINANCE & CONTROLLERPersonTitleTxt
Phone5152615500PhoneNum
Signature2022-11-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSHERRYPersonFirstNm
Person LastPERKINSPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRENT L ALEXANDER CPAPreparerPersonNm
PTINP00075113PTIN
Phone5157275700PhoneNum
Preparation2022-11-11PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJEFFREY S RUSSELLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line19000 NORTHPARK DRIVEAddressLine1Txt
CityJOHNSTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50131ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$221,775,397GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressWWW.DELTADENTALIA.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1970FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionDELTA DENTAL OF IOWA IS COMMITED TO IMPROVING THE HEALTH AND SMILES OF THE PEOPLE WE SERVE. THIS IS ACCOMPLISHED WITH PROGRAMS, EDUCATION AND CONTRIBUTIONS TO VARIOUS HEALTH FOCUSED ENTITIES AND INITIATIVES. DELTA DENTAL OF IOWA INVESTS IN DENTAL PROGRAMS, VISION PROGRAMS, MENTAL HEALTH PROGRAMS AND OTHER HEALTH RELATED INITIATIVES TO SUPPORT THE OVERALL HEALTH OF THE PEOPLE WE SERVE.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee197TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$467,800TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$165,642,750PYProgramServiceRevenueAmt
CY Program Service Revenue$204,217,367CYProgramServiceRevenueAmt
PY Investment Income$2,595,165PYInvestmentIncomeAmt
CY Investment Income$5,893,811CYInvestmentIncomeAmt
PY Other Revenue$411,146PYOtherRevenueAmt
CY Other Revenue$531,564CYOtherRevenueAmt
PY Total Revenue$168,649,061PYTotalRevenueAmt
CY Total Revenue$210,642,742CYTotalRevenueAmt
PY Grants And Similar Paid$6,282,243PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$6,206,620CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$114,606,543PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$149,329,554CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$19,563,881PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$20,826,948CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$21,595,156PYOtherExpensesAmt
CY Other Expenses$21,194,878CYOtherExpensesAmt
PY Total Expenses$162,047,823PYTotalExpensesAmt
CY Total Expenses$197,558,000CYTotalExpensesAmt
PY Revenues Less Expenses$6,601,238PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$13,084,742CYRevenuesLessExpensesAmt
Total Assets BOY$151,558,803TotalAssetsBOYAmt
Total Assets EOY$171,274,321TotalAssetsEOYAmt
Total Liabilities BOY$55,579,927TotalLiabilitiesBOYAmt
Total Liabilities EOY$63,553,316TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$95,978,876NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$107,721,005NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionDELTA DENTAL OF IOWA'S MISSION IS TO IMPROVE THE HEALTH AND SMILES OF THE PEOPLE WE SERVE. THE PRIMARY WAY THIS IS ACCOMPLISHED IS THROUGH THE PROVISION OF DENTAL BENEFTIS AND PUBLIC HEALTH CONTRIBUTIONS THAT FOCUS ON ACCESS TO ORAL HEALTH SERVICES AND EDUCATION RELATED TO GOOD ORAL HEALTH BEHAVIORS. DELTA DENTAL OF IOWA ALSO INVESTS IN OTHER HEALTH RELATED INITIATIVES SUCH AS VISION AND MENTAL HEALTH PROGRAMS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$187,258,897ExpenseAmt
Grant$6,206,620GrantAmt
Revenue$204,281,131RevenueAmt
DescSINCE 1970, DELTA DENTAL OF IOWA HAS EXPANDED ACCESS TO DENTAL CARE BY PROVIDING AFFORDABLE, NETWORK BASED DENTAL BENEFITS PLANS TO IOWA EMPLOYERS AND INDIVIDUALS THAT RESULT IN LONG-TERM COST SAVINGS AND SUPPORT GOOD ORAL HEALTH. DELTA DENTAL OF IOWA'S DENTAL BENEFIT PLANS STRIVE TO INCORPORATE THE CURRENT BEST PRACTICES IN DENTAL SCIENCE. DELTA DENTAL IS COMMITTED TO ITS MISSION OF IMPROVING THE HEALTH AND SMILES OF THE PEOPLE AND COMMUNITIES IT SERVES. DELTA DENTAL FULFILLS ITS NOT-FOR-PROFIT OJECTIVES BY ACTIVELY PARTICIPATING IN THE COMMUNITIES IT SERVES AS A CHAMPION AND MAJOR FUNDER OF ORAL HEALTH INITIATIVES IN THE STATE OF IOWA. DELTA DENTAL INVESTS IN ORAL HEALTH PROJECTS THAT MEET THE NEEDS OF UNDERSERVED POPULATIONS AND THAT FOCUS ON ACCESS TO CARE,PREVENTION, EDUCATION AND RESEARCH.Desc
Total Program Service Expenses$187,258,897TotalProgramServiceExpensesAmt
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (1)BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document19718IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee197EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SHERRY PERKINSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5152615500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line19000 NORTHPARK DRIVEAddressLine1Txt
CityJOHNSTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50131ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
JEFFREY S RUSSELL
PRESIDENT AND CEO40.000.39Yes (X)Yes (X)$997,918$0$58,700
CHARLES EDWARD BROWN
DIRECTOR2.50Yes (X)$30,900$0$0
JOHN MALETTA DDS
DIRECTOR (ENDED 6/21)1.60Yes (X)$132,726$0$8,830
ROWENA CROSBIE
DIRECTOR1.601.00Yes (X)$4,300$300$19,500
GREGORY DUNN
DIRECTOR1.60Yes (X)$21,800$0$0
KRISTA TANNER
DIRECTOR1.60Yes (X)$22,300$0$0
DONNA GRANT
DIRECTOR1.600.50Yes (X)$23,800$300$0
TOM MAHONEY
DIRECTOR1.60Yes (X)$4,100$0$19,500
MARIA FULLER
DIRECTOR1.60Yes (X)$14,300$0$0
SCOTT YEGGE DDS
DIRECTOR1.60Yes (X)$5,250$0$17,650
TODD HERREN
SENIOR VP, TECHNOLOGY & OP40.00Yes (X)$449,236$0$46,857
JEFF CHAFFIN
DENTAL DIRECTOR40.001.17Yes (X)$439,007$0$25,277
APRIL SCHMALTZ
SENIOR VP, MARKETING & SAL40.00Yes (X)$409,393$0$46,857
ELIZABETH MYERS
VP, OPERATIONS40.00Yes (X)$404,814$0$25,036
MICHAEL ELAM
VP, UNDERWRITING & ACTUARI40.00Yes (X)$354,972$0$46,857
SHERRY PERKINS
VP, FINANCE & CONTROLLER40.000.67Yes (X)$338,856$0$25,277
SUZANNE HECKENLAIBLE
VP, PUBLIC AFFAIRS30.0010.00Yes (X)$309,304$0$58,700
GRETCHEN HAGEMAN
VP, GOVERNMENT PROGRAMS40.00Yes (X)$262,581$0$23,129
RANAE CALVERT
DIRECTOR, STRATEGIC BUSINE40.00$192,208$0$51,552Yes (X)
RYAN BLACKARD
DIRECTOR, MARKETING40.00$200,874$0$50,518Yes (X)
CORY BAUER
DIRECTOR, SALES & CUSTOMER RELATIONS40.00$181,557$0$9,198Yes (X)
BETH RUSSETT
DIRECTOR, HUMAN RESOURCES40.00$168,507$0$25,877Yes (X)
TOM WALTON
DIRECTOR, LEGAL SERVICES & GNERAL CONSULTING40.00$165,028$0$47,425Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$5,133,731TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$600TotReportableCompRltdOrgAmt
Total Other Compensation$606,740TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K30IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
UNIVERSITY OF IOWA
322 DENTAL SCIENCE BLDG SIOWA CITYIA52242DENTAL SERVICES$8,622,611
APPLEWHITE DENTAL IOWA PC
40 MAIN ST SUITE 100DUBUQUEIA52001DENTAL SERVICES$5,482,740
DENTISTRY FOR CHILDREN OF IOWA PLC
1350 SPRING ST NW SUITE 600ATLANTAGA30309DENTAL SERVICES$3,090,292
ORAL SURGEONS PC
7400 FLEUR DRIVE SUITE 200DES MOINESIA50321DENTAL SERVICES$2,885,089
RIVER HILLS COMMUNITY HEALTH CENTER
PO BOX 458OTTUMWAIA52501DENTAL SERVICES$2,076,090
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K682CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PREMIUMS EARNED524114$187,833,722$187,833,722
ADMINISTRATIVE SERVICE REVENUE524292$16,383,645$16,383,645
FieldValueIRS element (for citing)
Total Program Service Revenue$204,217,367TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,587,817TotalRevenueColumnAmt
Exclusion$2,587,817ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$14,438,649SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$11,132,655SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$3,305,994SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,305,994TotalRevenueColumnAmt
Exclusion$3,305,994ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MANAGEMENT FEES541610$467,800$467,800
OTHER INCOME900099$63,764$63,764
FieldValueIRS element (for citing)
Other Revenue Total$531,564OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$210,642,742TotalRevenueColumnAmt
Related Or Exempt Func Income$204,281,131RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$467,800UnrelatedBusinessRevenueAmt
Exclusion$5,893,811ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$6,206,620TotalAmt
Program Services$6,206,620ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$149,329,554TotalAmt
Program Services$149,329,554ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$4,647,726TotalAmt
Program Services$2,104,167ProgramServicesAmt
Management And General$2,543,559ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$11,197,416TotalAmt
Program Services$8,823,540ProgramServicesAmt
Management And General$2,373,876ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,248,624TotalAmt
Program Services$1,363,699ProgramServicesAmt
Management And General$884,925ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,536,959TotalAmt
Program Services$1,650,735ProgramServicesAmt
Management And General-$113,776ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,196,223TotalAmt
Program Services$868,625ProgramServicesAmt
Management And General$327,598ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$107,493TotalAmt
Management And General$107,493ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$203,725TotalAmt
Program Services$61,000ProgramServicesAmt
Management And General$142,725ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$30,000TotalAmt
Management And General$30,000ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$191,314TotalAmt
Management And General$191,314ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,422,477TotalAmt
Program Services$3,073,823ProgramServicesAmt
Management And General$348,654ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,326,570TotalAmt
Program Services$1,280,925ProgramServicesAmt
Management And General$45,645ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,906,620TotalAmt
Program Services$3,252,927ProgramServicesAmt
Management And General$653,693ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$725,605TotalAmt
Management And General$725,605ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$77,411TotalAmt
Program Services$38,887ProgramServicesAmt
Management And General$38,524ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$85,655TotalAmt
Program Services$38,839ProgramServicesAmt
Management And General$46,816ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,259,847TotalAmt
Program Services$1,751,714ProgramServicesAmt
Management And General$508,133ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$391,179TotalAmt
Management And General$391,179ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BROKER COMMISSIONS$6,217,139$6,217,139
PREMIUM TAXES$962,866$962,866
DDPA DUES$471,081$471,081
CIVIC AND CHARITABLE CO$321,908$68,101$253,807

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$493,988TotalAmt
Program Services$165,736ProgramServicesAmt
Management And General$328,252ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$197,558,000TotalAmt
Program Services$187,258,897ProgramServicesAmt
Management And General$10,299,103ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$52,171,300BOYAmt
EOY$62,665,895EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$919,703BOYAmt
EOY$865,139EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$6,180,746BOYAmt
EOY$8,464,981EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$685,705BOYAmt
EOY$728,714EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$35,163,925LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$20,583,617LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$15,536,624BOYAmt
EOY$14,580,308EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$69,212,809BOYAmt
EOY$73,343,841EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$3,870,960BOYAmt
EOY$6,169,760EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,980,956BOYAmt
EOY$4,455,683EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$151,558,803BOYAmt
EOY$171,274,321EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$15,969,419BOYAmt
EOY$14,371,538EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$39,610,508BOYAmt
EOY$49,181,778EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$55,579,927BOYAmt
EOY$63,553,316EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$95,978,876BOYAmt
EOY$107,721,005EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$95,978,876BOYAmt
EOY$107,721,005EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$151,558,803BOYAmt
EOY$171,274,321EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$13,084,742ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,342,613NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,665,500OtherCostOrOtherBasisAmt
Book Value$2,665,500BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,851,832OtherCostOrOtherBasisAmt
Depreciation$2,796,448DepreciationAmt
Book Value$9,055,384BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$19,311,009OtherCostOrOtherBasisAmt
Depreciation$16,982,057DepreciationAmt
Book Value$2,328,952BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,335,584OtherCostOrOtherBasisAmt
Depreciation$805,112DepreciationAmt
Book Value$530,472BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$14,580,308TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
UNEARNED PREMIUMS$2,741,938
CLAIMS UNPAID AND RESERVE$7,888,481
OTHER POLICY RESERVES$34,903,117
INTERCOMPANY PAYABLE$537,164
OTHER LONG TERM LIABILITIES$3,111,078
FieldValueIRS element (for citing)
Total Liability$49,181,778TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationDELTA DENTAL OF IOWA IS EXEMPT FROM FEDERAL INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE COMPANY ACCOUNTS FOR INCOME TAXES OF TAXABLE CONSOLIDATED ENTITIES, WHEREBY DEFERRED TAXES ARE PROVIDED ON TEMPORARY DIFFERENCES ARISING FROM ASSETS AND LIABILITIES WHOSE BASES ARE DIFFERENT FOR FINANCIAL REPORTING AND INCOME TAX PURPOSES. DEFERRED TAXES WERE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIALS STATEMENTS. AS OF DECEMBER 31, 2021 AND 2020, THE COMPANY'S UNRECOGNIZED TAX BENEFITS WERE NOT SIGNIFICANT. THERE WERE NO SIGNIFICANT PENALTIES OR INTEREST RECOGNIZED OR ACCURED DURING 2021 AND 2020.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
DELTA DENTAL OF IOWA FOUNDATION
9000 NORTHPARK DRIVEJOHNSTONIA50131260762771501(C)(3)$5,600,000$0CONTRIBUTION TO DELTA DENTAL OF IOWA FOUNDATION TO SUPPORT & IMPROVE THE ORAL HEALTH OF IOWANS
COMMUNITY FOUNDATION OF GREATER DES MOINES
1915 GRAND AVEDES MOINESIA50309426139033501(C)(3)$250,000$0CONTRIBUTION TO CFGDM FOR THE DDIA DONOR ADVISED FUND. THE DONOR ADVISED FUND IS USED FOR THE REPAYMENT OF DENTAL EDUCATION DEBT FOR A DENTIST WHO AGREES TO ESTABLISH AN OFFICE IN A RURAL, UNDERSERVED AREA.
UNITED WAYS OF IOWA
1111 NINTH STREET STE 295DES MOINESIA50314421216277501(C)(3)$25,000$0DONATION TO ESTABLISH A STATEWIDE ASSOCIATION TO SERVE AND STRENGTHEN IOWA'S NONPROFIT SECTOR
GREAT OUTDOORS FOUNDATION
501 SW 7TH STREET SUITE GDES MOINESIA50309421441098501(C)(3)$25,000$0CENTRAL IOWA WATER TRAILS DONATION
DES MOINES WATER WORKS PARK
501 SW 7TH STREET SUITE G3DES MOINESIA50309464894890501(C)(3)$10,000$0"BIG SPLASH" DONATION - CONNECTS WW PARK TO GRAY'S LAKE, TRAILS, AMPHITHEATER, MORE ACCESSIBILITY
EASTER SEALS OF IOWA
401 NE 66TH AVEDES MOINESIA50313208392083501(C)(3)$20,000$0DONATION TO CHILDREN'S MENTAL HEALTH CRISIS STABILIZATION PROJECT
CONNECTCR
PO BOX 11186CEDAR RAPIDSIA52410271554605501(C)(3)$25,000$0CEDAR RAPIDS TRANSFORMATION PROJECT DONATION
IOWA SOCCER DEVELOPMENT FOUNDATION
1459 GRAND AVENUEDES MOINESIA50309844367003501(C)(3)$50,000$0DONATION
UNIVERSITY OF IOWA CENTER FOR ADVANCEMENT
PO BOX 4550IOWA CITYIA52244420796760501(C)(3)$15,000$0DONATION TO DR. JENIFER WOLFE MEMORIAL FUND FOR SUICIDE PREVENTION
ONESIGHT
PO BOX 637509CINCINNATIOH45263311385607501(C)(3)$6,755$0SUPPORT SERVICES FOR VISION CLINIC
BUSINESS PUBLICATION CORP
100 4TH STREETDES MOINESIA50309273813987N/A$11,000$0LIFTING THE VEIL - SPONSORSHIP OF MENTAL HEALTH SERIES
FieldValueIRS element (for citing)
Total501c3 Org10Total501c3OrgCnt
Total Other Org1TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationDELTA DENTAL OF IOWA MAINTAINS A DONOR ADVISED FUND AT THE COMMUNITY FOUNDATION OF GREATER DES MOINES FOR THE PURPOSE OF AWARDING LOAN REPAYMENT AWARDS TO DENTISTS WHO AGREE TO PRACTICE IN AN UNDERSERVED AREA IN THE STATE OF IOWA AND TO DEDICATE A PORTION OF THEIR PRACTICE TO LOW INCOME PATIENTS. DELTA DENTAL OF IOWA ADVISES THE COMMUNITY FOUNDATION OF GREATER DES MOINES ON HOW TO AWARD THIS MONEY AND THE COMMUNITY FOUNDATION OF GREATER DES MOINES ONLY GRANTS THIS MONEY TO DENTISTS IN THE STATE OF IOWA. THE COMMUNITY FOUNDATION OF GREATER DES MOINES AND DELTA DENTAL OF IOWA MAINTAIN RECORDS TO SUBSTANTIATE THE AMOUNT OF GRANTS, THE GRANTEEES' ELIGIBILITY AND THE SELECTION CRITERIA. DELTA DENTAL OF IOWA ALSO MAKES GRANTS TO THE DELTA DENTAL OF IOWA FOUNDATION. THE DELTA DENTAL OF IOWA FOUNDATION MAINTAINS RECORDS TO SUBSTANTIATE THE AMOUNT OF GRANTS, THE GRANTEES' ELIGIBILITY AND THE SELECTION CRITERIA. ORGANIZATIONS RECEIVING GRANTS ARE REQUIRED TO SUBMIT FINANCIAL INFORMATION.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgYes (1)CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JEFFREY S RUSSELL
PRESIDENT AND CEO$613,366$0$320,044$0$64,508$0$23,200$0$35,500$0$1,056,618$0$57,147$0
TODD HERREN
SENIOR VP, TECHNOLOGY & OP$293,636$0$132,378$0$23,222$0$23,200$0$23,657$0$496,093$0$21,065$0
JEFF CHAFFIN
DENTAL DIRECTOR$278,596$0$121,731$0$38,680$0$23,200$0$2,077$0$464,284$0$36,990$0
APRIL SCHMALTZ
SENIOR VP, MARKETING & SAL$270,011$0$123,929$0$15,453$0$23,200$0$23,657$0$456,250$0$13,963$0
ELIZABETH MYERS
VP, OPERATIONS$245,174$0$112,706$0$46,934$0$23,200$0$1,836$0$429,850$0$44,784$0
MICHAEL ELAM
VP, UNDERWRITING & ACTUARI$265,835$0$86,827$0$2,310$0$23,200$0$23,657$0$401,829$0$55,306$0
SUZANNE HECKENLAIBLE
VP, PUBLIC AFFAIRS$203,142$0$97,153$0$9,009$0$23,200$0$35,500$0$368,004$0$7,092$0
SHERRY PERKINS
VP, FINANCE & CONTROLLER$223,491$0$102,961$0$12,404$0$23,200$0$2,077$0$364,133$0$10,468$0
GRETCHEN HAGEMAN
VP, GOVERNMENT PROGRAMS$188,772$0$72,060$0$1,749$0$21,052$0$2,077$0$285,710$0$0$0
RYAN BLACKARD
DIRECTOR, MARKETING$160,634$0$38,550$0$1,690$0$16,877$0$33,641$0$251,392$0$0$0
RANAE CALVERT
DIRECTOR, STRATEGIC BUSINE$151,883$0$38,835$0$1,490$0$16,052$0$35,500$0$243,760$0$0$0
TOM WALTON
DIRECTOR, LEGAL SERVICES & GNERAL CO$150,734$0$12,804$0$1,490$0$13,947$0$33,478$0$212,453$0$0$0
BETH RUSSETT
DIRECTOR, HUMAN RESOURCES$135,238$0$31,779$0$1,490$0$13,778$0$12,099$0$194,384$0$0$0
CORY BAUER
DIRECTOR, SALES & CUSTOMER RELATIONS$117,276$0$62,791$0$1,490$0$7,197$0$2,001$0$190,755$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ATRAVEL FOR THE SPOUSE OF THE PRESIDENT AND CEO IS PAID BY THE COMPANY. THE TOTAL AMOUNT OF THE TRAVEL IS INCLUDED IN TAXABLE WAGES FOR THE PRESIDENT AND CEO. TAX GROSS UP PAYMENTS ARE RELATED TO TAXABLE FRINGE BENEFITS INCLUDED AS COMPENSATION FOR ALL COMPANY EMPLOYEES INCLUDING THE PERSONS LISTED IN PART VII, SECTION A, LINE 1. THE PAYMENTS REPRESENT 1% OR LESS OF COMPENSATION FOR THE INDIVIDUALS. SOCIAL CLUB DUES FOR THE PRESIDENT & CEO ARE PAID BY THE COMPANY. THE AMOUNT OF PERSONAL USAGE OF THE CLUB IS INCLUDED IN TAXABLE WAGES FOR THE PRESIDENT & CEO.
PART I, LINE 4BEFFECTIVE JANUARY 1, 2016, THE OFFICERS OF DELTA DENTAL OF IOWA PARTICIPATE IN A SEC. 457(F) PLAN. DELTA DENTAL OF IOWA MAKES A CONTRIBUTION TO THE PLAN ANNUALLY ON BEHALF OF THE OFFICERS. THIS CONTRIBUTION IS A PERCENTAGE OF SALARY AND IS SET AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF DELTA DENTAL OF IOWA. THE PORTION OF A PARTICIPANT'S ACCOUNT BALANCE ALLOCATED TO A PARTICULAR PLAN YEAR'S AWARD BECOMES VESTED ON JANUARY 1ST OF THE FOURTH YEAR FOLLOWING THE PLAN YEAR FOR WHICH THE AWARD IS GRANTED. THAT AMOUNT IS THEN PAID TO THE OFFICER. OTHER THAN THE VESTING CRITERIA, THE OFFICERS CANNOT ACCESS THE FUNDS UNTIL RETIREMENT, LEAVING THE COMPANY, OR DEATH. OFFICERS WHO RECEIVED DEPOSITS IN 2021 FROM DELTA DENTAL OF IOWA AND THE AMOUNTS ARE: SHERRY PERKINS - $47,396 SUZANNE HECKENLAIBLE - $50,419 JEFFREY S. RUSSELL - $106,577 JEFF CHAFFIN - $54,361 MICHAEL ELAM - $48,973 TODD HERREN - $72,441 APRIL SCHMALTZ - $62,390 ELIZABETH MYERS - $68,921 GRETCHEN HAGEMAN - $45,262 OFFICERS THAT RECEIVED PAYMENTS OF VESTED AMOUNTS IN 2021 AND THE AMOUNTS ARE: SHERRY PERKINS - $10,468 SUZANNE HECKENLAIBLE - $7,092 JEFFREY S. RUSSELL - $57,147 JEFF CHAFFIN - $36,990 TODD HERREN - $21,065 APRIL SCHMALTZ - $13,963 ELIZABETH MYERS - $44,784 MICHAEL ELAM - $55,306 THE OFFICERS OF DELTA DENTAL OF IOWA ALSO PARTICIPATE IN A LONG-TERM INCENTIVE PLAN. THE PLAN IS INTENDED AND AT ALL TIMES SHALL BE AN UNFUNDED AND UNSECURED PLAN THAT IS LIMITED TO KEY MANAGEMENT EMPLOYEES OF THE ORGANIZATION DESIGNED TO ENHANCE THE BOARD'S EFFORT AT RETENTION OF ITS EXECUTIVE STAFF. OFFICERS THAT RECEIVED PAYMENTS IN LONG-TERM INCENTIVE PLAN: NONE WERE RECEIVED IN 2021
PART I, LINE 5ONE EMPLOYEE OF THE COMPANY HAS COMPENSATION CONTINGENT ON REVENUES. THE INDIVIDUAL WORKS IN THE SALES DEPARTMENT AND RECEIVES COMMISSIONS BASED ON SALES OF GROUP BUSINESS. THE INDIVIDUAL IS RESPONSIBLE FOR SELLING NEW BUSINESS.
PART I, LINE 6CONSISTENT WITH THE COMPANY'S TOTAL COMPENSATION POLICY, THE OFFICERS AND KEY EMPLOYEES, ALONG WITH ALL EMPLOYEES OF THE COMPANY, PARTICIPATE IN A COMPANY INCENTIVE COMPENSATION PLAN. THIS PLAN CONTAINS NINE METRICS WHICH REPRESENT KEY GOALS FOR THE PLAN YEAR. AN OVERALL WEIGHTED SCORE IS CALCULATED. A BONUS WILL BE PAID IF THE COMPANY MEETS A RANGE OF GOAL ACCOMPLISHMENTS FOR THE YEAR. THE AMOUNT OF THE BONUS IS BASED ON THE TOTAL SCORE. ONE OF THESE METRICS IS PROFITABILITY, WHICH IS DEFINED AS "TOTAL NET GAIN IN DOLLARS PRIOR TO PUBLIC BENEFIT CONTRIBUTIONS FOR THE FISCAL YEAR PER AUDITED FINANCIAL RESULTS."

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
DONNA GRANT
DIRECTOR$273,083INDEPENDENT CONTRACTOR PAYMENTS MADE FOR DENTAL SERVIECES FROM DDIA THROUGH NORWALK FAMILY DENTISTRY0
SCOTT YEGGE
DIRECTOR$258,202INDEPENDENT CONTRACTOR PAYMENTS MADE FOR DENTAL SERVIECES FROM DDIA THROUGH ADVANCED FAMILY DENTRISTRY. TRANSACTIONS WERE DONE AT0
MARIA FULLER
DIRECTOR$120,649INDEPENDENT CONTRACTOR PAYMENTS MADE FOR DENTAL SERVIECES FROM DDIA THROUGH FULLER FAMILY DENTRISTRY. TRANSACTIONS WER DONE AT FMV.0
TOM MAHONEY
DIRECTOR$106,324PAYMENTS MADE TO ITA GROUP FOR FEES AND PREMIUMS - TOM MAHONEY IS CHAIRMAN. TRANSACTIONS WERE DONE AT FAIR MARKET VALUE.0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE MEMBERS OF THE CORPORATION CONSIST OF THE PROVIDERS (PARTICIPATING DENTISTS), AND SUBSCRIBERS WHO ARE ELECTED BY THE BOARD.
FORM 990, PART VI, SECTION A, LINE 7ATHE DIRECTORS SHALL BE ELECTED BY THE MEMBERS. SUBSCRIBER MEMBERS MAY NOMINATE CANDIDATES FOR SUBSCRIBER DIRECTOR POSITIONS AND PROVIDER MEMBERS MAY NOMINATE CANDIDATES FOR THE PROVIDER DIRECTOR POSITIONS.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 AND ALL RELATED SCHEDULES WERE REVIEWED BY BOTH THE MANAGEMENT OF THE COMPANY AND THE BOARD OF DIRECTORS PRIOR TO FILING. THE FORM 990 WAS REVIEWED BY MANAGEMENT OF THE COMPANY PRIOR TO PRESENTATION TO THE BOARD. THE MEMBERS OF THE MANAGEMENT TEAM WHO REVIEWED THE FORM 990 WERE THE CEO, COMPLIANCE MANAGER, AND VICE PRESIDENT FINANCE. AN ELECTRONIC DRAFT COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS. ALL MEMBERS OF THE BOARD REVIEWED THE FORM 990 AND RELATED SCHEDULES PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE COMPLIANCE MANAGER, ON BEHALF OF THE GOVERNANCE COMMITTEE, CONDUCTS AN ANNUAL CONFLICT OF INTEREST REVIEW FOR COMPLIANCE WITH FEDERAL AND STATE LAW AND THE GOVERNANCE POLICY. THE REVIEW INCLUDES ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES. COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES AND DISCLOSURES ARE COMPARED TO THE GROUP FOR POTENTIALLY CONFLICTING TRANSACTIONS, BUSINESS AND FAMILY RELATIONSHIPS, AND AFFILIATIONS. ANNUAL COMPENSATION, REIMBURSEMENTS, BENEFIT PAYMENTS, AND OTHER TRANSACTIONS ARE ALSO REVIEWED FOR APPROPRIATENESS. A WRITTEN REPORT OF THE FINDINGS IS PRESENTED TO THE GOVERNANACE COMMITTEE, BOARD OF DIRECTORS AND SENIOR MANAGEMENT. SOLUTIONS TO POTENTIAL CONFLICTS ARE DISCUSSED AND DOCUMENTED IN THE BOARD OF DIRECTOR'S MEETING MINUTES.
FORM 990, PART VI, SECTION B, LINE 15ON A BI-ANNUAL BASIS, DELTA DENTAL OF IOWA DOES A MARKET PRICE AND BENCHMARKING COMPARISON OF THE COMPENSATION OF THE LEADERSHIP TEAM AND THE STAFF. THIS ANALYSIS IS PERFORMED BY AN INDEPENDENT THIRD PARTY. THIS ANALYSIS INCLUDES THE USE OF DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THE DOCUMENTED RESULTS AND RECOMMENDATIONS OF THIS ANALYSIS ARE PRESENTED TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS REVIEWS THE DOCUMENTATION AND APPROVES THE COMPENSATION. THESE DECISIONS ARE DOCUMENTED IN THE MINUTES OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19DELTA DENTAL OF IOWA'S GOVERNING DOCUMENTS BECOME A MATTER OF PUBLIC RECORD WHEN THEY ARE FILED WITH THE IOWA SECRETARY OF STATE. THE FINANCIAL STATEMENTS BECOME A MATTER OF PUBLIC RECORD WHEN THEY ARE FILED WITH THE IOWA INSURANCE DIVISION. BOTH AGENCIES HAVE ONLINE PUBLIC VIEWING ACCESS. THE CONFLICT OF INTEREST POLICY IS NOT FILED WITH THE STATE AGENCIES; HOWEVER, IT WOULD BE MADE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 2C:THE ORGANIZATION HAS A FINANCE AND AUDIT COMMITTEE THAT HAS RESPONSIBILITY FOR SELECTION OF THE INDEPENDENT ACCOUNTANT AND OVERSIGHT OF THE AUDIT. THE BOARD OF DIRECTORS APPROVES THE ANNUAL APPOINTMENT OF THE INDEPENDENT ACCOUNTANT.
SCHEDULE R, PART I, COLUMN B:VERATRUS INVESTMENTS, LLC IS A FOR-PROFIT CORPORATION OWNED BY VERATRUS HEALTH, INC. VERATRUS INVESTMENTS, LLC INVESTS IN ORGANIZATIONS THAT FURTHER THE MISSION OF VERATRUS HEALTH, INC.
SCHEDULE R, PART II, COLUMN B:DELTA DENTAL OF IOWA'S MISSION IS TO IMPROVE THE HEALTH AND SMILES OF THOSE WE SERVE. AN AMOUNT IS SET ASIDE EACH YEAR TO FUND THIS MISSION. THE AMOUNT IS DETERMINED BY THE PERFORMANCE AND FINANCIAL STRENGTH OF THE COMPANY. AFTER THE AUDITED FINANCIALS ARE COMPLETE, AN AMOUNT IS PAID TO THE DELTA DENTAL OF IOWA FOUNDATION. THE DELTA DENTAL OF IOWA FOUNDATION IS A SEC. 501(C)3 ORGANIZATION AND IS A TYPE 1 SUPPORTING ORGANIZATION UNDER SEC. 509(A)(3). IT IS THE RESPONSIBILITY OF THE FOUNDATION TO DISTRIBUTE THE MONIES CONSISTENT WITH ITS MISSION AND FOUNDING DOCUMENTS. THE MISSION OF THE DELTA DENTAL OF IOWA FOUNDATION IS TO SUPPORT AND IMPROVE THE ORAL HEALTH OF IOWANS. THE FOUNDATION WILL PROVIDE FUNDS TO OTHER SEC. 501(C)(3) ORGANIZATIONS, GOVERNMENTS, OR ACADEMIC INSTITUTIONS THAT ARE UNDERTAKING PROJECTS THAT SUPPORT AND IMPROVE THE ORAL HEALTH OF IOWANS. THE FOUNDATION WILL PROVIDE FUNDS TO OTHER TAX-EXEMPT ORGANIZATIONS THROUGH THEIR GRANTS PROGRAM THAT ALIGN WITH THE PROJECTS OF ACCESS TO CARE, RESEARCH, EDUCATION AND PREVENTION. THE AMOUNT CONTRIBUTED TO THE FOUNDATION IN 2021 WAS $5,600,000 ADDITIONALLY, DELTA DENTAL OF IOWA PROVIDES MANAGEMENT SERVICES FOR THE FOUNDATION. THIS INCLUDES DUTIES PERFORMED BY THE CHIEF EXECUTIVE OFFICER AND THE VICE PRESIDENT, FINANCE. THE EXECUTIVE DIRECTOR OF THE FOUNDATION IS THE DIRECTOR OF GOVERNMENT AND COMMUNITY RELATIONS FOR DELTA DENTAL OF IOWA. ALSO, DELTA DENTAL OF IOWA PROVIDES SOME ACCOUNTING FUNCTIONS. THE FOUNDATION REIMBURSES DELTA DENTAL OF IOWA FOR ALL STAFF CHARGES RELATED TO THE FOUNDATION. THE AMOUNT REIMBURSED TO DELTA DENTAL OF IOWA IN 2020 WAS $483,702 FOR MANAGEMENT FEES AND $45,507 FOR OTHER EXPENSES.
SCHEDULE R, PART IV, COLUMN B:VERATRUS BENEFIT SOLUTIONS, INC. IS A FOR-PROFIT CORPORATION AND A WHOLLY-OWNED SUBSIDIARY OF VERATRUS HEALTH. PRIOR TO 2017, IT WAS A WHOLLY OWNED SUBSIDIARY OF DELTA DENTAL OF IOWA. VERATRUS WAS ORGANIZED TO DISTRIBUTE THE DELTA VISION PRODUCT. DELTA DENTAL OF IOWA MADE NO ADDITIONAL INVESTMENTS IN PAID IN CAPITAL IN VERATRUS IN 2020. DELTA DENTAL OF IOWA COLLECTS PREMIUMS FROM GROUPS FOR VISION COVERAGE AND TRANSFERS THIS PREMIUM TO VERATRUS. IN 2021, DELTA DENTAL OF IOWA TRANSFERRED $7,370,658 TO VERATRUS FOR PREMIUM COLLECTED ON THEIR BEHALF. IN ADDITION, DELTA DENTAL OF IOWA PROVIDES MANAGEMENT SERVICES TO VERATRUS. VERATRUS REIMBURSES DELTA DENTAL OF IOWA FOR ALL STAFF CHARGES RELATED TO VERATRUS. THE AMOUNT REIMBURSED TO DELTA DENTAL OF IOWA IN 2020 WAS $467,800 FOR MANAGEMENT FEES AND $855,855 FOR OTHER EXPENSES. DELTA DENTAL OF IOWA ALSO PURCHASES VISION BENEFITS FROM VERATRUS FOR DDIA EMPLOYEES. THE AMOUNT PAID TO VERATRUS IN 2020 FOR VISION BENEFITS FOR DDIA EMPLOYEES WAS $26,345.
SCHEDULE R, PART IV, COLUMN B:VERATRUS HEALTH, INC. IS A FOR PROFIT CORPORATION FORMED IN 2017 AND IS WHOLLY-OWNED BY DELTA DENTAL OF IOWA. IN 2017, DELTA DENTAL OF IOWA TRANSFERRED 100% OF THE OWNERSHIP OF VERATRUS BENEFIT SOLUTIONS TO VERATRUS HEALTH, INC. VALUED AT $624,541.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1VERATRUS INVESTMENTS LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line19000 NORTHPARK DRIVEAddressLine1Txt
CityJOHNSTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50131ZIPCd
FieldValueIRS element (for citing)
EIN384028167EIN
Primary ActivitiesINVESTING IN ORGANIZATIONS THAT FURTHER THE MISSION OF VERATRUS HEALTH, INC.PrimaryActivitiesTxt
Legal Domicile StateIALegalDomicileStateCd
Total Income$0TotalIncomeAmt
End Of Year Assets$0EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1VERATRUS HEALTH INCBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF IOWA FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line19000 NORTHPARK DRIVEAddressLine1Txt
CityJOHNSTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50131ZIPCd
FieldValueIRS element (for citing)
EIN260762771EIN
Primary ActivitiesNP ORGANIZED TO STRENGTHEN AND TRANSFORM THE HEALTH AND SMILES OF ALL IOWANSPrimaryActivitiesTxt
Legal Domicile StateIALegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 12A, IPublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF IOWABusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
VERATRUS HEALTH INC
9000 NORTHPARK DRIVEJOHNSTONIA50131815414506HOLDING COMPANYIADENTAL DENTAL OF IOWAC$7,450,227$6,193,8091.00000Yes (1)
VERATRUS BENEFIT SOLUTIONS INC
9000 NORTHPARK DRIVEJOHNSTONIA50131271584394FOR-PROFIT CORPORATION ORGANIZED TO DISTRIBUTE THE DELTA VISION PRODUCT.IAVERATRUS HEALTH INCC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
DELTA DENTAL OF IOWA FOUNDATION
B$5,600,000SEE PART VII - SUPPLEMENTAL INFO.
DELTA DENTAL OF IOWA FOUNDATION
O$483,702SEE PART VII - SUPPLEMENTAL INFO.
VERATRUS BENEFIT SOLUTIONS INC
O$467,800SEE PART VII - SUPPLEMENTAL INFO.
VERATRUS BENEFIT SOLUTIONS INC
R$7,370,658SEE PART VII - SUPPLEMENTAL INFO.
VERATRUS BENEFIT SOLUTIONS INC
Q$855,855SEE PART VII - SUPPLEMENTAL INFO.

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, SCHEDULE R, PART V, LINE 2(1), COLUMN D:PERCENTAGE OF REVENUE BASED ON BOARD APPROVED POLICY
FORM 990, SCHEDULE R, PART V, LINE 2(2), COLUMN D:MANAGEMENT FEES CHARGED TO DELTA DENTAL OF IOWA FOUNDATION BASED ON HOURS WORKED
FORM 990, SCHEDULE R, PART V, LINE 2(3), COLUMN D:MANAGEMENT FEES CHARGED TO VERATRUS BENEFIT SOLUTIONS, INC. BASED ON HOURS WORKED
FORM 990, SCHEDULE R, PART V, LINE 2(4), COLUMN D:VISION PREMIUMS BILLED AND COLLECTED BY DDIA ON BEHALF OF VERATRUS BENEFIT SOLUTIONS, INC. CASH WAS TRANSFERRED FROM DDIA TO VERATRUS FOR THESE PREMIUMS.
FORM 990, SCHEDULE R, PART V, LINE 2(5), COLUMN D:ACTUAL COST OF INVOICES PAID BY DDIA ON BEHALF OF VERATRUS BENEFIT SOLUTIONS, INC.

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