DELTA DENTAL OF KENTUCKY INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL OF KENTUCKY INC (EIN 61-0659432)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-14
IRS object ID
202223189349303257
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)
Return2022-11-14T08:47:21-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN381357951PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11111 MICHIGAN AVE STE 100AddressLine1Txt
CityEAST LANSINGCityNm
State AbbreviationMIStateAbbreviationCd
ZIP48823ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN610659432EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF KENTUCKY INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlDELTBusinessNameControlTxt
Phone5027365000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110100 LINN STATION ROAD NO 700AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP40223ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCHRISTOPHER W GREENPersonNm
Person TitleVICE PRESIDENT & CFOPersonTitleTxt
Phone5027365000PhoneNum
Signature2022-11-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstCHRISTOPHERPersonFirstNm
Person LastGREENPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDAVID LOWENTHAL CPAPreparerPersonNm
PTINP00378651PTIN
Phone5173326200PhoneNum
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 OfficerJ JUDE THOMPSONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line110100 LINN STATION ROAD NO 700AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP40223ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$190,548,479GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressWWW.DELTADENTALKY.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1966FormationYr
Legal Domicile StateKYLegalDomicileStateCd
Activity Or MissionDELTA DENTAL OF KENTUCKY'S MISSION HAS ALWAYS BEEN TO BE THE LEADER IN THE MARKETS WE SERVE, TO DELIVER UNMATCHED QUALITY AND VALUE IN OUR PROGRAMS AND SERVICES, AND TO VIGOROUSLY PROMOTE THE IMPORTANCE OF ORAL HEALTH AS AN ESSENTIAL PART OF OVERALL HEALTH. ITS OVERARCHING MISSION IS TO BE THE DENTAL BENEFITS COMPANY OF CHOICE IN THE MARKETS WE SERVE.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee82TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$4,001,428TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$92,927NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$156,745,570PYProgramServiceRevenueAmt
CY Program Service Revenue$156,480,838CYProgramServiceRevenueAmt
PY Investment Income$2,058,349PYInvestmentIncomeAmt
CY Investment Income$7,571,757CYInvestmentIncomeAmt
PY Other Revenue-$708,248PYOtherRevenueAmt
CY Other Revenue-$151,770CYOtherRevenueAmt
PY Total Revenue$158,095,671PYTotalRevenueAmt
CY Total Revenue$163,900,825CYTotalRevenueAmt
PY Grants And Similar Paid$3,651,243PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,330,572CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$107,279,363PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$120,043,918CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$10,703,950PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$11,827,276CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$19,333,421PYOtherExpensesAmt
CY Other Expenses$19,250,545CYOtherExpensesAmt
PY Total Expenses$140,967,977PYTotalExpensesAmt
CY Total Expenses$153,452,311CYTotalExpensesAmt
PY Revenues Less Expenses$17,127,694PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$10,448,514CYRevenuesLessExpensesAmt
Total Assets BOY$127,336,348TotalAssetsBOYAmt
Total Assets EOY$125,956,305TotalAssetsEOYAmt
Total Liabilities BOY$19,540,235TotalLiabilitiesBOYAmt
Total Liabilities EOY$12,729,409TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$107,796,113NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$113,226,896NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE ODELTA DENTAL OF KENTUCKY'S MISSION HAS ALWAYS BEEN TO BE THE LEADER IN THE MARKETS WE SERVE, TO DELIVER UNMATCHED QUALITY AND VALUE IN OUR PROGRAMS AND SERVICES, AND TO VIGOROUSLY PROMOTE THE IMPORTANCE OF ORAL HEALTH AS AN ESSENTIAL PART OF OVERALL HEALTH. ITS OVERARCHING MISSION IS TO BE THE DENTAL BENEFITS COMPANY OF CHOICE IN THE MARKETS WE SERVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$148,478,165ExpenseAmt
Grant$2,330,572GrantAmt
Revenue$152,479,410RevenueAmt
DescDELTA DENTAL OF KENTUCKY IS THE LARGEST AND MOST EXPERIENCED DENTAL BENEFIT ADMINISTRATOR IN KENTUCKY. AS A NOT-FOR-PROFIT ORGANIZATION, DELTA DENTAL'S CORE MISSION IS EVERYONE DESERVES A HAPPY AND HEALTHY SMILE. DELTA DENTAL OF KENTUCKY IS COMMITTED TO FULFILLING THIS MISSION THROUGH THEIR DENTAL, VISION AND LIFE BENEFIT PROGRAMS AS WELL AS CORPORATE PHILANTHROPIC INITIATIVES. DELTA DENTAL OF KENTUCKY INSURES NEARLY 800,000 SMILES THROUGHOUT THE COMMONWEALTH OF KENTUCKY THROUGH GROUP AND INDIVIDUAL PLANS. SEE SCHEDULE O FOR CONTINUATIONFOR CLOSE TO SIX DECADES, DELTA DENTAL OF KENTUCKY HAS HELPED PROMOTE HEALTHY SMILES FOR ITS MEMBERS BY DESIGNING AND ADMINISTERING INNOVATIVE, COST-EFFECTIVE DENTAL BENEFIT PROGRAMS. THESE PLANS MEET MEMBERS' COST-OBJECTIVES WHILE IMPROVING AND MAINTAINING THEIR ORAL HEALTH. DELTA DENTAL OF KENTUCKY IS DEDICATED TO ITS MEMBERS AND ENSURES SUPERIOR CUSTOMER SERVICE, AS EVIDENCED BY NEARLY 90% OF CALLS ANSWERED IN LESS THAN 14 SECONDS. DELTA DENTAL'S AWARD-WINNING CUSTOMER SERVICE HAS A 95% SATISFACTION RATE.DELTA DENTAL OF KENTUCKY OPERATES THE LARGEST DENTAL NETWORKS WITH 89% OF PARTICIPATION AMONG KENTUCKY DENTISTS. DELTA DENTAL'S TWO LARGE NETWORKS, DELTA DENTAL PPO AND DELTA DENTAL PREMIER, GIVE MEMBERS ADDED PROTECTION BY GUARANTEEING THAT PARTICIPATING DENTISTS HAVE AGREED TO ACCEPT THE ALLOWABLE AMOUNT NEGOTIATED BY DELTA DENTAL AS PAYMENT FOR COVERED SERVICES. DELTA DENTAL'S DENTIST-CREDENTIALING PROGRAM, COST MANAGEMENT POLICIES AND FEE REDUCTION AGREEMENTS WITH PARTICIPATING DENTISTS HELP MEMBERS RECEIVE QUALITY DENTISTRY AND BEST DENTAL OUTCOMES. IN 2019, DELTA DENTAL EXPANDED PRODUCT OFFERINGS TO INCLUDE VISION INSURANCE FOR GROUPS AND INDIVIDUALS. IN EARLY 2020, DELTA DENTAL AGAIN EXPANDED INTO MORE ANCILLARY LINES OFFERING GROUP LIFE AND DISABILITY COVERAGE. ENSURING OUR MISSION OF HAPPY AND HEALTHY SMILES IS A CORE COMPONENT OF DELTA DENTAL OF KENTUCKY, A SEPARATE ACCOUNT WAS ESTABLISHED AT THE COMMUNITY FOUNDATION OF LOUISVILLE IN 2003 WHICH IS FUNDED ANNUALLY FOR GIVING PURPOSES. SINCE THE INCEPTION OF THE COMMUNITY FOUNDATION OF LOUISVILLE ACCOUNT IN 2003, THE CORPORATE PHILANTHROPIC GIVING HAS PROVIDED OVER $20 MILLION IN GRANTS TO OVER 160 ORGANIZATIONS. IN 2021, DONATIONS TOTALED $2.331 MILLION AND USED TO SUPPORT 81 ORGANIZATIONS THROUGH KENTUCKY. THESE DONATIONS FUNDED 22 DENTAL CLINICS ACROSS THE COMMONWEALTH AND 70% OF THESE DOLLARS WERE GRANTED TO ORGANIZATIONS PROVIDING DENTAL CARE AND ORAL HEALTH EDUCATION TO UNDERSERVED POPULATIONS. IN 2021, DELTA DENTAL OF KENTUCKY ALLOCATED AN ADDITIONAL $1.5 MILLION TOWARDS DISASTER RELIEF EFFORTS IN RESPONSE TO THE DEVASTATING NATURAL DISASTERS THAT OCCURRED IN WESTERN KENTUCKY IN DECEMBER 2021.Desc
Total Program Service Expenses$148,478,165TotalProgramServiceExpensesAmt
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 SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
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 Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
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 Document23273IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee82EmployeeCnt
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 Members10GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
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 ApprovaYes (1)DecisionsSubjectToApprovaInd
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 VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHRISTOPHER W GREEN CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5027365000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110100 LINN STATION ROAD STE 700AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP40223ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
J JUDE THOMPSON
PRESIDENT, CEO40.001.00Yes (X)Yes (X)$925,269$0$172,405
MICHAEL CHILDERS DMD
DIRECTOR4.006.00Yes (X)$24,350$24,996$0
J DAVID SMITH
CHAIR2.000.00Yes (X)Yes (X)$32,600$0$0
STEVE S REED
DIRECTOR2.000.00Yes (X)$21,350$0$0
DIANE CORNWELL
DIRECTOR4.000.00Yes (X)$24,350$0$0
RODNEY A JACKSON DMD
VICE CHAIR2.000.00Yes (X)Yes (X)$18,600$0$0
OLIVIA F KIRTLEY
DIRECTOR - PART YEAR4.000.00Yes (X)$6,550$0$5,500
RANDALL F DYER JR
DIRECTOR2.001.00Yes (X)$20,600$0$0
JOHNNA REEDER KLEYMEYER
DIRECTOR2.000.00Yes (X)$27,150$0$0
ROBERT T MCINTIRE
DIRECTOR2.001.00Yes (X)$7,500$0$0
JAMES EDWARD GEISLER
DIRECTOR2.000.00Yes (X)$7,500$0$0
BRIAN D HART
VP/CRO40.001.00Yes (X)$682,066$0$133,890
ANGELA J NENNI
VP/CAO40.001.00Yes (X)$587,187$0$116,235
CHRISTOPHER W GREEN
VP/CFO40.001.00Yes (X)$584,784$0$113,069
DANIELLE JACKSON
SECRETARY, CORPORATE COUNSEL40.000.00Yes (X)$161,499$0$41,773
JEFFREY D DUES
DIRECTOR, ACCOUNT MGMT40.000.00$228,011$0$50,443Yes (X)
TAUNYA L ESHENBAUGH
DIRECTOR, SALES40.000.00$170,254$0$25,458Yes (X)
LAURA F WINCE
DIRECTOR, MARKETING40.000.00$196,411$0$45,476Yes (X)
KASSANDRA L KULB
DIRECTOR, DENTAL40.000.00$156,880$0$34,982Yes (X)
RUTH A DEVORE
DIRECTOR, GROUP ADMIN40.000.00$148,034$0$30,996Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,030,945TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$24,996TotReportableCompRltdOrgAmt
Total Other Compensation$770,227TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K18IndivRcvdGreaterThan100KCnt
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
DELTA DENTAL PLAN OF MICHIGAN
PO BOX 30416LANSINGMI48909ADMINISTRATIVE SERVICES$3,981,862
KELLEY CONSTRUCTION INC
12550 LAKE STATION PLACELOUISVILLEKY40299BUILDING RENOVATIONS$1,300,757
MCGRIFF INSURANCE SERVICES INC
3201 BEECHLEAF COURT SUITE 200RALEIGHNC27604BENEFITS CONSULTING$1,075,175
ASSURED PARTNERS NL LLC
2305 RIVER ROADLOUISVILLEKY40206BENEFITS CONSULTING$999,062
SKYGEN
N92 W14612 ANTHONY AVENUEMENOMONEE FALLSWI53051SOFTWARE & CONSULTING$921,863
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K40CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
DENTAL CARE REVENUE524114$152,472,534$152,472,534
VISION INSURANCE REVENUE524114$4,001,428$4,001,428
OTHER FEES561000$6,876$6,876
FieldValueIRS element (for citing)
Total Program Service Revenue$156,480,838TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,401,881TotalRevenueColumnAmt
Exclusion$1,401,881ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,322,060RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,473,830RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$151,770RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$151,770TotalRevenueColumnAmt
Exclusion-$151,770ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$31,343,700SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$25,173,824SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$6,169,876SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,169,876TotalRevenueColumnAmt
Exclusion$6,169,876ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$163,900,825TotalRevenueColumnAmt
Related Or Exempt Func Income$152,479,410RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$4,001,428UnrelatedBusinessRevenueAmt
Exclusion$7,419,987ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$2,330,572TotalAmt
Program Services$2,330,572ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$120,043,918TotalAmt
Program Services$120,043,918ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$3,314,905TotalAmt
Program Services$873,104ProgramServicesAmt
Management And General$2,441,801ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,934,276TotalAmt
Program Services$5,934,276ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$843,693TotalAmt
Program Services$843,693ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,223,900TotalAmt
Program Services$1,223,900ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$510,502TotalAmt
Program Services$393,087ProgramServicesAmt
Management And General$117,415ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$608,363TotalAmt
Management And General$608,363ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$88,639TotalAmt
Management And General$88,639ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$125,175TotalAmt
Management And General$125,175ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$197,934TotalAmt
Management And General$197,934ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$798,133TotalAmt
Program Services$718,320ProgramServicesAmt
Management And General$79,813ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,665,184TotalAmt
Program Services$1,082,370ProgramServicesAmt
Management And General$582,814ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$845,454TotalAmt
Program Services$845,454ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$977,982TotalAmt
Program Services$850,844ProgramServicesAmt
Management And General$127,138ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$894,782TotalAmt
Program Services$447,391ProgramServicesAmt
Management And General$447,391ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$30,744TotalAmt
Program Services$18,446ProgramServicesAmt
Management And General$12,298ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$93,907TotalAmt
Program Services$84,516ProgramServicesAmt
Management And General$9,391ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$131,013TotalAmt
Management And General$131,013ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
FEDERAL INCOME TAX$150,000$150,000
BROKER COMMISSIONS$8,438,916$8,438,916
PROCESSING FEES$3,268,189$3,268,189
POSTAGE & SHIPPING$496,083$491,122$4,961

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$440,047TotalAmt
Program Services$440,047ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$153,452,311TotalAmt
Program Services$148,478,165ProgramServicesAmt
Management And General$4,974,146ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,659,484BOYAmt
EOY$3,640,253EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$20,937,811BOYAmt
EOY$10,632,937EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$14,258,771BOYAmt
EOY$12,421,793EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$96,347BOYAmt
EOY$390,697EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$20,269,497LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$8,017,043LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$9,466,574BOYAmt
EOY$12,252,454EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$27,303,330BOYAmt
EOY$27,861,427EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$39,889,519BOYAmt
EOY$46,852,493EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$11,724,512BOYAmt
EOY$11,904,251EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$127,336,348BOYAmt
EOY$125,956,305EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,922,626BOYAmt
EOY$5,385,327EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$2,094,136BOYAmt
EOY$1,899,614EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,523,473BOYAmt
EOY$5,444,468EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$19,540,235BOYAmt
EOY$12,729,409EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$107,796,113BOYAmt
EOY$113,226,896EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$107,796,113BOYAmt
EOY$113,226,896EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$127,336,348BOYAmt
EOY$125,956,305EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$10,448,514ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$478,956NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$4,538,775OtherChangesInNetAssetsAmt
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$830,000OtherCostOrOtherBasisAmt
Book Value$830,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,944,150OtherCostOrOtherBasisAmt
Depreciation$5,155,841DepreciationAmt
Book Value$7,788,309BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,062,422OtherCostOrOtherBasisAmt
Depreciation$1,269,326DepreciationAmt
Book Value$793,096BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,594,294OtherCostOrOtherBasisAmt
Depreciation$1,108,971DepreciationAmt
Book Value$485,323BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,838,631OtherCostOrOtherBasisAmt
Depreciation$482,905DepreciationAmt
Book Value$2,355,726BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$12,252,454TotalBookValueLandBuildingsAmt

Closely Held Equity Interests CloselyHeldEquityInterestsGrp

FieldValueIRS element (for citing)
Book Value$39,537,459BookValueAmt
Method ValuationFMethodValuationCd

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescINVESTMENT - DENTAL CHOICE, INC.Desc
Book Value$7,315,034BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$46,852,493TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
ACCRUED INVESTMENT INCOME$132,929
457(B) PLAN$721,668
INVESTMENT - RHC$11,049,654
FieldValueIRS element (for citing)
Total Book Value Other Assets$11,904,251TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
ESTIMATED CLAIMS LIABILITY$4,727,848
457(B) PLAN$716,620
FieldValueIRS element (for citing)
Total Liability$5,444,468TotalLiabilityAmt

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDescPurpose Of GrantPurposeOfGrantTxt
AMERICAN HEART ASSOCIATION
7272 GREENVILLE AVENUEDALLASTX75231135613797501(C)(3)$13,000$0CASHN/ASUPPORT GENERAL MISSION
COMMUNITY FOUNDATION OF LOUISVILLE
325 WEST MAIN STREET SUITE 1110LOUISVILLEKY40202310997017501(C)(3)$2,200,000$0CASHN/AGENERAL DONATION
LOUISVILLE BALLET
315 EAST MAIN STREETLOUISVILLEKY40202616033779501(C)(3)$7,686$0CASHN/ASUPPORT GENERAL MISSION
KENTUCKY CHAMBER OF COMMERCE
464 CHENAULT ROADFRANKFORTKY40601610405718501(C)(6)$30,850$0CASHN/ASUPPORT GENERAL MISSION
LINDSEY WILSON COLLEGE
210 LINDSEY WILSON STREETCOLUMBIAKY42728610444763501(C)(3)$10,000$0CASHN/ASUPPORT GENERAL MISSION
FieldValueIRS element (for citing)
Total501c3 Org4Total501c3OrgCnt
Total Other Org1TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationGRANTS ARE MADE AND MONITORED UNDER A BOARD APPROVED CORPORATE POLICY WHICH SETS OUT THE GRANT CRITERIA, INCLUDING PROCESSES FOR APPROVAL, DISTRIBUTION, AND MONITORING. THE GRANT REVIEW AND APPROVAL COMMITTEE CONSISTS OF MEMBERS OF THE BOARD AND COMPANY EXECUTIVES. GRANTS MUST BE SUBMITTED ON SPECIFIED FORMS WHICH REQUIRE INFORMATION ABOUT THE GRANTEE ORGANIZATION AND HOW THE GRANTS WILL BE USED. GRANTEE ORGANIZATIONS MUST PERIODICALLY REPORT ON HOW THE FUNDS HAVE BEEN UTILIZED AND CERTIFY THAT FUNDS ARE DISBURSED IN ACCORDANCE WITH THE APPROVED GRANT APPLICATION. THESE REPORTS ARE REGULARLY REVIEWED BY COMPANY STAFF AND SUMMARIZED FOR THE GRANT COMMITTEE. THE COMMITTEE REVIEWS THE REPORTS AT LEAST QUARTERLY AND COMMUNICATES QUESTIONS OR CONCERNS BACK TO THE GRANTEE ORGANIZATION.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
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 Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 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
J JUDE THOMPSON
PRESIDENT, CEO$485,894$0$439,375$0$0$0$139,358$0$33,047$0$1,097,674$0$0$0
BRIAN D HART
VP/CRO$404,566$0$277,500$0$0$0$103,874$0$30,016$0$815,956$0$0$0
ANGELA J NENNI
VP/CAO$346,687$0$240,500$0$0$0$94,082$0$22,153$0$703,422$0$0$0
CHRISTOPHER W GREEN
VP/CFO$344,284$0$240,500$0$0$0$93,543$0$19,526$0$697,853$0$0$0
JEFFREY D DUES
DIRECTOR, ACCOUNT MGMT$87,261$0$140,750$0$0$0$23,030$0$27,413$0$278,454$0$0$0
LAURA F WINCE
DIRECTOR, MARKETING$131,035$0$65,376$0$0$0$19,209$0$26,267$0$241,887$0$0$0
DANIELLE JACKSON
SECRETARY, CORPORATE COUNSEL$115,845$0$45,654$0$0$0$13,359$0$28,414$0$203,272$0$0$0
TAUNYA L ESHENBAUGH
DIRECTOR, SALES$42,479$0$127,775$0$0$0$19,385$0$6,073$0$195,712$0$0$0
KASSANDRA L KULB
DIRECTOR, DENTAL$132,909$0$23,971$0$0$0$8,840$0$26,142$0$191,862$0$0$0
RUTH A DEVORE
DIRECTOR, GROUP ADMIN$93,637$0$54,397$0$0$0$13,595$0$17,401$0$179,030$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ABOARD MEMBERS ARE ALLOWED A TRAVEL COMPANION FOR THE ANNUAL RHSC CONFERENCE. THE COMPANION TRAVEL IS TAXABLE TO THE BOARD MEMBER. SINCE THERE WAS NO CONFERENCE IN 2021, NO BOARD MEMBER RECEIVED THIS BENEFIT IN 2021.
PART I, LINE 4BDELTA DENTAL OF KENTUCKY, INC. MAINTAINS A RETENTION BONUS AGREEMENT WITH A SELECT GROUP OF EXECUTIVES OF THE ORGANIZATION. THE BONUS AGREEMENT IS A NONQUALIFIED DEFERRED COMPENSATION PLAN THAT IS INTENDED TO COMPLY WITH SECTION 457(F) OF THE INTERNAL REVENUE CODE. BENEFITS UNDER THIS AGREEMENT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE AND ARE TAXABLE TO THE PARTICIPATING EXECUTIVES WHEN SUCH AMOUNTS ARE VESTED. THE FOLLOWING EXECUTIVES PARTICIPATE IN THE RETENTION BONUS AGREEMENT: J. JUDE THOMPSON BRIAN D. HART ANGELA J. NENNI CHRISTOPHER W. GREEN NO AMOUNTS WERE PAID OUT OR VESTED UNDER THIS AGREEMENT DURING 2021.
PART I, LINE 7AS INDICATED IN SCHEDULE J, PART II, TOP MANAGEMENT OFFICIALS RECEIVED A BONUS BASED UPON EMPLOYEE PERFORMANCE AND THE FINANCIAL RESULTS OF THE ORGANIZATION AS COMPARED TO BUDGET. THIS BONUS WAS APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6EFFECTIVE JULY 1, 2009 RENAISSANCE HEALTH SERVICE CORPORATION BECAME THE SOLE CORPORATE MEMBER OF DELTA DENTAL OF KENTUCKY.
FORM 990, PART VI, SECTION A, LINE 7APURSUANT TO AN AFFILIATION AGREEMENT BETWEEN DDKY AND RENAISSANCE HEALTH SERVICE CORP ("RHSC"), RHSC IS THE SOLE VOTING MEMBER OF DELTA DENTAL OF KENTUCKY, INC. ("DDKY"). UNDER THE TERMS OF THAT AGREEMENT THE DDKY BOARD OF DIRECTORS (THE "BOARD") SELECTS DIRECTOR CANDIDATES AND SUBMITS ITS RECOMMENDATIONS TO RHSC, SUBJECT ONLY TO "JUST CAUSE" REVIEW BY RHSC. RHSC CAN REJECT PROPOSED DDKY BOARD CANDIDATES FOR "JUST CAUSE" AS DEFINED IN THE AGREEMENT. OTHERWISE, RHSC MUST APPROVE ALL THE BOARD CANDIDATES PROPOSED BY THE DDKY BOARD. PURSUANT TO THE TERMS OF THE AGREEMENT, DDKY HAS THE RIGHT TO ELECT A NUMBER OF DIRECTORS TO THE RHSC BOARD. AS OF 12/31/2021, DDKY HAS APPOINTED ONE MEMBER OF ITS BOARD TO SIT ON THE RHSC BOARD.
FORM 990, PART VI, SECTION A, LINE 7BTHE RIGHTS OF THE DDKY BOARD ARE TO APPROVE THE ANNUAL BUDGETS FOR OPERATIONS, ELECT OFFICERS OF THE DDKY BOARD OF DIRECTORS, APPROVE THE TRANSFER OF ANY OF ITS ASSETS, APPROVE THE INCURRENCE OR GUARANTY OF DEBT AND APPROVE THE MANAGEMENT OF ITS INVESTMENTS. RHSC MUST APPROVE ANY TRANSFER OF ASSETS, INVESTMENTS, LOANS, GUARANTIES OR EXPENDITURES WHICH EXCEEDS TEN PERCENT OF DDKY'S NET ASSETS. RHSC MUST APPROVE THE FOLLOWING CHANGES TO THE DDKY BYLAWS: THE IDENTITY, QUALIFICATION OR RIGHTS OF DDKY'S VOTING MEMBER, THE QUALIFICATIONS, CLASSIFICATIONS, TERMS OF OFFICE OR PERMISSIBLE NUMBER OF DIRECTORS ON DDKY'S BOARD OR ANY LIMITATION ON THE RIGHTS OR AUTHORITY OF THE DDKY BOARD CONTAINED IN DDKY'S ORGANIZATIONAL DOCUMENTS.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS FIRST REVIEWED INTERNALLY BY THE VICE PRESIDENT AND CFO, CORPORATE COUNSEL AND CEO. A DRAFT IS THEN PROVIDED TO THE AUDIT AND FINANCE COMMITTEE FOR REVIEW. PRIOR TO FILING, A COPY OF THE FINAL FORM 990 IS DISTRIBUTED TO THE ENTIRE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12COFFICERS, DIRECTORS AND KEY EMPLOYEES MUST COMPLETE AND SUBMIT A CONFLICT OF INTEREST DISCLOSURE ANNUALLY. THESE FORMS ARE REVIEWED BY THE CEO, THE CORPORATE COMPLIANCE OFFICER, AND A REPORT IS MADE TO THE AUDIT AND FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. THE AUDIT COMMITTEE REVIEWS ALL POTENTIAL CONFLICTS TO DETERMINE IF THE CONFLICTS REPRESENT MATERIAL FINANCIAL RISK TO THE COMPANY AND TAKES ANY ACTION NECESSARY TO RESOLVE OR MITIGATE THE EFFECT OF THE CONFLICTS. WHEN A CONFLICT EXISTS AMONG THE VOTING BOARD MEMBERS, THAT BOARD MEMBER WILL ABSTAIN FROM VOTING ON THE CONFLICTED ISSUE. ALL EMPLOYEES AND DIRECTORS ARE ADVISED ANNUALLY OF THE REQUIREMENT TO REPORT ANY POTENTIAL CONFLICTS OF INTEREST AS THEY OCCUR. EMPLOYEES AND DIRECTORS MAY ALSO MAKE ANONYMOUS REPORTS OF ANY VIOLATIONS OF CORPORATE POLICIES THROUGH A DEDICATED WHISTLEBLOWER SYSTEM ADMINISTERED BY A THIRD PARTY.
FORM 990, PART VI, SECTION B, LINE 15CEO AND OTHER OFFICERS COMPENSATION ARE REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS IS PERFORMED, AT A MINIMUM, ANNUALLY. COMPENSATION WAS LAST REVIEWED BY DELTA DENTAL OF KENTUCKY'S COMPENSATION COMMITTEE IN THE FIRST QUARTER OF 2021. THE COMMITTEE IS MADE UP OF BOARD MEMBERS. THE COMMITTEE UTILIZES CERTAIN COMPENSATION SURVEYS AND OUTSIDE CONSULTANTS ARE ENGAGED AS NEEDED.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE FILED WITH THE KENTUCKY DEPARTMENT OF INSURANCE AND ARE AVAILABLE FOR INSPECTION BY THE PUBLIC THROUGH THAT AGENCY. ADDITIONALLY, THE COMPANY MAKES ORGANIZATIONAL DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS AVAILABLE AT NO COST UPON RECEIPT OF A WRITTEN REQUEST.
FORM 990, PART VII:CERTAIN EMPLOYEES ARE OFFICERS OF MULTIPLE COMPANIES WITHIN THE LARGER ORGANIZATION. THE AVERAGE HOURS WORKED REFLECTS APPROXIMATE TIME SPENT IN EACH OF THOSE INDIVIDUAL COMPANIES. WHILE THE HOURS ARE ALLOCATED TO INDIVIDUAL COMPANIES, MUCH OF THE OFFICERS' TIME IS SPENT WORKING ON ISSUES THAT IMPACT THE ENTIRE ORGANIZATION, NOT JUST ONE COMPANY. COMPENSATION IS REPORTED IN FULL TO AGREE TO THE EMPLOYEE'S W-2 AS REQUIRED BY IRS INSTRUCTIONS. ANY ALLOCATION OF COMPENSATION IS INCLUDED ON SCHEDULE R.
FORM 990, PART XI, LINE 9:EQUITY IN SUBSIDIARY -4,538,775.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1DENTAL CHOICE PROPERTIES LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line110100 LINN STATION RD SUITEAddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP40223ZIPCd
FieldValueIRS element (for citing)
EIN610659432EIN
Primary ActivitiesREAL ESTATE HOLDING COMPANYPrimaryActivitiesTxt
Legal Domicile StateKYLegalDomicileStateCd
Total Income-$151,770TotalIncomeAmt
End Of Year Assets$8,685,331EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF KENTUCKYBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (13 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
RENAISSANCE HEALTH SERVICE CORPORATION
PO BOX 30416LANSINGMI489097916381675667PROMOTING DENTAL CAREMI501(C)(4)N/AN/A0
DELTA DENTAL PLAN OF MICHIGAN INC
4100 OKEMOS ROADOKEMOSMI48864381791480PROVIDE DENTAL SERVICE PLANSMI501(C)(4)N/A0RENAISSANCE HEALTH SERVICE CORPORATION
DELTA DENTAL OF TENNESSEE INC
240 VENTURE CIRCLENASHVILLETN37228620812197PROVIDE DENTAL SERVICE PLANSTN501(C)(4)N/A0RENAISSANCE HEALTH SERVICE CORPORATION
DELTA DENTAL PLAN OF NEW MEXICO INC
100 SUN AVE NE SUITE 400ALBUQUERQUENM87109850224562PROVIDE DENTAL SERVICE PLANSNM501(C)(4)N/A0RENAISSANCE HEALTH SERVICE CORPORATION
DELTA DENTAL OF NORTH CAROLINA
4242 SIX FORKS ROADRALEIGHNC27609561018068PROVIDE DENTAL SERVICE PLANSNC501(C)(4)N/A0RENAISSANCE HEALTH SERVICE CORPORATION
DELTA DENTAL PLAN OF OHIO INC
PO BOX 30416LANSINGMI489097916310685339PROVIDE DENTAL SERVICE PLANSOH501(C)(4)N/A0DELTA DENTAL PLAN OF MICHIGAN INC
DELTA DENTAL PLAN OF INDIANA INC
PO BOX 30416LANSINGMI489097916351545647PROVIDE DENTAL SERVICE PLANSIN501(C)(4)N/A0DELTA DENTAL PLAN OF MICHIGAN INC
DELTA DENTAL FUND
PO BOX 30416LANSINGMI489097916382337000SUPPORT DENTAL EDUCATION AND RESEARCH PROGRAMSMI501(C)(3)LINE 12A, I0DELTA DENTAL PLAN OF MICHIGAN INC
DELTA DENTAL PLAN OF ARKANSAS INC
1513 COUNTRY CLUB RDSHERWOODAR72120710561140PROVIDE DENTAL SERVICE PLANSAR501(C)(4)NA0RENAISSANCE HEALTH SERVICE CORPORATION
DELTA DENTAL OF ARKANSAS FOUNDATION INC
1513 COUNTRY CLUB RDSHERWOODAR72120261569324PROVIDE DENTAL SERVICE PLANSAR501(C)(3)PF0RENAISSANCE HEALTH SERVICE CORPORATION
RENAISSANCE FAMILY FOUNDATION INC
4100 OKEMOS ROADOKEMOSMI48864461376165EMPHASIZE DENTAL HEALTH IN COMMUNITIESIN501(C)(3)PF0RENAISSANCE HOLDING COMPANY
SMILE 180 FOUNDATION
240 VENTURE CIRCLENASHVILLETN37228471654054EMPHASIZE DENTAL HEALTH IN COMMUNITIESTN501(C)(3)LINE 12A, I0DELTA DENTAL OF TENNESSEE INC
DELTA DENTAL OF KENTUCKY FOUNDATION INC
10100 LINN STATION ROAD SUITE 700LOUISVILLEKY40223874045357EMPHASIZE DENTAL HEALTH IN COMMUNITIESKY501(C)(3)PFYes (1)DELTA DENTAL OF KENTUCKY

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
CHESME LLC
124 N BRIDGE STDEWITTMI48820200061957CAPITAL MANAGEMENTMIN/A00
RED CEDAR INVESTMENT MANAGEMENT LLC
333 BRIDGE STREET NW SUITE 601GRAND RAPIDSMI49546462667997CAPITAL MANAGEMENTMIN/A00
DH LOGIX LLC
1000 SOUTH MIAMI TRAILSARASOTAFL34236815265121CAPITAL MANAGEMENTDEN/A00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
DENTAL CHOICE INC
10100 LINN STATION RD SUITE 700LOUISVILLEKY40223611105118PROVIDE DENTAL SERVICE PLANSKYDELTA DENTAL OF KENTUCKYC-$4,375,217$8,781,8901.00000Yes (1)
DENTAL CHOICE AGENCY INC
10100 LINN STATION RD SUITE 700LOUISVILLEKY40223611336003PRIMARY GENERAL AGENCY FOR DDKY & DENTAL CHOICEKYDELTA DENTAL OF KENTUCKYC-$6251.00000Yes (1)
RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF NEW YORK
PO BOX 30381LANSINGMI48909134098096INSURANCENYRENAISSANCE HOLDING COMPANYC$49,929$945,9450.059000
RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA
PO BOX 30381LANSINGMI48909470397286INSURANCEINRENAISSANCE HOLDING COMPANYC-$176,434$8,238,2560.059000
RENAISSANCE HOLDING COMPANY
PO BOX 30381LANSINGMI48909412177193HOLDING COMPANYMIDELTA DENTAL OF MICHIGANC-$19,942$5,754,0010.059000
DEWPOINT INC
300 S WASHIGNTON SQUARELANSINGMI48933383300595COMPUTER CONSULTINGMIC0N/A
FORE HOLDING CORPORATION
240 VENTURE CIRCLENASHVILLETN37228204116122EMPLOYEE BENEFITSTNC0N/A
OMEGA ADMINISTRATORS INC
1513 COUNTRY CLUB ROADSHERWOODAR72120043740469PROVIDE THIRD-PARTY ADMINISTRATIVE SERVICESARC0N/A
THE 4100 GROUP
4100 OKEMOS ROADOKEMOSMI48864472557772INVESTMENT IN SUBSIDIARIESMIC0N/A
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 OrgYes (1)LoansOrGuaranteesToOtherOrgInd
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 OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
DELTA DENTAL PLAN OF MICHIGAN INC
M$3,520,685ACTUAL COST
DENTAL CHOICE INC
L$331,614ACTUAL COST
DENTAL CHOICE INC
B$3,000,000ACTUAL COST

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