2020-11-16T13:08:27-06:00 2019-12-31 381357951 PLANTE & MORAN PLLC 1111 MICHIGAN AVE STE 100 EAST LANSING MI 48823 990 2019-01-01 610659432 DELTA DENTAL OF KENTUCKY INC DELT 5027365000 10100 LINN STATION ROAD NO 700 LOUISVILLE KY 40223 CHRISTOPHER W GREEN CFO 5027365000 2020-11-12 1 DAVID LOWENTHAL CPA P00378651 5173326200 2020-11-12 68.62.32.134 2020-11-12 09:03:28 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 AFBDF4DF54CCD05CFBA4AEDC275F7F3808ECB98B 2019 2021-04-22 16:20:28Z CHRISTOPHER W GREEN 10100 LINN STATION ROAD NO 700 LOUISVILLE KY 40223 170437174 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 87 0 579748 -96437 0 0 194147209 146696663 1499200 1359948 -1034347 -883222 194612062 147173389 1890558 1665998 165381833 116397006 8775838 10086152 0 0 0 16547680 16100242 192595909 144249398 2016153 2923991 99319564 102860273 18676804 16078508 80642760 86781765 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 140922904 1665998 146116915 DELTA 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. 140922904 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 22175 0 1 87 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 35.00 5.00 X X 547764 0 38685 BRIAN D HART VP/CRO 40.00 0.00 X 365209 0 36744 ANGELA J NENNI VP/CAO 40.00 0.00 X 368848 0 25638 JOHN L WEEKS III VP/CLO/SECRETARY (THRU 7/2019) 40.00 0.00 X 309832 0 14298 RONALD E STORY VP/CIO 40.00 0.00 X 280108 0 15995 RUSSELL W SKAGGS VP/CFO (THRU 2/2019) 40.00 0.00 X 265688 0 20984 TAUNYA L ESHENBAUGH DIRECTOR, SALES 40.00 0.00 X 245781 0 17571 JEFFREY D DUES DIRECTOR, ACCOUNT MGMT 40.00 0.00 X 186263 0 31657 LAURA F WINCE DIRECTOR, MARKETING 40.00 0.00 X 110485 0 28329 CLIFFORD T MAESAKA FORMER CEO (THRU 3/2017) 0.00 0.00 X 136207 0 0 TAMMY W CANNON MANAGER, UNDERWRITING 40.00 0.00 X 112699 0 18548 TAMARA L YORK-DAY FORMER VP (THRU 12/2017) 0.00 0.00 X 131127 0 0 MATTHEW D ENGEL LEAD SOFTWARE DESIGNER 40.00 0.00 X 101661 0 12280 CHRISTOPHER W GREEN VP/CFO 40.00 0.00 X 100385 0 3854 MICHAEL CHILDERS DMD CHAIR 4.00 5.00 X X 36700 24996 0 STEVE S REED DIRECTOR 2.00 0.00 X 25200 0 0 DIANE CORNWELL DIRECTOR 4.00 0.00 X 24200 0 0 OLIVIA F KIRTLEY DIRECTOR 4.00 0.00 X 4200 0 19000 RODNEY A JACKSON DMD DIRECTOR 2.00 0.00 X 22700 0 0 J DAVID SMITH VICE CHAIR 2.00 0.00 X X 20700 0 0 RANDALL F DYER JR DIRECTOR 2.00 0.00 X 18700 0 0 JOHN N WILLIAMS JR DMD DIRECTOR 2.00 0.00 X 11200 0 0 JOHNNA REEDER KLEYMEYER DIRECTOR 2.00 0.00 X 9100 0 0 3434757 24996 283583 16 1 1 0 DELTA DENTAL PLAN OF MICHIGAN PO BOX 30416 LANSING MI 48909 ADMINISTRATIVE SERVICES 3585297 MCGRIFF INSURANCE SERVICES INC 3605 GLENWOOD AVENUE STE 201 RALEIGH NC 27612 BENEFITS CONSULTING 1055455 HOUCHENS INSURANCE GROUP INC 1750 SCOTTSVILLE ROAD STE 4 BOWLING GREEN KY 42104 BENEFITS CONSULTING 721296 RENAISSANCE LIFE & HEALTH INSURANCE COMP PO BOX 30416 LANSING MI 48909 ADMINISTRATIVE SERVICES 690100 ASSURED PARTNERS NL LLC 2305 RIVER ROAD LOUISVILLE KY 40206 BENEFITS CONSULTING 598232 26 DENTAL CARE REVENUE 524114 146110915 146110915 VISION INSURANCE REVENUE 524114 579748 579748 OTHER FEES 900099 6000 6000 146696663 1137855 1137855 539834 1423056 -883222 -883222 -883222 22062822 21840729 222093 222093 222093 147173389 146116915 579748 476726 1665998 1665998 116397006 116397006 2585732 1292866 1292866 5719149 5719149 361067 361067 970386 970386 449818 346360 103458 612996 612996 148410 148410 81749 81749 135387 135387 596748 537073 59675 894935 581708 313227 467768 467768 373874 325270 48604 815066 407533 407533 16699 10019 6680 67 67 132247 119022 13225 97304 97304 BROKER COMMISSIONS 7903424 7903424 PROCESSING FEES 2852325 2852325 POSTAGE & SHIPPING 537970 532590 5380 DUES & ASSESSMENTS 373297 373297 59976 59976 144249398 140922904 3326494 0 14610089 10695270 246761 412681 17709508 20933603 0 46909 17632092 8400705 9500337 9231387 22819043 23477283 26396295 29830439 8037531 8232701 99319564 102860273 3430847 1711153 2299950 1999508 12946007 12367847 18676804 16078508 X 80642760 86781765 80642760 86781765 99319564 102860273 X 2923991 6944762 -3729748 X X 0 1 X 1 0 830000 830000 11727036 4401439 7325597 1582626 993295 589331 1952728 1502862 449866 1539702 1503109 36593 9231387 26194783 F INVESTMENT - DENTAL CHOICE, INC. 3635656 F 29830439 ACCRUED INVESTMENT INCOME 133968 457(B) PLAN 645879 INVESTMENT - RHC 7452854 8232701 CLAIMS CHECKS OUTSTANDING 4942166 ESTIMATED CLAIMS LIABILITY 7425681 12367847 1 COMMUNITY FOUNDATION OF LOUISVILLE 325 WEST MAIN STREET SUITE 1110 LOUISVILLE KY 40202 310997017 501(C)(3) 1300000 CASH GENERAL DONATION LEADERSHIP LOUISVILLE FOUNDATION 732 W MAIN STREET LOUISVILLE KY 40202 310958491 501(C)(3) 10000 CASH GENERAL DONATION KENTUCKY YOUTH ADVOCATES 11001 BLUEGRASS PKWY SUITE 100 LOUISVILLE KY 40299 610929390 501(C)(3) 5000 CASH GENERAL DONATION LOUISVILLE BALLET 315 EAST MAIN STREET LOUISVILLE KY 40202 616033779 501(C)(3) 6000 CASH GENERAL DONATION 4 0 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 1 1 0 0 0 0 0 1 0 J JUDE THOMPSON PRESIDENT, CEO 414967 0 132797 0 0 0 0 0 38685 0 586449 0 0 0 BRIAN D HART VP/CRO 291305 0 73904 0 0 0 0 0 36744 0 401953 0 0 0 ANGELA J NENNI VP/CAO 297330 0 71518 0 0 0 0 0 25638 0 394486 0 0 0 JOHN L WEEKS III VP/CLO/SECRETARY (THRU 7/2019) 137706 0 71219 0 100907 0 0 0 14298 0 324130 0 0 0 RONALD E STORY VP/CIO 132898 0 54051 0 93159 0 0 0 15995 0 296103 0 0 0 RUSSELL W SKAGGS VP/CFO (THRU 2/2019) 61737 0 53472 0 150479 0 0 0 20984 0 286672 0 0 0 TAUNYA L ESHENBAUGH DIRECTOR, SALES 74646 0 171135 0 0 0 0 0 17571 0 263352 0 0 0 JEFFREY D DUES DIRECTOR, ACCOUNT MGMT 80763 0 105500 0 0 0 0 0 31657 0 217920 0 0 0 CLIFFORD T MAESAKA FORMER CEO (THRU 3/2017) 0 0 0 0 136207 0 0 0 0 0 136207 0 0 0 TAMARA L YORK-DAY FORMER VP (THRU 12/2017) 0 0 0 0 131127 0 0 0 0 0 131127 0 0 0 PART I, LINE 1A FOR 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-B DURING 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 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 RHSC 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 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 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 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 -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. DENTAL CHOICE PROPERTIES LLC 10100 LINN STATION RD SUITE LOUISVILLE KY 40223 610659432 NO BUSINESS ACTIVITY KY 0 0 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 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 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 CHESME LLC 124 N BRIDGE ST DEWITT MI 48820 200061957 CAPITAL MANAGEMENT MI THE 4100 GROUP RELATED 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 -3285012 7333947 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 -600 1.00000 1 RENAISSANCE HOLDING COMPANY PO BOX 30381 LANSING MI 48909 412177193 HOLDING COMPANY MI DELTA DENTAL OF MICHIGAN C -168083 2726194 0.05900 0 RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA PO BOX 30381 LANSING MI 48909 470397286 INSURANCE IN RENAISSANCE HOLDING COMPANY C 283687 6953194 0.05900 0 RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF NEW YORK PO BOX 30381 LANSING MI 48909 134098096 INSURANCE NY RENAISSANCE HOLDING COMPANY C 12484 728526 0.05900 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 DEWPOINT INC 300 S WASHIGNTON SQUARE LANSING MI 48933 383300595 COMPUTER CONSULTING MI N/A C 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 DELTA DENTAL PLAN OF MICHIGAN INC M 2893771 ACTUAL COST RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA M 690100 ACTUAL COST DENTAL CHOICE INC L 324911 ACTUAL COST DELTA DENTAL OF NORTH CAROLINA S 1298 ACTUAL COST