DELTA DENTAL OF KENTUCKY INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL OF KENTUCKY INC (EIN 61-0659432)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-16
IRS object ID
202003219349310975
Schema version
2019v5.1
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)
Return2020-11-16T13:08:27-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

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 Begin2019-01-01TaxPeriodBeginDt

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 TitleCFOPersonTitleTxt
Phone5027365000PhoneNum
Signature2020-11-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDAVID LOWENTHAL CPAPreparerPersonNm
PTINP00378651PTIN
Phone5173326200PhoneNum
Preparation2020-11-12PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address68.62.32.134IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-11-12IPDt
IP Tm09:03:28IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device IdAFBDF4DF54CCD05CFBA4AEDC275F7F3808ECB98BAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-04-22 16:20:28ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCHRISTOPHER W GREENPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line110100 LINN STATION ROAD NO 700AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP40223ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$170,437,174GrossReceiptsAmt
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 Employee87TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$579,748TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$96,437NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$194,147,209PYProgramServiceRevenueAmt
CY Program Service Revenue$146,696,663CYProgramServiceRevenueAmt
PY Investment Income$1,499,200PYInvestmentIncomeAmt
CY Investment Income$1,359,948CYInvestmentIncomeAmt
PY Other Revenue-$1,034,347PYOtherRevenueAmt
CY Other Revenue-$883,222CYOtherRevenueAmt
PY Total Revenue$194,612,062PYTotalRevenueAmt
CY Total Revenue$147,173,389CYTotalRevenueAmt
PY Grants And Similar Paid$1,890,558PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,665,998CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$165,381,833PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$116,397,006CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,775,838PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$10,086,152CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$16,547,680PYOtherExpensesAmt
CY Other Expenses$16,100,242CYOtherExpensesAmt
PY Total Expenses$192,595,909PYTotalExpensesAmt
CY Total Expenses$144,249,398CYTotalExpensesAmt
PY Revenues Less Expenses$2,016,153PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,923,991CYRevenuesLessExpensesAmt
Total Assets BOY$99,319,564TotalAssetsBOYAmt
Total Assets EOY$102,860,273TotalAssetsEOYAmt
Total Liabilities BOY$18,676,804TotalLiabilitiesBOYAmt
Total Liabilities EOY$16,078,508TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$80,642,760NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$86,781,765NetAssetsOrFundBalancesEOYAmt
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$140,922,904ExpenseAmt
Grant$1,665,998GrantAmt
Revenue$146,116,915RevenueAmt
DescDELTA DENTAL OF KENTUCKY IS THE LARGEST AND OLDEST DENTAL BENEFIT ADMINISTRATOR IN KENTUCKY. AS A NOT-FOR-PROFIT ORGANIZATION, OUR CORE MISSION IS THAT EVERYONE DESERVES A HAPPY AND HEALTHY SMILE. WE ARE COMMITTED TO FULFILLING THIS MISSION THROUGH OUR DENTAL AND VISION BENEFIT PROGRAMS AS WELL AS OUR CORPORATE PHILANTHROPIC INITIATIVES. DELTA DENTAL OF KENTUCKY INSURES NEARLY 800,000 SMILES IN 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 OUR MEMBERS BY DESIGNING AND ADMINISTERING INNOVATIVE, COST-EFFECTIVE DENTAL BENEFIT PROGRAMS. THESE PLANS MEET OUR MEMBERS' COST-OBJECTIVES WHILE IMPROVING AND MAINTAINING THEIR ORAL HEALTH. DELTA DENTAL OF KENTUCKY IS DEDICATED TO OUR MEMBERS AND ENSURING WE PROVIDE SUPERIOR CUSTOMER SERVICE, AS EVIDENCED BY NEARLY 90% OF CALLS ANSWERED IN LESS THAN 30 SECONDS. OUR AWARD WINNING CUSTOMER SERVICE HAS A 95% SATISFACTION RATE.DELTA DENTAL OF KENTUCKY OPERATES THE LARGEST DENTAL NETWORKS WITH OVER 90% OF PARTICIPATION AMONG KENTUCKY DENTISTS. OUR TWO LARGE NETWORKS GIVE DELTA DENTAL MEMBERS ADDED PROTECTION BECAUSE THEY GUARANTEE THAT PARTICIPATING DENTISTS WILL ACCEPT THEIR PAYMENT FOR COVERED SERVICES AND THAT NO CHARGES, OTHER THAN CO-PAYMENTS AND DEDUCTIBLES ARE BILLED. OUR DENTIST-CREDENTIALING PROGRAM, COST MANAGEMENT POLICIES AND FEE REDUCTION AGREEMENTS WITH PARTICIPATING DENTISTS HELP MEMBERS RECEIVE QUALITY DENTISTRY AND BEST DENTAL OUTCOMES. ENSURING OUR MISSION OF HAPPY AND HEALTHY SMILES IS A CORE COMPONENT OF THE DELTA DENTAL OF KENTUCKY. SINCE THE INCEPTION OF DELTA DENTAL OF KENTUCKY FUND AT THE COMMUNITY FOUNDATION IN 2003, OUR CORPORATE PHILANTHROPIC GIVING HAS PROVIDED OVER $15 MILLION IN GRANTS TO OVER 160 ORGANIZATIONS. IN 2019, THE FUNDS DONATED TO THE COMMUNITY FOUNDATION OF $1.5 MILLION ULTIMATELY BENEFITED 45 ORGANIZATIONS THROUGHOUT THE ENTIRE STATE. THESE DOLLARS FUNDED 21 DENTAL CLINICS ACROSS THE COMMONWEALTH AND 75% OF THESE DOLLARS WERE GRANTED TO ORGANIZATIONS PROVIDING DENTAL CARE AND ORAL HEALTH EDUCATION TO VULNERABLE POPULATIONS.Desc
Total Program Service Expenses$140,922,904TotalProgramServiceExpensesAmt
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 Document22175IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee87EmployeeCnt
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 (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
J JUDE THOMPSON
PRESIDENT, CEO35.005.00Yes (X)Yes (X)$547,764$0$38,685
BRIAN D HART
VP/CRO40.000.00Yes (X)$365,209$0$36,744
ANGELA J NENNI
VP/CAO40.000.00Yes (X)$368,848$0$25,638
JOHN L WEEKS III
VP/CLO/SECRETARY (THRU 7/2019)40.000.00Yes (X)$309,832$0$14,298
RONALD E STORY
VP/CIO40.000.00Yes (X)$280,108$0$15,995
RUSSELL W SKAGGS
VP/CFO (THRU 2/2019)40.000.00Yes (X)$265,688$0$20,984
TAUNYA L ESHENBAUGH
DIRECTOR, SALES40.000.00$245,781$0$17,571Yes (X)
JEFFREY D DUES
DIRECTOR, ACCOUNT MGMT40.000.00$186,263$0$31,657Yes (X)
LAURA F WINCE
DIRECTOR, MARKETING40.000.00$110,485$0$28,329Yes (X)
CLIFFORD T MAESAKA
FORMER CEO (THRU 3/2017)0.000.00$136,207$0$0Yes (X)
TAMMY W CANNON
MANAGER, UNDERWRITING40.000.00$112,699$0$18,548Yes (X)
TAMARA L YORK-DAY
FORMER VP (THRU 12/2017)0.000.00$131,127$0$0Yes (X)
MATTHEW D ENGEL
LEAD SOFTWARE DESIGNER40.000.00$101,661$0$12,280Yes (X)
CHRISTOPHER W GREEN
VP/CFO40.000.00Yes (X)$100,385$0$3,854
MICHAEL CHILDERS DMD
CHAIR4.005.00Yes (X)Yes (X)$36,700$24,996$0
STEVE S REED
DIRECTOR2.000.00Yes (X)$25,200$0$0
DIANE CORNWELL
DIRECTOR4.000.00Yes (X)$24,200$0$0
OLIVIA F KIRTLEY
DIRECTOR4.000.00Yes (X)$4,200$0$19,000
RODNEY A JACKSON DMD
DIRECTOR2.000.00Yes (X)$22,700$0$0
J DAVID SMITH
VICE CHAIR2.000.00Yes (X)Yes (X)$20,700$0$0
RANDALL F DYER JR
DIRECTOR2.000.00Yes (X)$18,700$0$0
JOHN N WILLIAMS JR DMD
DIRECTOR2.000.00Yes (X)$11,200$0$0
JOHNNA REEDER KLEYMEYER
DIRECTOR2.000.00Yes (X)$9,100$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,434,757TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$24,996TotReportableCompRltdOrgAmt
Total Other Compensation$283,583TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K16IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
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$3,585,297
MCGRIFF INSURANCE SERVICES INC
3605 GLENWOOD AVENUE STE 201RALEIGHNC27612BENEFITS CONSULTING$1,055,455
HOUCHENS INSURANCE GROUP INC
1750 SCOTTSVILLE ROAD STE 4BOWLING GREENKY42104BENEFITS CONSULTING$721,296
RENAISSANCE LIFE & HEALTH INSURANCE COMP
PO BOX 30416LANSINGMI48909ADMINISTRATIVE SERVICES$690,100
ASSURED PARTNERS NL LLC
2305 RIVER ROADLOUISVILLEKY40206BENEFITS CONSULTING$598,232
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K26CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
DENTAL CARE REVENUE524114$146,110,915$146,110,915
VISION INSURANCE REVENUE524114$579,748$579,748
OTHER FEES900099$6,000$6,000
FieldValueIRS element (for citing)
Total Program Service Revenue$146,696,663TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,137,855TotalRevenueColumnAmt
Exclusion$1,137,855ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$539,834RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,423,056RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$883,222RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$883,222TotalRevenueColumnAmt
Exclusion-$883,222ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$22,062,822SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$21,840,729SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$222,093SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$222,093TotalRevenueColumnAmt
Exclusion$222,093ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$147,173,389TotalRevenueColumnAmt
Related Or Exempt Func Income$146,116,915RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$579,748UnrelatedBusinessRevenueAmt
Exclusion$476,726ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,665,998TotalAmt
Program Services$1,665,998ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$116,397,006TotalAmt
Program Services$116,397,006ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,585,732TotalAmt
Program Services$1,292,866ProgramServicesAmt
Management And General$1,292,866ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,719,149TotalAmt
Program Services$5,719,149ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$361,067TotalAmt
Program Services$361,067ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$970,386TotalAmt
Program Services$970,386ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$449,818TotalAmt
Program Services$346,360ProgramServicesAmt
Management And General$103,458ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$612,996TotalAmt
Management And General$612,996ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$148,410TotalAmt
Management And General$148,410ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$81,749TotalAmt
Management And General$81,749ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$135,387TotalAmt
Management And General$135,387ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$596,748TotalAmt
Program Services$537,073ProgramServicesAmt
Management And General$59,675ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$894,935TotalAmt
Program Services$581,708ProgramServicesAmt
Management And General$313,227ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$467,768TotalAmt
Program Services$467,768ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$373,874TotalAmt
Program Services$325,270ProgramServicesAmt
Management And General$48,604ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$815,066TotalAmt
Program Services$407,533ProgramServicesAmt
Management And General$407,533ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$16,699TotalAmt
Program Services$10,019ProgramServicesAmt
Management And General$6,680ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$67TotalAmt
Program Services$67ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$132,247TotalAmt
Program Services$119,022ProgramServicesAmt
Management And General$13,225ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$97,304TotalAmt
Management And General$97,304ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BROKER COMMISSIONS$7,903,424$7,903,424
PROCESSING FEES$2,852,325$2,852,325
POSTAGE & SHIPPING$537,970$532,590$5,380
DUES & ASSESSMENTS$373,297$373,297

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$59,976TotalAmt
Program Services$59,976ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$144,249,398TotalAmt
Program Services$140,922,904ProgramServicesAmt
Management And General$3,326,494ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$14,610,089BOYAmt
EOY$10,695,270EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$246,761BOYAmt
EOY$412,681EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$17,709,508BOYAmt
EOY$20,933,603EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$46,909EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$17,632,092LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$8,400,705LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$9,500,337BOYAmt
EOY$9,231,387EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$22,819,043BOYAmt
EOY$23,477,283EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$26,396,295BOYAmt
EOY$29,830,439EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$8,037,531BOYAmt
EOY$8,232,701EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$99,319,564BOYAmt
EOY$102,860,273EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,430,847BOYAmt
EOY$1,711,153EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$2,299,950BOYAmt
EOY$1,999,508EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,946,007BOYAmt
EOY$12,367,847EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$18,676,804BOYAmt
EOY$16,078,508EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$80,642,760BOYAmt
EOY$86,781,765EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$80,642,760BOYAmt
EOY$86,781,765EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$99,319,564BOYAmt
EOY$102,860,273EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,923,991ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$6,944,762NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$3,729,748OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$830,000OtherCostOrOtherBasisAmt
Book Value$830,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,727,036OtherCostOrOtherBasisAmt
Depreciation$4,401,439DepreciationAmt
Book Value$7,325,597BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,582,626OtherCostOrOtherBasisAmt
Depreciation$993,295DepreciationAmt
Book Value$589,331BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,952,728OtherCostOrOtherBasisAmt
Depreciation$1,502,862DepreciationAmt
Book Value$449,866BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,539,702OtherCostOrOtherBasisAmt
Depreciation$1,503,109DepreciationAmt
Book Value$36,593BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$9,231,387TotalBookValueLandBuildingsAmt

Closely Held Equity Interests CloselyHeldEquityInterestsGrp

FieldValueIRS element (for citing)
Book Value$26,194,783BookValueAmt
Method ValuationFMethodValuationCd

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescINVESTMENT - DENTAL CHOICE, INC.Desc
Book Value$3,635,656BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$29,830,439TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
ACCRUED INVESTMENT INCOME$133,968
457(B) PLAN$645,879
INVESTMENT - RHC$7,452,854
FieldValueIRS element (for citing)
Total Book Value Other Assets$8,232,701TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
CLAIMS CHECKS OUTSTANDING$4,942,166
ESTIMATED CLAIMS LIABILITY$7,425,681
FieldValueIRS element (for citing)
Total Liability$12,367,847TotalLiabilityAmt

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtValuation Method UsedValuationMethodUsedDescPurpose Of GrantPurposeOfGrantTxt
COMMUNITY FOUNDATION OF LOUISVILLE
325 WEST MAIN STREET SUITE 1110LOUISVILLEKY40202310997017501(C)(3)$1,300,000CASHGENERAL DONATION
LEADERSHIP LOUISVILLE FOUNDATION
732 W MAIN STREETLOUISVILLEKY40202310958491501(C)(3)$10,000CASHGENERAL DONATION
KENTUCKY YOUTH ADVOCATES
11001 BLUEGRASS PKWY SUITE 100LOUISVILLEKY40299610929390501(C)(3)$5,000CASHGENERAL DONATION
LOUISVILLE BALLET
315 EAST MAIN STREETLOUISVILLEKY40202616033779501(C)(3)$6,000CASHGENERAL DONATION
FieldValueIRS element (for citing)
Total501c3 Org4Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

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 PaymentYes (1)SeverancePaymentInd
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$414,967$0$132,797$0$0$0$0$0$38,685$0$586,449$0$0$0
BRIAN D HART
VP/CRO$291,305$0$73,904$0$0$0$0$0$36,744$0$401,953$0$0$0
ANGELA J NENNI
VP/CAO$297,330$0$71,518$0$0$0$0$0$25,638$0$394,486$0$0$0
JOHN L WEEKS III
VP/CLO/SECRETARY (THRU 7/2019)$137,706$0$71,219$0$100,907$0$0$0$14,298$0$324,130$0$0$0
RONALD E STORY
VP/CIO$132,898$0$54,051$0$93,159$0$0$0$15,995$0$296,103$0$0$0
RUSSELL W SKAGGS
VP/CFO (THRU 2/2019)$61,737$0$53,472$0$150,479$0$0$0$20,984$0$286,672$0$0$0
TAUNYA L ESHENBAUGH
DIRECTOR, SALES$74,646$0$171,135$0$0$0$0$0$17,571$0$263,352$0$0$0
JEFFREY D DUES
DIRECTOR, ACCOUNT MGMT$80,763$0$105,500$0$0$0$0$0$31,657$0$217,920$0$0$0
CLIFFORD T MAESAKA
FORMER CEO (THRU 3/2017)$0$0$0$0$136,207$0$0$0$0$0$136,207$0$0$0
TAMARA L YORK-DAY
FORMER VP (THRU 12/2017)$0$0$0$0$131,127$0$0$0$0$0$131,127$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1AFOR THE ANNUAL RHSC CONFERENCE THE BOARD MEMBERS ARE ALLOWED TO HAVE COMPANION TRAVEL WITH THEM. THIS IS TAXABLE TO THE BOARD MEMBER.
PART I, LINES 4A-BDURING 2019, THE FOLLOWING RECEIVED SEVERANCE PAYMENTS: TAMARA L. YORK-DAY, THE FORMER COO, $131,127, RUSSELL W. SKAGGS, THE FORMER CFO, $150,479, AND RONALD E. STORY, THE FORMER CIO, $93,159. LASTLY, JOHN L. WEEKS, III, FORMER CLO, RECEIVED PAYMENTS THROUGH A SEPARATION AGREEMENT IN THE AMOUNT OF $100,907. DELTA DENTAL OF KENTUCKY, HAD A 457(F) SERP, A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, THAT WAS TERMINATED IN JUNE 2019 . ONLY THE FORMER CEO, CLIFFORD T. MAESAKA, RECEIVED A DISTRIBUTION FROM THE SERP OF $136,207. NO ONE ELSE PARTICIPATED IN THIS PLAN NOR RECEIVED A DISTRIBUTION OR ACCRUED BENEFITS.
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 (11 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 7ARHSC IS THE SOLE VOTING MEMBER OF DDKY. HOWEVER, UNDER THE TERMS OF THE AFFILIATION AGREEMENT THE PARTIES AGREED THAT THE DELTA DENTAL OF KENTUCKY (DDKY) BOARD SELECTS DIRECTOR CANDIDATES AND SUBMITS THEM TO RENAISSANCE HEALTH SERVICE CORP (RHSC). RHSC THEN APPROVES THE CANDIDATES. RHSC CAN REJECT PROPOSED CANDIDATES ONLY FOR "JUST CAUSE" AS DEFINED IN THE AGREEMENT. OTHERWISE, RHSC MUST APPROVE ALL THE CANDIDATES PROPOSED BY THE DDKY BOARD. RHSC HAS THE RIGHT TO ELECT A NUMBER OF DIRECTORS TO THE DDKY BOARD PROPORTIONAL TO THE NUMBER OF DIRECTORS THAT DDKY MAY NOMINATE TO THE RHSC BOARD. AS OF 12/31/2019, RHSC APPOINTED ONE MEMBER OF THE 10 MEMBER DDKY 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 2020. THE COMMITTEE IS MADE UP OF BOARD MEMBERS. THE COMMITTEE UTILIZES CERTAIN COMPENSATION SURVEYS AND OUTSIDE CONSULTANTS ARE ENGAGED AS NEEDED. COMPENSATION WAS ALSO REVIEWED UNDER DELTA DENTAL PLAN OF MICHIGAN'S HR EXECUTIVE COMPENSATION PROCESS DURING 2018. THE REPORT BASED ON THIS REVIEW WAS THEN ISSUED BY THE CONSULTANTS IN JUNE OF 2019.
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 VIICERTAIN 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 -3,729,748.
FORM 990, PART XII, LINE 2C:PROCESS IS THE SAME AS THE PRIOR YEAR.
FORM 990, PART I, LINE 12 AND 18:AS OF JANUARY 1, 2019, THE COMPANY ADOPTED FASB ASU NO. 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606). THE ASU IS BASED ON THE PRINCIPLE THAT REVENUE IS RECOGNIZED TO DEPICT THE TRANSFER OF GOODS OR SERVICES TO CUSTOMERS IN AN AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE ENTITY EXPECTS TO BE ENTITLED IN EXCHANGE FOR THOSE GOODS OR SERVICES. THE COMPANY'S REVENUE CONSISTS OF DENTAL CARE CONTRACTS, ADMINISTRATIVE SERVICE CONTRACTS, AND ADMINISTRATIVE FEES. ADMINISTRATIVE SERVICES CONTRACTS IN PLACE WITH CUSTOMERS PROVIDE ACCESS TO A NETWORK OF DENTAL PROVIDERS AND SERVICE COST PROCESSING SERVICES. AS A RESULT, ADMINISTRATIVE SERVICES CONTRACTS ARE NOT ACCOUNTED FOR AS DENTAL CARE CONTRACTS. PRIOR TO THE ADOPTION OF ASU 2014-09, ADMINISTRATIVE SERVICE CONTRACTS WERE REPORTED ON A GROSS BASIS. UPON ADOPTION OF ASU 2014-09 ADMINISTRATIVE SERVICE CONTRACTS ARE REPORTED NET AND ONLY THE ADMINISTRATIVE FEES ARE REPORTED AS DENTAL CARE REVENUE. THE CHANGE IN ACCOUNTING PRINCIPLE HAD NO CUMULATIVE EFFECT ON JANUARY 1, 2018 NET ASSETS. DURING 2019, THE COMPANY PAID DENTAL SERVICE EXPENSES, AND RECEIVED REIMBURSEMENT, TOTALING $54,354,500, WHICH HAS BEEN EXCLUDED FROM PROGRAM SERVICE REVENUE AND PURCHASED DENTAL SERVICE EXPENSE IN ACCORDANCE WITH ASU 2014-09.

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 ActivitiesNO BUSINESS ACTIVITYPrimaryActivitiesTxt
Legal Domicile StateKYLegalDomicileStateCd
Total Income$0TotalIncomeAmt
End Of Year Assets$0EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

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

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 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
2500 LOUISIANA BLVD NEALBUQUERQUENM87110850224562PROVIDE 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

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CHESME LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1124 N BRIDGE STAddressLine1Txt
CityDEWITTCityNm
State AbbreviationMIStateAbbreviationCd
ZIP48820ZIPCd
FieldValueIRS element (for citing)
EIN200061957EIN
Primary ActivitiesCAPITAL MANAGEMENTPrimaryActivitiesTxt
Legal Domicile StateMILegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1THE 4100 GROUPBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd

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-$3,285,012$7,333,9471.00000Yes (1)
DENTAL CHOICE AGENCY INC
10100 LINN STATION RD SUITE 700LOUISVILLEKY40223611336003PRIMARY GENERAL AGENCY FOR DDKY & DENTAL CHOICEKYDELTA DENTAL OF KENTUCKYC-$6001.00000Yes (1)
RENAISSANCE HOLDING COMPANY
PO BOX 30381LANSINGMI48909412177193HOLDING COMPANYMIDELTA DENTAL OF MICHIGANC-$168,083$2,726,1940.059000
RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA
PO BOX 30381LANSINGMI48909470397286INSURANCEINRENAISSANCE HOLDING COMPANYC$283,687$6,953,1940.059000
RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF NEW YORK
PO BOX 30381LANSINGMI48909134098096INSURANCENYRENAISSANCE HOLDING COMPANYC$12,484$728,5260.059000
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
DEWPOINT INC
300 S WASHIGNTON SQUARELANSINGMI48933383300595COMPUTER CONSULTINGMIC0N/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
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 OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
DELTA DENTAL PLAN OF MICHIGAN INC
M$2,893,771ACTUAL COST
RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA
M$690,100ACTUAL COST
DENTAL CHOICE INC
L$324,911ACTUAL COST
DELTA DENTAL OF NORTH CAROLINA
S$1,298ACTUAL COST

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