2021-11-15T08:22:32-06:00 2020-12-31 381357951 PLANTE & MORAN PLLC 1111 MICHIGAN AVE STE 100 EAST LANSING MI 48823 990 2020-01-01 561018068 DELTA DENTAL OF NORTH CAROLINA DELT 8005879514 4242 SIX FORKS ROAD NO 970 RALEIGH NC 27609 AMY BASEL CHIEF FINANCIAL OFFICER 8005879514 2021-11-09 1 AMY BASEL 999009999 DAVID LOWENTHAL CPA P00378651 5173326200 2021-11-09 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z CURTIS R LADIG CPA 4242 SIX FORKS ROAD NO 970 RALEIGH NC 27609 93304586 0 X WWW.DELTADENTALNC.COM X 1970 NC DELTA DENTAL OF NORTH CAROLINA'S MISSION IS TO ADVANCE AND PROMOTE THE IMPROVEMENT OF ORAL HEALTH THROUGH DENTAL SERVICES, SUPPORT FOR RESEARCH AND EDUCATION, AND COMMUNITY OUTREACH DIRECTED TOWARD SECURING ACCESS TO QUALITY DENTAL CARE FOR ALL. 11 10 25 0 0 0 0 0 78472730 89940478 163797 126082 0 0 78636527 90066560 194500 425000 0 0 3829464 4765211 0 0 0 70440939 76361015 74464903 81551226 4171624 8515334 19177209 31368287 7911505 11281985 11265704 20086302 X SEE SCHEDULE ODELTA DENTAL OF NORTH CAROLINA'S MISSION IS TO ADVANCE AND PROMOTE THE IMPROVEMENT OF ORAL HEALTH THROUGH DENTAL SERVICES, SUPPORT FOR RESEARCH AND EDUCATION, AND COMMUNITY OUTREACH DIRECTED TOWARD SECURING ACCESS TO QUALITY DENTAL CARE FOR ALL. 0 0 76758913 425000 89940478 PROMOTING DENTAL CAREDELTA DENTAL OF NORTH CAROLINA IS A LEADNG GROUP DENTAL BENEFITS PROVIDER. THE PURPOSE OF THE ORGANIZATION IS TO ADVANCE AND PROMOTE THE IMPROVEMEMNT OF ORAL HEALTH. THIS IS DONE BY OFFERING INNOVATIVE, COST-EFFECTIVE PRODUCTS THAT MEET THE NEEDS OF CUSTOMERS. THIS WAS DEMONSTRATED IN 2020 BY PAYING OUT OVER $60 MILLION IN CLAIMS AND BY PROVIDING DENTAL BENEFITS FOR THE PUBLIC AND ADVANCING THE SCIENCE OF DENTISTRY. IN ADDITION, OVER 1 MILLION CLAIMS WERE PROCESSED FOR OVER 665,000 MEMBERS. SEE SCHEDULE O FOR CONTINUATION COST SAVING STRATEGIESDELTA DENTAL BENEFIT PLANS ARE COMMITTED TO SAVING GROUPS AND MEMBERS MONEY. THE DELTA DIFFERENCE IS AN INTEGRATION OF ACTIVITIES SUCH AS COST MANAGEMENT POLICIES, FEE REDUCTION AGREEMENTS WITH DENTISTS, AND ANTI-FRAUD PROGRAMS, ALL OF WHICH ENSURE QUALITY, COST-EFFECTIVE DENTAL BENEFIT DELIVERY. COMMITMENT TO THE COMMUNITYTHE DELTA DENTAL FUND, THE COMPANY'S PHILANTHROPIC AFFILIATE, ENCOURAGES ADVANCES IN DENTISTRY AND SUPPORTS DENTAL EDUCATION AND RESEARCH. IN 2020, DELTA DENTAL FUND CONTRIBUTED OVER $251,000 TO ORGANIZATIONS IN NORTH CAROLINA TO SUPPORT THESE CAUSES. IN 2020 THE COVID-19 PANDEMIC BEGAN; TO DO OUR PART TO HELP DURING THIS TIME OF CRISIS, WE FOCUSED OUR EFFORTS ON OUR CUSTOMERS. WE WERE ONE OF THE FIRST DENTAL BENEFITS ADMINISTRATORS TO PROVIDE CLIENTS A GRACE PERIOD DURING THE CRISIS. TO FURTHER ADDRESS FINANCIAL CHALLENGES OUR CUSTOMERS FACED, WE ESTABLISHED THE PANDEMIC RELIEF PROGRAM WHICH PROVIDED OUR GROUP CUSTOMERS A CREDIT OF 50% OF ONE MONTH'S PREMIUM OR ADMINISTRATIVE FEES. UNEQUALED ACCESS TO DENTISTS FOR FIVE DECADES, DELTA DENTAL HAS HELPED PROMOTE ORAL HEALTH BY DESIGNING AND ADMINISTERING INNOVATIVE, COST-EFFECTIVE DENTAL BENEFIT PROGRAMS. EXPERTS AT PLAN DESIGN, DELTA DENTAL HAS CREATED DENTAL BENEFIT PROGRAMS THAT MEET CUSTOMER COST-OBJECTIVES WHILE HELPING TO IMPROVE AND MAINTAIN ORAL HEALTH.OUR LONG STANDING RELATIONSHIPS WITH PROVIDERS IN THE COMMUNITIES WE SERVE ALLOW US TO MAINTAIN LARGE NETWORKS, ALLOWING BROAD ACCESS FOR MEMBERS AND COST-EFFECTIVE CARE. DELTA DENTAL'S GROUP MEMBERS ARE AFFORDED ADDED PROTECTION BECAUSE THEY GUARANTEE THAT PARTICIPATING DENTISTS WILL ACCEPT THEIR PAYMENT FOR COVERED SERVICES AND NO CHARGE, OTHER THAN CO-PAYMENTS AND DEDUCTIBLES ARE BILLED BACK TO THE MEMBER. THIS LOWERS CLAIM COSTS FOR CUSTOMERS AND REDUCES OUT-OF-POCKET COSTS FOR SUBSCRIBERS.WITH TWO NETWORKS OF FULL-TIME PARTICIPATING DENTISTS IN ONE INTEGRATED CLAIMS SYSTEM, DELTA DENTAL CAN DELIVER TO CUSTOMERS AND GROUP MEMBERS BROAD ACCESS TO CARE. 76758913 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 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 0 1 1 1 0 1 25600 0 1 25 1 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X AMY BASEL CHIEF FINANCIAL OFFICER 5173496000 4100 OKEMOS ROAD OKEMOS MI 48864 X AMY L BASEL CHIEF FINANCIAL OFFICER 5.00 45.00 X 0 1439577 1045609 CURT LADIG CHIEF EXECUTIVE OFFICER 50.00 0.00 X 634271 0 182210 THOMAS J FLESZAR DDS MS DIRECTOR 2.00 0.00 X 15000 408184 0 DEBORAH JONES VP, SALES & CLIENT MGT 40.00 0.00 X 254387 0 40585 JOHN SINGLETARY ACCOUNT EXECUTIVE 40.00 0.00 X 221194 0 39066 MARIROSE STEIGERWALD SVP & CAO 40.00 0.00 X 198590 0 37917 ANNIE DONALDSON STRATEGIC CLIENT CONSULTANT 40.00 0.00 X 152456 0 35593 DENISE SAUNDERS POWELL ACCOUNT EXECUTIVE 40.00 0.00 X 146310 0 32210 JOHN PEATTIE ACCOUNT EXECUTIVE 40.00 0.00 X 114992 0 35263 MOIRA LOCASCIO CHAIRPERSON 2.00 5.00 X X 20004 24996 0 CARL EXNER TREASURER 1.00 0.00 X X 18000 0 0 JAMES R ROSE JR VICE CHAIRPERSON 2.00 0.00 X X 15180 0 0 KATHY TRUSCH SECRETARY 2.00 0.00 X X 15000 0 0 COURTNEY CROWDER DIRECTOR 2.00 0.00 X 15000 0 0 BRADFORD PRESSLEY DIRECTOR 2.00 0.00 X 15000 0 0 ALAN CLARKE IMMEDIATE PAST CHAIR 2.00 0.00 X X 15000 0 0 STEWART DECLARE HOLMES DIRECTOR 2.00 0.00 X 15000 0 0 SHEILA AHLER CPA DIRECTOR 2.00 0.00 X 11250 0 0 LEAH DEVLIN DIRECTOR 2.00 0.00 X 11250 0 0 1887884 1872757 1448453 12 0 1 0 PIERCE GROUP BENEFITS LLC 4928 LINKSLAND DR HOLLY SPRINGS NC 27540 COMMISSIONS 677008 GALLAGHER BENEFITS SERICES INC TWO PIERCE PLACE ITASCA IL 60143 COMMISSIONS 370974 USI INSURANCE SERVICES LLC PO BOX 601478 CHARLOTTE NC 28260 COMMISSIONS 348610 MARSH & MCLENNAN AGENCY LLC ONE S JEFFERSON ST ROANOKE VA 24011 COMMISSIONS 348265 JAMES A SCOTT & SON INC 628 GREEN VALLEY RD GREENSBORO NC 27408 COMMISSIONS 280177 12 DENTAL CARE REVENUE 524114 89854873 89854873 SUBCRIBER FEE 524114 85605 85605 89940478 192600 192600 3171508 3238026 -66518 -66518 -66518 90066560 89940478 0 126082 X 425000 425000 1607286 1044736 562550 2418801 2243885 174916 108465 102064 6401 421506 368034 53472 209153 184962 24191 241767 53881 187886 244486 244486 84338 84338 9965 9965 62519512 61651034 868478 242132 242132 945238 27824 917414 492243 47823 444420 315050 315050 110666 26223 84443 46487 37746 8741 13776 6845 6931 63113 63113 COMMISSION 5016268 5016268 PROCESSING FEES 3344827 3344827 PREMIUM TAX 1710362 1710362 TAXES, FEES & LICENSES 836247 342861 493386 124538 124538 81551226 76758913 4792313 0 14416468 15603518 4596593 5098968 35161 103318 158834 108422 64188 50412 10245771 64799 266300 19177209 31368287 5421707 7877713 956450 1361577 1533348 2042695 7911505 11281985 X 11265704 20086302 11265704 20086302 19177209 31368287 8515334 305264 0 X 0 1 X 1 0 158834 108422 50412 50412 DUE TO AFFILIATES 2042695 2042695 90056595 0 90056595 9965 9965 90066560 81541261 0 81541261 9965 9965 81551226 1 DELTA DENTAL FUND PO BOX 30416 LANSING MI 48909 382337000 501(C)(3) 400000 GENERAL CONTRIBUTION FRIENDS OF THE NC MUSEUM OF NATURAL SCIENCE 11 WEST JONES ST RALEIGH NC 27601 561240806 501(C)(3) 25000 MUSEUM EXHIBIT 2 0 PART I, LINE 2: CONTRIBUTIONS ARE MADE AT MANAGEMENT DISCRETION TO ORGANIZATIONS THAT SUPPORT DELTA DENTAL PLAN OF NORTH CAROLINA'S MISSION. CONTRIBUTIONS MADE TO THE DELTA DENTAL FUND ARE APPROVED BY THE BOARD OF DIRECTORS. IN ORDER FOR FUNDS TO BE DISBURSED, VOUCHER RECORDS MUST PASS THROUGH THE APPROVAL PROCESS, SIMILAR TO ANY OTHER EXPENDITURE MADE BY DELTA DENTAL PLAN OF NORTH CAROLINA. X X 1 1 X X X X 0 1 0 0 0 0 0 1 0 AMY L BASEL CHIEF FINANCIAL OFFICER 0 449514 0 454522 0 535541 0 1021904 0 23705 0 2485186 0 510043 CURT LADIG CHIEF EXECUTIVE OFFICER 454901 0 147000 0 32370 0 164259 0 17951 0 816481 0 0 0 THOMAS J FLESZAR DDS MS DIRECTOR 15000 408184 0 0 0 0 0 0 0 0 15000 408184 0 0 DEBORAH JONES VP, SALES & CLIENT MGT 141666 0 110250 0 2471 0 12777 0 27808 0 294972 0 0 0 JOHN SINGLETARY ACCOUNT EXECUTIVE 63221 0 157563 0 410 0 11258 0 27808 0 260260 0 0 0 MARIROSE STEIGERWALD SVP & CAO 162267 0 35000 0 1323 0 10109 0 27808 0 236507 0 0 0 ANNIE DONALDSON STRATEGIC CLIENT CONSULTANT 75781 0 76288 0 387 0 7785 0 27808 0 188049 0 0 0 DENISE SAUNDERS POWELL ACCOUNT EXECUTIVE 58527 0 86429 0 1354 0 14259 0 17951 0 178520 0 0 0 JOHN PEATTIE ACCOUNT EXECUTIVE 62037 0 52471 0 484 0 7455 0 27808 0 150255 0 0 0 PART I, LINE 1A TRAVEL FOR COMPANIONS RELATED TO TRAVEL FOR A SPOUSE. THIS AMOUNT WAS TREATED AS TAXABLE TO THE BOARD MEMBER OR EMPLOYEE. DUE TO THE COVID-19 PANDEMIC, THERE WAS NO TRAVEL FOR COMPANIONS IN 2020. THE CEO IS ELIGIBLE FOR REIMBURSEMENT OF SUBSTANTIATED HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES THAT HAVE A BUSINESS PURPOSE. THIS BENEFIT IS NOT TAXABLE BUT THE EXPENSES MUST BE SUBSTANTIATED AS A BUSINESS EXPENSE. PART I, LINE 4B A RELATED ORGANIZATION, DELTA DENTAL PLAN OF MICHIGAN, HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). IN ORDER TO BE ELIGIBLE FOR THE SERP, AN EMPLOYEE MUST BE A SENIOR VICE PRESIDENT OR HIGHER AND ADDED TO THE PLAN BY THE BOARD OF DIRECTORS. THE SERP BENEFITS ARE REVIEWED AS PART OF THE TOTAL COMPENSATION BY AN INDEPENDENT CONSULTANT; TOWERS WATSON. IN 2020, AMY BASEL ACCRUED BENEFITS AS A PARTICIPANT IN THE SERP PLAN. AMY BASEL BECAME VESTED IN A PORTION OF HER ACCRUED BENEFITS AND, AS REQUIRED BY THE IRS, THE VESTED PORTION WAS TREATED AS TAXABLE WAGES DURING 2020. THESE WAGES WERE ALSO REPORTED ON SCHEDULE J AS COMPENSATION THAT HAS BEEN REPORTED AS DEFERRED ON PRIOR FORM 990S. EFFECTIVE SEPTEMBER 1, 2020, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN UNDER SEC. 457(F) IS MAINTAINED BY THE ORGANIZATION FOR CERTAIN EXECUTIVE EMPLOYEES. UPON SEVERANCE FROM SERVICE PRIOR TO ATTAINMENT OF NORMAL RETIREMENT AGE, THE PARTICIPANT SHALL FORFEIT INELIGIBLE AMOUNTS IN THE PLAN UNLESS SUCH SEVERANCE IS DUE TO DEATH, DISABILITY, INVOLUNTARY TERMINATION WITHOUT CAUSE, OR A SEVERANCE FROM EMPLOYMENT FOR GOOD REASON. IN 2020, CURTIS LADIG ACCRUED BENEFITS AS A PARTICIPANT IN THE PLAN, BUT DID NOT RECEIVE A DISTRIBUTION. PART I, LINE 7 AS INDICATED IN SCHEDULE J, PART II, TOP MANAGEMENT OFFICIALS RECEIVED A BONUS BASED ON PERFORMANCE AND THE FINANCIAL RESULTS OF THE ORGANIZATION. THIS BONUS IS APPROVED BY THE BOARD OF DIRECTORS. SCHEDULE J, PART II: THOMAS FLESZAR, A FORMER EXECUTIVE OF A RELATED ORGANIZATION, RECEIVED A ONE-TIME LUMP SUM SETTLEMENT FOR A NON-QUALIFIED POST-RETIREMENT BENEFIT. DUE TO THE FACT THAT HE IS REPORTED AS A DIRECTOR OF THE COMPANY, THE PAYMENT IS REPORTED AS REQUIRED BY IRS RULES. FORM 990, PART VI, SECTION A, LINE 6 DELTA DENTAL OF NORTH CAROLINA HAS A SOLE MEMBER, RENAISSANCE HEALTH SERVICE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS VOTING RIGHTS AND ELECTS DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS THE RIGHTS THAT ARE PRESCRIBED BY LAW, FOR MEMBERS OF NON-PROFIT CORPORATIONS, INCLUDING THE APPROVAL OF SIGNIFICANT EXPENDITURES AND CEO APPOINTMENT. FORM 990, PART VI, SECTION B, LINE 11B THE INFORMATION PRESENTED ON THE FORM 990 IS GATHERED BY THE SENIOR TAX ADMINISTRATOR FOR THE ORGANIZATION. THE CFO REVIEWS THE INFORMATION. ONCE APPROVED THE INFORMATION IS GIVEN TO OUTSIDE TAX PREPARERS WHO PREPARE AND REVIEW THE FORM 990. ONCE COMPLETE, AN ELECTRONIC COPY OF THE FORM 990 IS PLACED IN A SECURE PORTAL FOR THE BOARD TO REVIEW. THIS IS DONE BEFORE THE RETURN IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ENTERPRISE'S GENERAL COUNSEL IS CHARGED WITH REVIEWING AND MONITORING ANY POTENTIAL CONFLICT OF INTEREST TRANSACTIONS. ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO REVIEW AND EXECUTE A CONFLICT OF INTEREST POLICY. THIS POLICY REQUIRES THAT ANY CONFLICTS OF INTEREST BE DISCLOSED ON AN ANNUAL BASIS, OR AT ANY OTHER TIME THAT THE PERSON EXECUTING THE POLICY BECOMES AWARE OF A SITUATION OR TRANSACTION THAT ACTUALLY OR POTENTIALLY CREATES A CONFLICT OF INTEREST. ALL CONFLICT OF INTEREST DISCLOSURE FORMS ARE INITIALLY REVIEWED BY THE GENERAL COUNSEL. IF A PROHIBITED TRANSACTION IS IDENTIFIED, THE MATTER IS ESCALATED TO THE CEO AND TO THE AUDIT AND FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR FURTHER REVIEW AND APPROPRIATE ACTION. IN THE EVENT OF A CONFLICT OF INTEREST INVOLVING A MEMBER OF THE BOARD OF DIRECTORS, SUCH AS A VOTE, IN WHICH A MEMBER HAS AN INTEREST, THE MEMBER IS REQUIRED TO DISCLOSE THE POTENTIAL CONFLICT AND ABSTAIN FROM ANY VOTE ON THE MATTER. WHETHER FURTHER PRECAUTIONS ARE REQUIRED (E.G., PROHIBITING THE INTERESTED PARTY FROM ENGAGING IN DISCUSSIONS) WOULD DEPEND UPON THE SPECIFIC NATURE AND BACKGROUND OF THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A CEO COMPENSATION IS SET BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. MARKET DATA PROVIDED BY OUTSIDE CONSULTANTS, TOWERS WATSON, IS USED TO VALIDATE THE REASONABLENESS OF THE TOTAL COMPENSATION PACKAGE. COMPENSATION FOR CERTAIN OFFICERS, INCLUDING THE CFO, IS DETERMINED AND PAID THROUGH A RELATED ORGANIZATION, DELTA DENTAL PLAN OF MICHIGAN, INC. FORM 990, PART VI, SECTION C, LINE 19 NO DOCUMENTS AVAILABLE TO THE PUBLIC. 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 IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,002,439. MANAGEMENT AND GENERAL EXPENSES 868,478. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,870,917. PURCHASED DENTAL SERVICES: PROGRAM SERVICE EXPENSES 60,648,595. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 60,648,595. 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 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 OF ARKANSAS FOUNDATION INC 1513 COUNTRY CLUB RD SHERWOOD AR 72120 261269324 EMPHASIZE DENTAL HEALTH IN COMMUNITIES AR 501(C)(3) PF DELTA DENTAL OF ARKANSAS 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 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 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 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 NEW MEXICO INC 2500 LOUISIANA BLVD NE ALBUQUERQUE NM 87110 850224562 PROVIDE DENTAL SERVICE PLANS NM 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 0 DELTA DENTAL OF KENTUCKY INC 10100 LINN STATION ROAD NO 700 LOUISVILLE KY 40223 610659432 PROVIDE DENTAL SERVICE PLANS KY 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 0 DELTA DENTAL OF TENNESSEE 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 ARKANSAS INC 1513 COUNTRY CLUB RD SHERWOOD AR 72120 710561140 PROVIDE DENTAL SERVICE PLANS AR 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 0 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 RENAISSANCE HOLDING COMPANY PO BOX 30381 LANSING MI 48909 412177193 HOLDING COMPANY MI N/A C 0 RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA PO BOX 30381 LANSING MI 48909 470397286 INSURANCE IN N/A C 0 RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF NEW YORK PO BOX 30381 LANSING MI 48909 134098096 INSURANCE NY N/A C 0 FORE HOLDING CORPORATION 240 VENTURE CIRCLE NASHVILLE TN 37228 204116122 EMPLOYEE BENEFITS TN N/A C 0 DENTAL CHOICE INC 10100 LINN STATION RD SUITE 700 LOUISVILLE KY 40223 611105118 PROVIDE DENTAL SERVICE PLANS KY N/A C 0 DENTAL CHOICE AGENCY INC 10100 LINN STATION RD SUITE 700 LOUISVILLE KY 40223 611336003 PRIMARY GENERAL AGENCY FOR DDKY & DENTAL CHOICE KY N/A C 0 OMEGA ADMINISTRATORS INC 1513 COUNTRY CLUB ROAD SHERWOOD AR 72120 043740469 PROVIDING 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 DEWPOINT INC 300 S WASHINGTON SQUARE LANSING MI 48933 383300595 IT CONSULTING MI N/A C 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 DELTA DENTAL FUND B 400000 ACTUAL COST DELTA DENTAL PLAN OF MICHIGAN INC M 4478719 ACTUAL COST RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA M 628224 ACTUAL COST