2021-11-14T19:50:07-06:00 2020-12-31 BKD LLP 312 WALNUT STREET SUITE 3000 CINCINNATI OH 45202 990 2020-01-01 430908349 DELTA DENTAL OF MISSOURI % BARBARA C BENTRUP DELT 3146563000 12399 GRAVOIS ROAD ST LOUIS MO 631271702 BARBARA C BENTRUP CFO AND CORP COUNSEL 3146563000 2021-11-15 true BARBARA C BENTRUP 999009999 Aaron Hershberger P00961884 5136218300 2 2020 2022-09-23 18:48:47Z E B ROB GOREN 12399 GRAVOIS ROAD ST LOUIS MO 631271702 556272399 false X WWW.DELTADENTALMO.COM X 1958 MO OUR PURPOSE IS TO IMPROVE THE DENTAL HEALTH OF THE PUBLIC BY PROMOTING PREVENTIVE DENTISTRY AND PROVIDING COMPREHENSIVE DENTAL CARE AND MAINTENANCE ON A PREPAID BASIS. 15 11 263 0 0 0 0 600126132 551877993 3708235 3537176 7056291 857230 610890658 556272399 1067017 1970018 544165207 490430889 33370470 34856897 0 0 0 20834248 20427542 599436942 547685346 11453716 8587053 178340938 193102771 32877231 30918722 145463707 162184049 X THE ORGANIZATION'S PRIMARY PURPOSE IS TO IMPROVE THE DENTAL HEALTH OF THE PUBLIC BY PROMOTING PREVENTIVE DENTISTRY AND PROVIDING COMPREHENSIVE DENTAL CARE AND MAINTENANCE ON A PREPAID BASIS. false false 534249292 551877993 DELTA DENTAL OF MISSOURI IS A PREPAID DENTAL INSURANCE COMPANY. IN 2020, DELTA DENTAL PROCESSED 2,878,188 CLAIMS FOR DENTAL SERVICES. 1336018 1336018 ORAL HEALTH GRANT PROGRAM - SEE SCHEDULE O 379273 LAND OF SMILES PROGRAM - SEE SCHEDULE O 633999 633999 536598582 false false false false false false false false false true false true false true true false true false false false false false false false false false true false true false false false false false false false true false false false false false true true true false true 52321 0 true 263 true false false false false false false false false false false true false X 15 11 false false true false true true true true true false true true true true true true true true true true false X BARBARA C BENTRUP 3146563000 12399 GRAVOIS ROAD ST LOUIS MO 631271702 BARBARA C BENTRUP CFO & Corporate Counsel 60.0 0.0 X 1126751 0 145680 E B ROB GOREN President & CEO 60.0 0.0 X 987291 0 95902 RONALD E INGE Chief Dental Officer & COO 60.0 0.0 X 978620 0 81233 HENRY S LAFFITTE VP, Sales & Account Management 40.0 0.0 X 522693 0 74972 EDWARD A PATTROZZI SEE SCHEDULE O 60.0 0.0 X 499319 0 62149 JONATHAN R JENNINGS Chief Actuary/VP UW & PM 60.0 0.0 X 391250 0 83532 JAMES J BARONE SEE SCHEDULE O 60.0 0.0 X 426883 0 24622 KARL A MUDRA CIO 60.0 0.0 X 363436 0 78117 ERIC W MANN Director of Operations 40.0 0.0 X 268880 0 83999 ELLEN R SAMUELS Director, Corp. Communications 40.0 0.0 X 236228 0 86472 JANE STANHAUS DIRECTOR OF HUMAN RESOURCES 40.0 0.0 X 241942 0 70681 ROBERT WOZNIAK Account Executive 40.0 0.0 X 228345 0 58260 JAMES W RHEA Board Chairman/Director 2.0 0.0 X X 49000 0 0 MARK R ZUST First Vice Chairman/Director 2.0 0.0 X X 39750 0 0 ROSEMARY BISHOP Secretary/Director 2.0 0.0 X X 38600 0 0 GARY R WILLIAMS DIRECTOR 2.0 0.0 X 36950 0 0 WILLIAM EDWARDS 2nd Vice Chairman/Director 2.0 0.0 X X 36050 0 0 DEBORAH PATTERSON Director 2.0 0.0 X 36050 0 0 WILLIAM J BENDER Treasurer/Director 2.0 0.0 X X 34750 0 0 TIMOTHY S TAYLOR Director 2.0 0.0 X 34050 0 0 OLADIPUPO ADEFALA Director 2.0 0.0 X 32900 0 0 JOHN R LANDGRAF JR Director 2.0 0.0 X 31950 0 0 KATHLEEN TUCKER Director 2.0 0.0 X 31300 0 0 JOHNNY CUSTARDO Director 2.0 0.0 X 30800 0 0 STEVEN HARRIS Director 2.0 0.0 X 28800 0 0 MARK S MANCIN Director 2.0 0.0 X 27650 0 0 WILLIAM GRAY Director 2.0 0.0 X 26200 0 0 6732588 0 945619 62 false true false MISSOURI DENTAL PROFESSIONALS 1100 SPUR DR STE 30 MARSHFIELD MO 65706 DENTAL SERVICES 5833598 JAY F HAUSER DDS PC PO BOX 503094 SAINT LOUIS MO 63150 DENTAL SERVICES 2760306 M FERNANDEZ DDS E BROWN DDS J OSDIE 3555 SUNSET OFFICE DR STE 210 SAINT LOUIS MO 63127 DENTAL SERVICES 2458578 MICHAEL K PARSONS DDS PC 6 MCBRIDE AND SON CENTER DR STE 20 CHESTERFIELD MO 63005 DENTAL SERVICES 2423454 ST LOUIS PEDIATRIC DENTISTRY LLC 4142 KEATON CROSSING BLVD 102 O FALLON MO 63368 DENTAL SERVICES 2017339 811 0 DENTAL PREMIUMS 524114 551877993 551877993 551877993 3014515 3014515 0 0 0 0 0 522661 522661 522661 522661 0 0 0 0 0 0 0 0 0 MISCELLANEOUS INCOME 900099 363054 363054 INVESTMENT IN SUBSIDIARY 900003 494176 494176 857230 556272399 551877993 4394406 1970018 1970018 0 0 490430889 490430889 5859585 5859585 0 20632075 19100612 1531463 3369111 3012672 356439 3437432 3182281 255151 1558694 1442996 115698 0 410107 323876 86231 173818 137270 36548 0 0 278748 278748 3844419 3036070 808349 1488399 1377919 110480 2950058 2731083 218975 110872 102642 8230 0 874053 809174 64879 351394 325311 26083 0 69575 64411 5164 0 0 0 1921028 1778435 142593 639109 639109 BOARD AND BUREAU DUES 949912 879403 70509 SERVICE BUREAU FEES 2619693 2425240 194453 PUBLIC RELATIONS 337630 312569 25061 SERVICE AGREEMENTS 2052296 1899960 152336 1356431 1255751 100680 547685346 536598582 11086764 0 0 0 30720070 32465117 0 0 11611049 14807157 0 0 0 0 0 0 0 0 799227 1053987 24708136 16804224 8927252 7903912 109051228 119177138 0 0 15037153 15531329 0 0 2194959 2164131 178340938 193102771 15561397 15173757 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17315834 15744965 32877231 30918722 X 0 0 0 0 145463707 162184049 145463707 162184049 178340938 193102771 8587053 8133289 X false true X true false 1350000 1350000 8630866 4426507 4204359 1145351 981205 164146 6036385 4612268 1424117 7545534 6784244 761290 7903912 INVEST. IN ADVANTICA ADMIN 15531329 C 15531329 0 INCURRED BUT UNREPORTED CLAIMS 7178678 ESTIMATE UNPAID CLAIM PROCESS 1156656 UNEARNED PREMIUMS 6117451 EXPERIENCE RATED CREDIT LIAB 162850 ADVANCE DEPOSITS 1129330 15744965 X SCHEDULE D, PART X, LINE 2 FIN 48 FOOTNOTE The Organization is exempt from income taxes under Section 501 of the Internal Revenue Code and a similar provision of state law. Advantica Administrative Services, Inc. and its wholly-owned subsidiaries are subject to both federal and state income taxes and account for income taxes in accordance with income tax accounting guidance (ASC 740 Income Taxes). The income tax accounting guidance results in two components of income tax expense: current and deferred. Current income tax expense reflects taxes to be paid or refunded for the current period by applying the provisions of the enacted tax law to the taxable income or excess of deductions over revenues. The Company determines deferred income taxes using the liability (or balance sheet) method. Under this method, the net deferred tax asset or liability is based on the tax effects of the differences between the book and tax bases of assets and liabilities, and enacted changes in tax rates and laws are recognized in the period in which they occur. Deferred income tax expense results from changes in deferred tax assets and liabilities between periods. Deferred tax assets are reduced by a valuation allowance if, based on the weight of evidence available, it is more likely than not that some portion or all of a deferred tax asset will not be realized. Uncertain tax positions are recognized if it is more likely than not, based on the technical merits, that the tax position will be realized or sustained upon examination. The term more likely than not means a likelihood of more than 50 percent; the terms examined and upon examination also include resolution of the related appeals or litigation processes, if any. A tax position that meets the more likely-than-not recognition threshold is initially and subsequently measured as the largest amount of tax benefit that has a greater than 50 percent likelihood of being realized upon settlement with a taxing authority that has full knowledge of all relevant information. The determination of whether or not a tax position has met the more-likely-than-not recognition threshold considers the facts, circumstances and information available at the reporting date and is subject to management's judgment. The Organization recognizes interest and penalties on income taxes as a component of income tax expense. On a consolidated basis, Advantica Administrative Services, Inc. and its subsidiaries had an operating gain totaling $480,022 and $3,713,384 as of December 31, 2020 and 2019, respectively. At December 31, 2020 and 2019, Advantica Administrative had net operating loss carryforwards of approximately $21,426,000 and $20,495,000, respectively. Advantica Administrative and its subsidiaries had deferred tax assets of approximately $4,408,000 and $4,523,000 at December 31, 2020 and 2019, respectively, nearly all of which arise from these net operating loss carryforwards. Due to the remaining uncertainty regarding whether these will be realized, a full valuation allowance has been recorded against these deferred tax assets at December 31, 2020 and 2019. The Organization and its subsidiaries are currently open to examination under the statute of limitations by the Internal Revenue Service and states in which it files for the years ended December 31, 2017 through 2020. true Healthworks Kids Museum St Louis 1100 Macklind Ave St Louis MO 63110 753018876 501(c)(3) 200000 General Support Central Carolina Community Foundation 2142 Boyce St Columbia SC 292012673 570793960 501(c)(3) 200000 GENERAL SUPPORT Bluffton Jasper Cty Volunteers in Medicine 29 Planation Park Dr Bluffton SC 29910 320298086 501(c)(3) 100000 General Support North Charleston Dental Outreach PO Box 30994 SUITE 505 Charleston SC 29417 271629125 501(c)(3) 100000 General Support St Louis Community Foundation 2 Oak Knoll Park Clayton MO 63105 431758789 501(c)(3) 100000 General Support Give Kids a Smile 10 Worthington Dr MD Heights MO 63043 201287939 501(c)(3) 75000 General Support Heartland Outreach Providers 1215 State Route 7 Blue Springs MO 64014 274387842 501(c)(3) 75000 General Support Greenville Tech Foundation Inc PO Box 5616 Greenville SC 29606 570565961 501(c)(3) 67100 General Support Cass Community Health Foundation 2316 E Meyer Blvd Kansas City MO 64132 431349495 501(c)(3) 50000 General Support HNC Living Foundation 6240 W 135th St Overland Park KS 66223 464214254 501(c)(3) 50000 General Support KC Care Health Center 3515 Broadway Kansas City MO 64111 430967292 501(c)(3) 50000 General Support Medical University of South Carolina 19 Hagood Ave Ste 505 Charleston SC 29425 576000722 501(c)(3) 50000 General Support Rural Parish Clinic Archdiocese St LouiS 20 Archbishop May Drive St Louis MO 63119 843396327 501(c)(3) 50000 General Support Spectrum Health Care 1123 Wilkes Blvd Ste 250 Columbia MO 65201 431633822 501(c)(3) 50000 General Support Healthy Smiles of Spartanburg Inc PO Box 1441 Spartanburg SC 29304 030529473 501(c)(3) 43800 General Support Community Foundation of Central Missouri PO Box 6015 Columbia MO 65205 272930245 501(c)(3) 40000 General Support Community Foundation of the Ozarks Inc PO Box 8960 Springfield MO 65801 237290968 501(c)(3) 40000 General Support Greater Kansas City Community Foundation 1055 Broadway Blvd Kansas City MO 64105 431152398 501(c)(3) 40000 General Support Swope Health Services 3801 Blue Parkway Ste 130 Kansas City MO 64130 430957840 501(c)(3) 34483 General Support Dental Lifeline Network 1800 15th Street Denver CO 80202 846129064 501(c)(3) 30000 General Support Helping Hands of Georgetown Inc 1813 Highmarket Street Ste 100 Georgetown SC 29440 570883461 501(c)(3) 30000 General Support Our Lady of Mercy Community Outreach Svcs PO Box 607 Johns Island SC 29457 570905488 501(c)(3) 30000 General Support Children's Smile Center 601 N 21st Street Ozark MO 65721 571196229 501(c)(3) 25000 General Support Harvest Hope Food Bank PO Box 451 Columbia SC 29202 570725560 501(c)(3) 25000 General Support Senior Resources Inc 2817 Millwood Avenue Columbia SC 29205 570484965 501(c)(3) 25000 General Support Missouri Department of Health & Senior Svc PO Box 570 Jefferson City MO 65102 446000987 Gov't 25000 General Support Youth In Need 1815 Boones Lick Rd St Charles MO 63301 431033862 501(c)(3) 25000 General Support Midlands Technical College Foundation Inc 7300 College Street Irmo SC 29063 237085753 501(c)(3) 22400 General Support Big Springs Medical Association Inc 110 S 2nd St Ellington MO 63638 431068291 501(c)(3) 22336 General Support United Way of the Midlands 1818 Blanding Street Columbia SC 29201 570314396 501(c)(3) 22300 General Support Buchanan County Social Welfare Board 904 S 10th St Ste A Saint Joseph MO 64503 446000455 501(c)(3) 17826 General Support Hope House Inc PO Box 577 Lees Summit MO 64063 431265685 501(c)(3) 17410 General Support St Louis County Library Foundation 1640 S Lindbergh Blvd St Louis MO 63131 431863977 501(c)(3) 15898 General Support Ronald McDonald House Charities of Ozarks 949 E Primrose St Springfield MO 65807 431371143 501(c)(3) 15000 General Support Southeast Missouri Hospital Foundation 1849 Broadway Cape Girardeau MO 63701 431122759 501(c)(3) 14965 General Support YWCA Metro St Louis 3820 West Pine Blvd St Louis MO 63108 430653618 501(c)(3) 12500 General Support LevelUp Kids Inc 5416 NE Antioch Road Kansas City MO 64119 203664224 501(c)(3) 10000 General Support Missouri Coalition for Oral Health PO Box 1432 Jefferson City MO 65102 205032836 501(c)(3) 10000 General Support Operation Food Search Inc 1644 Lotsie Boulevard St Louis MO 63132 431241854 501(c)(3) 10000 General Support Providence Home PO Box 3188 Columbia SC 29230 570618585 501(c)(3) 10000 General Support St Louis Food Bank Inc 70 Corporate Woods Dr Bridgeton MO 63044 431253102 501(c)(3) 10000 General Support Mercy Medicine Free Clinic 500 S Colt Street Florence SC 29501 311693093 501(c)(3) 7500 General Support American Lung Association 55 W Wacker Dr Chicago IL 60601 131632524 501(c)(3) 6600 General Support 43 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S. DELTA DENTAL MAINTAINS RECORDS TO SUBSTANTIATE THE AMOUNT OF ASSISTANCE THAT IT PROVIDES TO THE COMMUNITY ORGANIZATIONS. DELTA DENTAL WORKS WITH THE INDIVIDUAL ORGANIZATIONS TO UNDERSTAND THEIR MISSIONS AND TO DETERMINE THE BENEFITS OF DELTA DENTAL'S PARTICIPATION. X X X X X false true false false false false false false false BARBARA C BENTRUP CFO & Corporate Counsel 511327 0 127913 0 487511 0 120921 0 24759 0 1272431 0 474829 E B ROB GOREN President & CEO 632467 0 176150 0 178674 0 62512 0 33390 0 1083193 0 165375 EDWARD A PATTROZZI SEE SCHEDULE O 187074 0 95340 0 216905 0 50892 0 11257 0 561468 0 20435 JONATHAN R JENNINGS Chief Actuary/VP UW & PM 296738 0 75877 0 18635 0 50317 0 33215 0 474782 0 6669 KARL A MUDRA CIO 282859 0 68120 0 12457 0 45509 0 32608 0 441553 0 5339 JAMES J BARONE SEE SCHEDULE O 319838 0 50000 0 57045 0 7104 0 17518 0 451505 0 RONALD E INGE Chief Dental Officer & COO 426327 105167 447126 58720 22513 1059853 425728 ELLEN R SAMUELS Director, Corp. Communications 184147 0 43797 0 8284 0 58068 0 28404 0 322700 0 HENRY S LAFFITTE VP, Sales & Account Management 232998 0 280223 0 9472 0 41632 0 33340 0 597665 0 ROBERT WOZNIAK Account Executive 88329 0 131331 0 8685 0 33826 0 24434 0 286605 0 ERIC W MANN Director of Operations 211789 0 48432 0 8659 0 63052 0 20947 0 352879 0 JANE STANHAUS DIRECTOR OF HUMAN RESOURCES 187639 0 46476 0 7827 0 40767 0 29914 0 312623 0 SCHEDULE J, PART I, LINE 4B NAMES, AMOUNTS, AND DETAILS OF ARRANGEMENTS THE ORGANIZATION HAS A NONQUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR THE BENEFIT OF CERTAIN EMPLOYEES TO RECEIVE CONTRIBUTIONS IN EXCESS OF THE LIMITATIONS IMPOSED BY THE INTERNAL REVENUE CODE ON STANDARD EMPLOYEE PENSION PLANS. AMOUNTS PAID DURING 2020 FOR THE FOLLOWING INDIVIDUALS WERE: BARBARA BENTRUP - $34,774 E.B. ROB GOREN - $50,375 KARL MUDRA - $5,339 EDWARD PATTAROZZI - $20,435 RONALD INGE - $26,258 JONATHAN JENNINGS - $6,669 THE ORGANIZATION HAS AN UNFUNDED NONQUALIFIED, DEFINED BENEFIT DEFERRED COMPENSATION PLAN (DBDCP) FOR ITS SENIOR LEVEL EXECUTIVES, WITH VESTING AT AGE 60 AND 10 YEARS OF SERVICE FOR EARLY RETIREMENT OR AGE 65 AND FIVE YEARS OF SERVICE FOR NORMAL RETIREMENT. THE PLAN WAS AMENDED TO CURTAIL BENEFITS ACCRUED AS OF DECEMBER 31, 2020 SUBJECT TO THE CONTINUING VESTING PROVISIONS IN THE DBDCP. THE ACTUARIALLY DETERMINED LIABILITY IS BASED UPON ASSUMPTIONS FOR REMAINING YEARS OF SERVICE UNTIL RETIREMENT, PROJECTED SALARIES FOR THE FINAL THREE YEARS OF SERVICE BUT IN NO CASE CONSIDERING ANY SALARY AFTER DECEMBER 31, 2020, AND A PREDETERMINED BENEFIT PERCENTAGE BASED UPON THE PARTICIPANT'S POSITION. INDIVIDUALS WHO PARTICIPATED IN THIS PLAN DURING 2020 WERE THE FOLLOWING: BARBARA BENTRUP, E. B. ROB GOREN, EDWARD PATTAROZZI, JONATHAN JENNINGS, RONALD INGE AND KARL MUDRA. ALL INCREASES IN THE PROJECTED BENEFIT ACCRUALS FOR THIS DBDCP ARE REPORTED ANNUALLY IN THE FORM 990 FOR EACH PARTICIPANT. IT IS IMPORTANT TO NOTE THAT SEVERAL PARTICIPANTS IN THIS PROGRAM ARE NOT YET VESTED, YET THE INCREASE IN THE VALUE OF THE COMPANY'S ACCRUAL HAS TO BE REPORTED ANNUALLY AS COMPENSATION ON THE FORM 990 FOR EACH OF THE PARTICIPANTS WHEN THERE WAS NO BENEFIT VALUE TO THEM PERSONALLY - IF PARTICIPANTS LEAVE THE COMPANY PRIOR TO MEETING THE AGE AND SERVICE REQUIREMENTS, THERE IS NO BENEFIT PAYABLE. SCHEDULE J, PART II, COLUMN C INCLUDES THESE AMOUNTS FOR THE INCREASES IN THE COMPANY'S ACCRUAL. THE AMOUNTS PER PARTICIPANT ARE: BARBARA BENTRUP - $79,314 E.B. ROB GOREN - $20,877 KARL MUDRA - $4,895 EDWARD PATTAROZZI - $9,437 JONATHAN JENNINGS - $8,710 RONALD INGE - $18,955 MARK R ZUST DDS LTD BOARD MEMBER AS OWNER 229738 DENTAL SERVICES PROVIDED false JAMES W RHEA DDS PC BOARD MEMBER AS OWNER 224998 DENTAL SERVICES PROVIDED false WILLIAM A GRAY DMD LLC BOARD MEMBER AS OWNER 295175 DENTAL SERVICES PROVIDED false FLORISSANT DENTAL ASSOCIATES LLC FAMILY OF BOARD MEMBER 368840 DENTAL SERVICES PROVIDED false PART IV, LINE 1 BUSINESS TRANSACTIONS BOARD MEMBER MARK ZUST AND DANIELLE RIORDAN, DAUGHTER OF BOARD MEMBER MARK ZUST, HAVE A REPORTABLE INTEREST IN MARK R ZUST DDS LTD WHICH PROVIDES DENTAL SERVICES TO SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION. BOARD MEMBER JAMES RHEA HAS A REPORTABLE INTEREST IN JAMES W RHEA DDS PC WHICH PROVIDES DENTAL SERVICES TO SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION. BOARD MEMBER WILLIAM GRAY HAS A REPORTABLE INTEREST IN WILLIAM A GRAY DMD LLC WHICH PROVIDES DENTAL SERVICES TO SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION. SEAN LANDGRAF, SON OF BOARD MEMBER JOHN R LANDGRAF JR, HAS A REPORTABLE INTEREST IN FLORISSANT DENTAL ASSOCIATES LLC WHICH PROVIDES DENTAL SERVICES TO THE SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION. FORM 990, PART III, LINE 4B PROGRAM SERVICE ACCOMPLISHMENTS ORAL HEALTH GRANT PROGRAM PROGRAM DESCRIPTION: DELTA DENTAL OF MISSOURI'S ORAL HEALTH GRANT PROGRAM HELPS REDUCE DENTAL DISEASE THROUGH EDUCATION, PREVENTION AND TREATMENT; ENSURE ACCESS TO AFFORDABLE, TIMELY AND HIGH-QUALITY DENTAL CARE; AND ENHANCE AWARENESS OF GOOD ORAL HEALTH WITH A FOCUS ON CHILDREN AND UNDERSERVED INDIVIDUALS. IN 2020, DELTA DENTAL OF MISSOURI AWARDED MORE THAN $1.3 MILLION IN GRANTS TO 32 MISSOURI AND SOUTH CAROLINA ORGANIZATIONS, WHICH ALIGN WITH ITS NON-PROFIT MISSION TO IMPROVE ORAL HEALTH. FUNDING INCLUDED DIRECT CARE GRANTS; EQUIPMENT/CAPITAL GRANTS; EDUCATIONAL GRANTS; AND LOAN REPAYMENT GRANTS FOR DENTISTS WHO COMMIT TO SERVING IN A DENTAL HEALTH PROFESSIONAL SHORTAGE AREA. THE COMPANY ACCEPTS GRANT APPLICATIONS IN ANNUAL TWO GRANT CYCLES. TO BE ELIGIBLE FOR AN ORAL HEALTH GRANT, APPLICANTS IN BOTH STATES MUST FIRST COMPLETE A LETTER OF INTENT THROUGH THE ONLINE GRANT APPLICATION SYSTEM. APPLICANTS MUST BE CONSIDERED TAX-EXEMPT UNDER 501(C)(3) OF THE INTERNAL REVENUE SERVICE CODE, OR BE A PUBLIC OR GOVERNMENTAL ENTITY, SUCH AS A PUBLIC SCHOOL OR HEALTH DEPARTMENT, AND SERVE THE PEOPLE OF MISSOURI OR SOUTH CAROLINA. THE MINIMUM GRANT AMOUNT IS $5,000. ORAL HEALTH GRANTS GREATER THAN $5,000 ARE INCLUDED IN SCHEDULE I. DELTA DENTAL OF MISSOURI BEGAN ADMINISTERING THIS ORAL HEALTH GRANT PROGRAM ONLINE IN 2017. FORM 990, PART III, LINE 4C PROGRAM SERVICE ACCOMPLISHMENTS LAND OF SMILES PROGRAM PROGRAM DESCRIPTION: DELTA DENTAL OF MISSOURI'S LAND OF SMILES IS AN EDUCATIONAL PROGRAM THAT FEATURES CAPTIVATING CHARACTERS, WHO TEACH GRADESCHOOLERS GOOD DENTAL HEALTH HABITS. IN 2020, THE COVID-19 PANDEMIC PREVENTED THE PROGRAM FROM VISITING ELEMENTARY SCHOOLS AS USUAL. SO, DELTA DENTAL OF MISSOURI LAUNCHED AN INNOVATIVE VIRTUAL EXPERIENCE, FEATURING A VIBRANT VIDEO WITH NEW SUPERHERO CHARACTERS, USED FOR STUDENTS IN THE CLASSROOM AND FOR THOSE INVOLVED IN PARTIAL OR FULL-TIME VIRTUAL LEARNING. IN 2020, THE PROGRAM REACHED MORE THAN 68,000 MISSOURI AND SOUTH CAROLINA KINDERGARTEN-THROUGH-3RD-GRADE STUDENTS THROUGH 300 ONLINE PERFORMANCES. STUDENTS LEARN THE IMPORTANCE OF BRUSHING TEETH TWICE A DAY, FLOSSING, EATING HEALTHY FOODS AND VISITING THE DENTIST REGULARLY. DELTA DENTAL OF MISSOURI OFFERS FREE "SMILE BAGS" TO SCHOOLS FOR STUDENTS WHO PARTICIPATE IN THE PROGRAM. EACH BAG INCLUDES A TOOTHBRUSH, TOOTHPASTE AND DENTAL FLOSS TO HELP STUDENTS PRACTICE THE GOOD ORAL HEALTH HABITS THAT THEY LEARN. EACH SCHOOL IS RESPONSIBLE FOR DISTRIBUTING THE BAGS TO PARTICIPATING STUDENTS WHO ATTEND SCHOOL IN PERSON OR VIRTUALLY. A SURVEY OF SCHOOL NURSES SHOWED THAT 100% RATED THE PROGRAM'S EDUCATIONAL VALUE AS EXCELLENT OR GOOD. PRE- AND POST-TEST DATA ALSO SHOWED AN INCREASE IN CHILDREN'S ORAL HEALTH KNOWLEDGE AFTER VIEWING THE PROGRAM. LONGEVITY: THIS PROGRAM HAS BEEN IN PLACE IN MISSOURI SINCE 2002, AND IN SOUTH CAROLINA SINCE 2014. FORM 990, PART III, LINE 4D PROGRAM SERVICE ACCOMPLISHMENTS COMMUNITY GIVING PROGRAM PROGRAM DESCRIPTION: THROUGH DELTA DENTAL OF MISSOURI'S COMMMUNITY GIVING PROGRAM, THE COMPANY SUPPORTS CHARITABLE ORGANIZATIONS AND PROGRAMS THAT ARE WORKING TO MAKE A DIFFERENCE IN MISSOURI AND SOUTH CAROLINA COMMUNITIES. IN RESPONSE TO THE PANDEMIC IN 2020, DELTA DENTAL OF MISSOURI DONATED $500,000 TO SUPPORT COVID-19 RELIEF EFFORTS IN MISSOURI AND SOUTH CAROLINA TO HELP THOSE IN NEED. DELTA DENTAL OF MISSOURI CONSIDERS COMMUNITY GIVING REQUESTS EACH QUARTER FROM REGISTERED 501(C)(3) CHARITABLE ORGANIZATIONS, WHICH SERVE INDIVIDUALS IN MISSOURI OR SOUTH CAROLINA, AND SUPPORT THE OVERALL HEALTH AND WELL-BEING OF AT-NEED OR AT-RISK POPULATIONS. ORGANIZATIONS MAY APPLY FOR FUNDING ONCE PER YEAR. DELTA DENTAL OF MISSOURI'S COMMUNITY GIVING INCLUDES ORAL HEALTH SUPPLY DONATIONS OF TOOTHBRUSHES AND DENTAL FLOSS TO ORGANIZATIONS TO HELP INDIVIDUALS MAINTAIN GOOD ORAL HYGIENE FOR BETTER DENTAL HEALTH. COMMUNITY GIVING GREATER THAN $5,000 IS INCLUDED IN SCHEDULE I. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS The Organization's Bylaws were revised effective September 15, 2020. The amendment to Article II, Section 4 allows for election of the directors to be conducted by means of remote communication, including virtual or electronic communications, by which members may participate and vote in the election at the Annual Meeting of the members as an alternative to the written or electronic ballot process currently allowed. The proposed amendment to Article XI, Section 1.b. similarly allows for bylaws amendments to be approved via a vote by means of remote communication at a meeting of the members as an alternative to a written ballot. The amendment to Article II, Section 8 provides that the presence of six members entitled to vote, whether in person or, if permitted by the Board of Directors, by means of remote communication constitutes a quorum at a meeting of the members. The new Section 9 in Article II provides that the Board of Directors may permit any or all members to participate in the Annual Meeting or any regular or special meeting of the members by, or conduct the meeting through the use of, any means of communications by which all members participating may simultaneously hear each other during the meeting, including any virtual or electronic means of communication. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS THE MEMBERS OF THE ORGANIZATION ARE COMPRISED OF LICENSED DENTISTS IN THE STATES OF MISSOURI AND SOUTH CAROLINA WHO HAVE AN EFFECTIVE SIGNED AND ACCEPTED PARTICIPATING DENTIST AGREEMENT WITH THE ORGANIZATION. THE MEMBERS MEET ANNUALLY. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR STOCKHOLDERS WHO CAN ELECT MEMBERS OF THE GOVERNING BODY THE ORGANIZATION HAS MEMBERS WHO ELECT THE INDIVIDUALS TO SERVE ON THE ORGANIZATION'S BOARD OF DIRECTORS. THE MEMBERS OF THE ORGANIZATION ARE COMPRISED OF LICENSED DENTISTS IN THE STATES OF MISSOURI AND SOUTH CAROLINA WHO HAVE AN EFFECTIVE SIGNED AND ACCEPTED PARTICIPATING DENTIST AGREEMENT WITH THE ORGANIZATION. THE MEMBERS MEET ANNUALLY. FORM 990, PART VI, SECTION A, LINE 7B GOVERNANCE DECISIONS CHANGES TO THE CORPORATE BYLAWS BY THE BOARD ARE SUBJECT TO APPROVAL BY THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990 THE FORM 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. THE FORM 990 IS THEN REVIEWED IN DETAIL BY THE ORGANIZATION'S CFO AND PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE ELECTRONIC FILING OF THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY DELTA DENTAL OF MISSOURI REGULARLY REQUIRES ITS OFFICERS, DIRECTORS, AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST STATEMENT. THE REVIEW OF THE STATEMENTS IS PART OF THE FINANCE AND AUDIT COMMITTEE'S RESPONSIBILITIES. FORM 990, PART VI, SECTION B, LINE 15A & 15B COMPENSATION APPROVAL PROCESS DELTA DENTAL OF MISSOURI HAS ESTABLISHED A COMPENSATION COMMITTEE (A SUBSET OF THE BOARD OF DIRECTORS) COMPOSED ENTIRELY OF PERSONS WITH NO CONFLICT OF INTEREST THAT REVIEWS AND SETS OFFICER COMPENSATION IN ACCORDANCE WITH THE PROCESS OUTLINED IN TREASURY REGULATION SECTION 53.4958-6 FOR ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS OF THE COMPENSATION OF THE CEO AND ALL OTHER OFFICERS. THIS PROCESS INCLUDES EMPLOYING INDEPENDENT COMPENSATION CONSULTANTS, UTILIZING RELEVANT COMPENSATION SURVEYS AND STUDIES, CONTEMPORANEOUSLY DOCUMENTING AND RECORDING THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT, AND SEEKING APPROVAL ON FINALIZED COMPENSATION PROPOSALS BY THE COMPENSATION COMMITTEE. REVIEWS ARE CONDUCTED AND APPROVED BY THE COMPENSATION COMMITTEE ON AN ANNUAL BASIS. THE ANNUAL COMPENSATION FOR 2020 WAS REVIEWED BY A THIRD PARTY COMPENSATION CONSULTANT AND THEN REVIEWED BY THE COMPENSATION COMMITTEE IN MARCH, 2020. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS THE ORGANIZATION'S CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A EDWARD A PATROZZI CHIEF SALES & MARKETING OFFICER - RETIRED IN MARCH 2020 JAMES J BARONE CHIEF SALES & MARKETING OFFICER - HIRED IN MARCH 2020 ADVANTICA ADMINISTRATIVE SERVICES INC 12399 GRAVOIS ROAD ST LOUIS MO 63127 431826684 THIRD PARTY ADMIN MO NA C-CORP 3317770 16215743 1.00000 true false false false false false false false false false false false false true false false false false false false ADVANTICA ADMINISTRATIVE SERVICES INC M 147108 ALLOCATIONS