2022-11-14T08:47:21-06:00 2021-12-31 381357951 PLANTE & MORAN PLLC 1111 MICHIGAN AVE STE 100 EAST LANSING MI 48823 990 2021-01-01 610659432 DELTA DENTAL OF KENTUCKY INC DELT 5027365000 10100 LINN STATION ROAD NO 700 LOUISVILLE KY 40223 CHRISTOPHER W GREEN VICE PRESIDENT & CFO 5027365000 2022-11-11 1 CHRISTOPHER GREEN 999009999 DAVID LOWENTHAL CPA P00378651 5173326200 2022-11-11 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z J JUDE THOMPSON 10100 LINN STATION ROAD NO 700 LOUISVILLE KY 40223 190548479 0 X WWW.DELTADENTALKY.COM X 1966 KY DELTA 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. 10 8 82 0 4001428 92927 0 0 156745570 156480838 2058349 7571757 -708248 -151770 158095671 163900825 3651243 2330572 107279363 120043918 10703950 11827276 0 0 0 19333421 19250545 140967977 153452311 17127694 10448514 127336348 125956305 19540235 12729409 107796113 113226896 X SEE 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. 0 0 148478165 2330572 152479410 DELTA 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. 148478165 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 23273 0 1 82 1 1 1 0 0 0 0 0 0 0 X 10 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X CHRISTOPHER W GREEN CFO 5027365000 10100 LINN STATION ROAD STE 700 LOUISVILLE KY 40223 X J JUDE THOMPSON PRESIDENT, CEO 40.00 1.00 X X 925269 0 172405 MICHAEL CHILDERS DMD DIRECTOR 4.00 6.00 X 24350 24996 0 J DAVID SMITH CHAIR 2.00 0.00 X X 32600 0 0 STEVE S REED DIRECTOR 2.00 0.00 X 21350 0 0 DIANE CORNWELL DIRECTOR 4.00 0.00 X 24350 0 0 RODNEY A JACKSON DMD VICE CHAIR 2.00 0.00 X X 18600 0 0 OLIVIA F KIRTLEY DIRECTOR - PART YEAR 4.00 0.00 X 6550 0 5500 RANDALL F DYER JR DIRECTOR 2.00 1.00 X 20600 0 0 JOHNNA REEDER KLEYMEYER DIRECTOR 2.00 0.00 X 27150 0 0 ROBERT T MCINTIRE DIRECTOR 2.00 1.00 X 7500 0 0 JAMES EDWARD GEISLER DIRECTOR 2.00 0.00 X 7500 0 0 BRIAN D HART VP/CRO 40.00 1.00 X 682066 0 133890 ANGELA J NENNI VP/CAO 40.00 1.00 X 587187 0 116235 CHRISTOPHER W GREEN VP/CFO 40.00 1.00 X 584784 0 113069 DANIELLE JACKSON SECRETARY, CORPORATE COUNSEL 40.00 0.00 X 161499 0 41773 JEFFREY D DUES DIRECTOR, ACCOUNT MGMT 40.00 0.00 X 228011 0 50443 TAUNYA L ESHENBAUGH DIRECTOR, SALES 40.00 0.00 X 170254 0 25458 LAURA F WINCE DIRECTOR, MARKETING 40.00 0.00 X 196411 0 45476 KASSANDRA L KULB DIRECTOR, DENTAL 40.00 0.00 X 156880 0 34982 RUTH A DEVORE DIRECTOR, GROUP ADMIN 40.00 0.00 X 148034 0 30996 4030945 24996 770227 18 0 1 0 DELTA DENTAL PLAN OF MICHIGAN PO BOX 30416 LANSING MI 48909 ADMINISTRATIVE SERVICES 3981862 KELLEY CONSTRUCTION INC 12550 LAKE STATION PLACE LOUISVILLE KY 40299 BUILDING RENOVATIONS 1300757 MCGRIFF INSURANCE SERVICES INC 3201 BEECHLEAF COURT SUITE 200 RALEIGH NC 27604 BENEFITS CONSULTING 1075175 ASSURED PARTNERS NL LLC 2305 RIVER ROAD LOUISVILLE KY 40206 BENEFITS CONSULTING 999062 SKYGEN N92 W14612 ANTHONY AVENUE MENOMONEE FALLS WI 53051 SOFTWARE & CONSULTING 921863 40 DENTAL CARE REVENUE 524114 152472534 152472534 VISION INSURANCE REVENUE 524114 4001428 4001428 OTHER FEES 561000 6876 6876 156480838 1401881 1401881 1322060 1473830 -151770 -151770 -151770 31343700 25173824 6169876 6169876 6169876 163900825 152479410 4001428 7419987 2330572 2330572 120043918 120043918 3314905 873104 2441801 5934276 5934276 843693 843693 1223900 1223900 510502 393087 117415 608363 608363 88639 88639 125175 125175 197934 197934 798133 718320 79813 1665184 1082370 582814 845454 845454 977982 850844 127138 894782 447391 447391 30744 18446 12298 93907 84516 9391 131013 131013 FEDERAL INCOME TAX 150000 150000 BROKER COMMISSIONS 8438916 8438916 PROCESSING FEES 3268189 3268189 POSTAGE & SHIPPING 496083 491122 4961 440047 440047 153452311 148478165 4974146 0 3659484 3640253 20937811 10632937 14258771 12421793 96347 390697 20269497 8017043 9466574 12252454 27303330 27861427 39889519 46852493 11724512 11904251 127336348 125956305 4922626 5385327 2094136 1899614 12523473 5444468 19540235 12729409 X 107796113 113226896 107796113 113226896 127336348 125956305 X 10448514 -478956 -4538775 X 0 1 X 1 0 830000 830000 12944150 5155841 7788309 2062422 1269326 793096 1594294 1108971 485323 2838631 482905 2355726 12252454 39537459 F INVESTMENT - DENTAL CHOICE, INC. 7315034 F 46852493 ACCRUED INVESTMENT INCOME 132929 457(B) PLAN 721668 INVESTMENT - RHC 11049654 11904251 ESTIMATED CLAIMS LIABILITY 4727848 457(B) PLAN 716620 5444468 1 AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVENUE DALLAS TX 75231 135613797 501(C)(3) 13000 0 CASH N/A SUPPORT GENERAL MISSION COMMUNITY FOUNDATION OF LOUISVILLE 325 WEST MAIN STREET SUITE 1110 LOUISVILLE KY 40202 310997017 501(C)(3) 2200000 0 CASH N/A GENERAL DONATION LOUISVILLE BALLET 315 EAST MAIN STREET LOUISVILLE KY 40202 616033779 501(C)(3) 7686 0 CASH N/A SUPPORT GENERAL MISSION KENTUCKY CHAMBER OF COMMERCE 464 CHENAULT ROAD FRANKFORT KY 40601 610405718 501(C)(6) 30850 0 CASH N/A SUPPORT GENERAL MISSION LINDSEY WILSON COLLEGE 210 LINDSEY WILSON STREET COLUMBIA KY 42728 610444763 501(C)(3) 10000 0 CASH N/A SUPPORT GENERAL MISSION 4 1 PART I, LINE 2: GRANTS 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. X 1 1 X X X X 0 1 0 0 0 0 0 1 0 J JUDE THOMPSON PRESIDENT, CEO 485894 0 439375 0 0 0 139358 0 33047 0 1097674 0 0 0 BRIAN D HART VP/CRO 404566 0 277500 0 0 0 103874 0 30016 0 815956 0 0 0 ANGELA J NENNI VP/CAO 346687 0 240500 0 0 0 94082 0 22153 0 703422 0 0 0 CHRISTOPHER W GREEN VP/CFO 344284 0 240500 0 0 0 93543 0 19526 0 697853 0 0 0 JEFFREY D DUES DIRECTOR, ACCOUNT MGMT 87261 0 140750 0 0 0 23030 0 27413 0 278454 0 0 0 LAURA F WINCE DIRECTOR, MARKETING 131035 0 65376 0 0 0 19209 0 26267 0 241887 0 0 0 DANIELLE JACKSON SECRETARY, CORPORATE COUNSEL 115845 0 45654 0 0 0 13359 0 28414 0 203272 0 0 0 TAUNYA L ESHENBAUGH DIRECTOR, SALES 42479 0 127775 0 0 0 19385 0 6073 0 195712 0 0 0 KASSANDRA L KULB DIRECTOR, DENTAL 132909 0 23971 0 0 0 8840 0 26142 0 191862 0 0 0 RUTH A DEVORE DIRECTOR, GROUP ADMIN 93637 0 54397 0 0 0 13595 0 17401 0 179030 0 0 0 PART I, LINE 1A BOARD 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 4B DELTA 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 7 AS 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. FORM 990, PART VI, SECTION A, LINE 6 EFFECTIVE JULY 1, 2009 RENAISSANCE HEALTH SERVICE CORPORATION BECAME THE SOLE CORPORATE MEMBER OF DELTA DENTAL OF KENTUCKY. FORM 990, PART VI, SECTION A, LINE 7A PURSUANT 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 7B THE 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 11B THE 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 12C OFFICERS, 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 15 CEO 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 19 GOVERNING 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. DENTAL CHOICE PROPERTIES LLC 10100 LINN STATION RD SUITE LOUISVILLE KY 40223 610659432 REAL ESTATE HOLDING COMPANY KY -151770 8685331 DELTA DENTAL OF KENTUCKY RENAISSANCE HEALTH SERVICE CORPORATION PO BOX 30416 LANSING MI 489097916 381675667 PROMOTING DENTAL CARE MI 501(C)(4) N/A N/A 0 DELTA DENTAL PLAN OF MICHIGAN INC 4100 OKEMOS ROAD OKEMOS MI 48864 381791480 PROVIDE DENTAL SERVICE PLANS MI 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 0 DELTA DENTAL OF TENNESSEE INC 240 VENTURE CIRCLE NASHVILLE TN 37228 620812197 PROVIDE DENTAL SERVICE PLANS TN 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 0 DELTA DENTAL PLAN OF NEW MEXICO INC 100 SUN AVE NE SUITE 400 ALBUQUERQUE NM 87109 850224562 PROVIDE DENTAL SERVICE PLANS NM 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 0 DELTA DENTAL OF NORTH CAROLINA 4242 SIX FORKS ROAD RALEIGH NC 27609 561018068 PROVIDE DENTAL SERVICE PLANS NC 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 0 DELTA DENTAL PLAN OF OHIO INC PO BOX 30416 LANSING MI 489097916 310685339 PROVIDE DENTAL SERVICE PLANS OH 501(C)(4) N/A DELTA DENTAL PLAN OF MICHIGAN INC 0 DELTA DENTAL PLAN OF INDIANA INC PO BOX 30416 LANSING MI 489097916 351545647 PROVIDE DENTAL SERVICE PLANS IN 501(C)(4) N/A DELTA DENTAL PLAN OF MICHIGAN INC 0 DELTA DENTAL FUND PO BOX 30416 LANSING MI 489097916 382337000 SUPPORT DENTAL EDUCATION AND RESEARCH PROGRAMS MI 501(C)(3) LINE 12A, I DELTA DENTAL PLAN OF MICHIGAN INC 0 DELTA DENTAL PLAN OF ARKANSAS INC 1513 COUNTRY CLUB RD SHERWOOD AR 72120 710561140 PROVIDE DENTAL SERVICE PLANS AR 501(C)(4) NA RENAISSANCE HEALTH SERVICE CORPORATION 0 DELTA DENTAL OF ARKANSAS FOUNDATION INC 1513 COUNTRY CLUB RD SHERWOOD AR 72120 261569324 PROVIDE DENTAL SERVICE PLANS AR 501(C)(3) PF RENAISSANCE HEALTH SERVICE CORPORATION 0 RENAISSANCE FAMILY FOUNDATION INC 4100 OKEMOS ROAD OKEMOS MI 48864 461376165 EMPHASIZE DENTAL HEALTH IN COMMUNITIES IN 501(C)(3) PF RENAISSANCE HOLDING COMPANY 0 SMILE 180 FOUNDATION 240 VENTURE CIRCLE NASHVILLE TN 37228 471654054 EMPHASIZE DENTAL HEALTH IN COMMUNITIES TN 501(C)(3) LINE 12A, I DELTA DENTAL OF TENNESSEE INC 0 DELTA DENTAL OF KENTUCKY FOUNDATION INC 10100 LINN STATION ROAD SUITE 700 LOUISVILLE KY 40223 874045357 EMPHASIZE DENTAL HEALTH IN COMMUNITIES KY 501(C)(3) PF DELTA DENTAL OF KENTUCKY 1 CHESME LLC 124 N BRIDGE ST DEWITT MI 48820 200061957 CAPITAL MANAGEMENT MI N/A 0 0 RED CEDAR INVESTMENT MANAGEMENT LLC 333 BRIDGE STREET NW SUITE 601 GRAND RAPIDS MI 49546 462667997 CAPITAL MANAGEMENT MI N/A 0 0 DH LOGIX LLC 1000 SOUTH MIAMI TRAIL SARASOTA FL 34236 815265121 CAPITAL MANAGEMENT DE N/A 0 0 DENTAL CHOICE INC 10100 LINN STATION RD SUITE 700 LOUISVILLE KY 40223 611105118 PROVIDE DENTAL SERVICE PLANS KY DELTA DENTAL OF KENTUCKY C -4375217 8781890 1.00000 1 DENTAL CHOICE AGENCY INC 10100 LINN STATION RD SUITE 700 LOUISVILLE KY 40223 611336003 PRIMARY GENERAL AGENCY FOR DDKY & DENTAL CHOICE KY DELTA DENTAL OF KENTUCKY C -625 1.00000 1 RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF NEW YORK PO BOX 30381 LANSING MI 48909 134098096 INSURANCE NY RENAISSANCE HOLDING COMPANY C 49929 945945 0.05900 0 RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA PO BOX 30381 LANSING MI 48909 470397286 INSURANCE IN RENAISSANCE HOLDING COMPANY C -176434 8238256 0.05900 0 RENAISSANCE HOLDING COMPANY PO BOX 30381 LANSING MI 48909 412177193 HOLDING COMPANY MI DELTA DENTAL OF MICHIGAN C -19942 5754001 0.05900 0 DEWPOINT INC 300 S WASHIGNTON SQUARE LANSING MI 48933 383300595 COMPUTER CONSULTING MI N/A C 0 FORE HOLDING CORPORATION 240 VENTURE CIRCLE NASHVILLE TN 37228 204116122 EMPLOYEE BENEFITS TN N/A C 0 OMEGA ADMINISTRATORS INC 1513 COUNTRY CLUB ROAD SHERWOOD AR 72120 043740469 PROVIDE THIRD-PARTY ADMINISTRATIVE SERVICES AR N/A C 0 THE 4100 GROUP 4100 OKEMOS ROAD OKEMOS MI 48864 472557772 INVESTMENT IN SUBSIDIARIES MI N/A C 0 0 1 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 DELTA DENTAL PLAN OF MICHIGAN INC M 3520685 ACTUAL COST DENTAL CHOICE INC L 331614 ACTUAL COST DENTAL CHOICE INC B 3000000 ACTUAL COST