2020-11-16T11:49:45-06:00 2019-12-31 BKD LLP 312 WALNUT STREET SUITE 3000 CINCINNATI OH 45202 990 2019-01-01 430908349 DELTA DENTAL OF MISSOURI % BARBARA C BENTRUP DELT 3146563000 12399 GRAVOIS ROAD ST LOUIS MO 631271702 BARBARA C BENTRUP CFO & CORP. COUNSEL 3146563000 2020-11-15 true Aaron Hershberger P00961884 5136218300 2020-11-15 167.68.126.162 31025420203215000030 2020-11-16 P 5ECFD7F4488FEC6F6ABE53B187DEB4499E915412 FDEAFD0406FF7141BFF80F52237CA5777F98C136 2019 2022-01-07 14:23:13Z E B ROB GOREN 12399 GRAVOIS ROAD ST LOUIS MO 631271702 610905568 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 11 275 0 0 0 624799099 600126132 2660072 3708235 -3701104 7056291 623758067 610890658 1641734 1067017 567017828 544165207 32626927 33370470 0 0 0 20638121 20834248 621924610 599436942 1833457 11453716 182550863 178340938 58018399 32877231 124532464 145463707 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 587764150 600126132 DELTA DENTAL OF MISSOURI IS A PREPAID DENTAL INSURANCE COMPANY. IN 2019, DELTA DENTAL PROCESSED 3,216,524 CLAIMS FOR DENTAL SERVICES. 1067017 1067017 ORAL HEALTH GRANT PROGRAM - SEE SCHEDULE O 326143 LAND OF SMILES PROGRAM - SEE SCHEDULE O 434209 0 0 589591519 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 57684 0 true 275 true false false false false false false false false false false false false X 15 11 false false false 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 994908 0 158670 E B ROB GOREN President & CEO 60.0 0.0 X 991887 0 72027 RONALD E INGE Chief Dental Officer 60.0 0.0 X 532658 0 184799 EDWARD A PATTAROZZI Chief Sales & Marketing Office 60.0 0.0 X 477013 0 140933 HENRY S LAFFITTE VP, Sales & Account Management 40.0 0.0 X 450146 0 72342 KARL A MUDRA CIO 60.0 0.0 X 341870 0 87733 JONATHAN R JENNINGS Chief Actuary/VP Underwriting 60.0 0.0 X 340902 0 81238 ERIC W MANN Director of Operations 40.0 0.0 X 251758 0 45252 ELLEN R SAMUELS Director, Corp. Communications 40.0 0.0 X 206929 0 79038 JANE STANHAUS Director of Human Resources 40.0 0.0 X 214616 0 69532 ROBERT WOZNIAK Account Executive 40.0 0.0 X 213490 0 53798 ROBERT E BUTLER Board Chair/Dir. - Left 11/19 2.0 0.0 X X 55700 0 0 ROSEMARY BISHOP Secretary/Director 2.0 0.0 X X 52550 0 0 MARK ZUST FIRST VICE CHAIR 2.0 0.0 X X 44600 0 0 GARY WILLIAMS Director 2.0 0.0 X 43000 0 0 DEBORAH PATTERSON Director 2.0 0.0 X 42300 0 0 WILLIAM J BENDER Treasurer/Director 2.0 0.0 X X 40700 0 0 BRIAN BERGLUND Director - Left 11/19 2.0 0.0 X 40550 0 0 WILLIAM EDWARDS 2nd Vice Chairman/Director 2.0 0.0 X X 37850 0 0 OLADIPUPO ADEFALA Director 2.0 0.0 X 35650 0 0 JAMES W RHEA Board Chairman/Director 2.0 0.0 X X 35050 0 0 TIMOTHY TAYLOR Director 2.0 0.0 X 34900 0 0 JOHNNY CUSTARDO Director 2.0 0.0 X 33650 0 0 MARK MANCIN Director 2.0 0.0 X 33650 0 0 RICHARD BRAUN Director - Left 11/19 2.0 0.0 X 29750 0 0 WILLIAM GRAY Director 2.0 0.0 X 26300 0 0 STEVEN HARRIS Director 2.0 0.0 X 0 0 0 JOHN R LANDGRAF JR Director 2.0 0.0 X 0 0 0 KATHLEEN TUCKER Director 2.0 0.0 X 0 0 0 5576077 0 1045362 61 false true false MISSOURI DENTAL PROFESSIONALS 1100 SPUR DR STE 30 MARSHFIELD MO 65706 DENTAL SERVICES 6790808 M FERNANDEZ DDS E BROWN DDS J OSDIE 3555 SUNSET OFFICE DR STE 210 SAINT LOUIS MO 63127 DENTAL SERVICES 3119250 JAY F HAUSER DDS PC PO BOX 503094 SAINT LOUIS MO 63150 DENTAL SERVICES 3706279 RED CARD 744 OFFICE PARKWAY SAINT LOUIS MO 63141 PRINT & MAIL SERVICE 1966586 IKHLAQ ROSINSKI DENTAL PARTNERS DDS 677 N NEW BALLAS RD STE 207 SAINT LOUIS MO 63141 DENTAL SERVICES 2058084 936 0 DENTAL PREMIUMS 524114 600126132 600126132 600126132 3548656 3548656 0 0 23240 14910 8330 0 8330 8330 159579 159579 159579 159579 0 0 0 0 0 0 0 0 0 MISCELLANEOUS INCOME 900099 3438729 3438729 INVESTMENT IN SUBSIDIARY 900003 3609232 3609232 7047961 610890658 600126132 10764526 1067017 1067017 0 0 544165207 544165207 4990835 4990835 0 20216944 18716295 1500649 2857403 2555101 302302 3777605 3497203 280402 1527683 1414287 113396 0 362585 286346 76239 362339 286152 76187 0 0 246343 246343 3375030 2665377 709653 1702880 1576480 126400 3167592 2932470 235122 133786 123855 9931 0 1298181 1201821 96360 717733 664458 53275 0 211135 195463 15672 0 0 1976259 1829567 146692 351667 351667 BOARD AND BUREAU DUES 904635 837486 67149 SERVICE BUREAU FEES 2869064 2656101 212963 PUBLIC RELATIONS 449352 416000 33352 SERVICE AGREEMENTS 1931195 1787848 143347 774472 716985 57487 599436942 589591519 9845423 0 0 0 36654529 30720070 0 0 40354044 11611049 0 0 0 0 0 0 0 0 1004141 799227 23810447 14883195 9909201 8927252 79707584 109051228 0 0 11427922 15037153 0 0 3493442 2194959 182550863 178340938 14400911 15561397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43617488 17315834 58018399 32877231 X 0 0 0 0 124532464 145463707 124532464 145463707 182550863 178340938 11453716 9477527 X false true X true false 1350000 1350000 7899248 4013943 3885305 1145351 967350 178001 5644324 3957397 1686927 7771524 5944505 1827019 8927252 INVEST. IN ADVANTICA ADMIN 15037153 C 15037153 0 INCURRED BUT UNREPORTED CLAIMS 7209690 ESTIMATE UNPAID CLAIM PROCESS 1171318 UNEARNED PREMIUMS 7458931 EXPERIENCE RATED CREDIT LIAB 81385 ADVANCE DEPOSITS 1394510 17315834 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 the 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 $3,713,384 and an operating loss totaling $4,281,002 as of December 31, 2019 and 2018, respectively. At December 31, 2019 and 2018, Advantica Administrative had net operating loss carryforwards of approximately $20,495,000 and $19,829,000, respectively. Advantica Administrative and its subsidiaries had deferred tax assets of approximately $4,523,000 and $5,408,000 at December 31, 2019 and 2018, 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, 2019 and 2018. 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, 2016 through 2019. true HEALTHWORKS KIDS MUSEUM ST LOUIS 1100 MACKLIND AVE ST LOUIS MO 63110 753018876 501(c)(3) 250000 GENERAL SUPPORT GIVE KIDS A SMILE 10 WORTHINGTON DR MD HEIGHTS MO 63043 201287939 501(c)(3) 75000 GENERAL SUPPORT MEDICAL UNIVERSITY OF SOUTH CAROLINA 19 HAGOOD AVE CHARLESTON SC 29425 576000722 501(c)(3) 50000 GENERAL SUPPORT OUR LADY OF MERCY COMMUNITY OUTREACH SVCS PO BOX 607 SUITE 505 JOHNS ISLAND SC 29457 570905488 501(c)(3) 50000 GENERAL SUPPORT MISSION DENTAL INC 1700 6TH AVE N BESSEMER AL 35020 271406376 501(c)(3) 50000 GENERAL SUPPORT ST LOUIS CHILDREN'S HOSPITAL FOUNDATION ONE CHILDRENS PLACE ST LOUIS MO 63110 431626863 501(c)(3) 50000 GENERAL SUPPORT SOUTH CAROLINA DENTAL ASSOCIATION 120 STONEMARK LN COLUMBIA SC 29210 570399460 501(c)(3) 50000 GENERAL SUPPORT EAST COOPER COMMUNITY OUTREACH 1145 SIX MILE RD MOUNT PLEASANT SC 29466 570939280 501(c)(3) 50000 GENERAL SUPPORT ST LOUIS COMMUNITY COLLEGE FOUNDATION 3221 MCKELVEY RD BRIDGETON MO 63044 431374500 501(c)(3) 39281 GENERAL SUPPORT HEALTHY SMILES OF SPARTANBURG INC PO BOX 1441 STE 295 SPARTANBURG SC 29304 030529473 501(c)(3) 35000 GENERAL SUPPORT PREFERRED FAMILY HEALTHCARE INC 900 E LAHARPE ST KIRKSVILLE MO 63501 431236557 501(c)(3) 25000 GENERAL SUPPORT MISSOURI DEPT OF HEALTH & SENIOR SERVICE PO BOX 570 JEFFERSON CITY MO 65102 446000987 GOV'T 25000 GENERAL SUPPORT HERBERT HOOVER BOYSGIRLS CLUB OF ST LOUIS 2901 NORTH GRAND AVE ST LOUIS MO 63107 436061693 501(c)(3) 25000 GENERAL SUPPORT ST LOUIS BOARD OF EDUCATION 801 N 11TH ST ST LOUIS MO 63101 436003220 501(c)(3) 25000 GENERAL SUPPORT ST LOUIS REGIONAL PUBLIC MEDIA INC 3655 OLIVE ST ST LOUIS MO 63108 430685345 501(c)(3) 20000 GENERAL SUPPORT CASS COMMUNITY HEALTH FOUNDATION 2316 E MEYER BLVD KANSAS CITY MO 64132 431349495 501(c)(3) 20000 GENERAL SUPPORT PUBLIC HEALTH FUND INC 5 HEALTH DEPARTMENT DR TROY MO 63379 431930096 501(c)(3) 19798 GENERAL SUPPORT RONALD MCDONALD HOUSE CHARITIES 949 E PRIMROSE ST SPRINGFIELD MO 65807 431371143 501(c)(3) 15000 GENERAL SUPPORT GREENVILLE FREE MEDICAL CLINIC INC PO BOX 8993 GREENVILLE SC 29604 570855205 501(c)(3) 15000 GENERAL SUPPORT COMMUNITY CLINIC OF SOUTHWEST MISSOURI 701 SOUTH JOPLIN AVE JOPLIN MO 64801 431643962 501(c)(3) 15000 GENERAL SUPPORT HEARTLAND OUTREACH PROVIDERS 1215 NW STATE RT 7 BLUE SPRINGS MO 64014 274387842 501(c)(3) 14812 GENERAL SUPPORT GIRL SCOUTS OF EASTERN MISSOURI INC 2300 BALL DR ST LOUIS MO 63146 430662471 501(c)(3) 13500 GENERAL SUPPORT EDVENTURE INC 211 GERVALS ST COLUMBIA SC SC 29201 571013857 501(c)(3) 10500 GENERAL SUPPORT ST LOUIS COUNTY LIBRARY FOUNDATION 1640 S LINDBERGH BLVD ST LOUIS MO 63131 431863977 501(c)(3) 12000 GENERAL SUPPORT YWCA METRO ST LOUIS 3820 WEST PINE BLVD ST LOUIS MO 63108 430653618 501(c)(3) 10000 GENERAL SUPPORT AMERICAN LUNG ASSOCIATION 55 W WACKER DR CHICAGO IL 60601 131632524 501(c)(3) 6910 GENERAL SUPPORT MERCY MEDICINE FREE CLINIC 500 S COLT ST FLORENCE SC 29501 311693093 501(c)(3) 5357 GENERAL SUPPORT HELPING HANDS OF GEORGETOWN INC 1813 HIGHMARKET ST GEORGETOWN SC 29440 570883461 501(C)(3) 70000 28 0 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 457539 0 109557 0 427812 0 136775 0 21895 0 1153578 0 424123 E B ROB GOREN President & CEO 545730 0 148290 0 297867 0 41685 0 30342 0 1063914 0 296453 EDWARD A PATTAROZZI Chief Sales & Marketing Office 352312 0 80005 0 44696 0 117868 0 23065 0 617946 0 25361 JONATHAN R JENNINGS Chief Actuary/VP Underwriting 269952 0 57247 0 13703 0 53749 0 27489 0 422140 0 5447 KARL A MUDRA CIO 255471 0 58081 0 28318 0 57531 0 30202 0 429603 0 8960 RONALD E INGE Chief Dental Officer 396389 0 85112 0 51157 0 164204 0 20595 0 717457 0 26083 ELLEN R SAMUELS Director, Corp. Communications 171583 0 33133 0 2213 0 50097 0 28941 0 285967 0 HENRY S LAFFITTE VP, Sales & Account Management 219276 0 225665 0 5205 0 42000 0 30342 0 522488 0 ROBERT WOZNIAK Account Executive 83931 0 119798 0 9761 0 31233 0 22565 0 267288 0 ERIC W MANN Director of Operations 198028 0 14245 0 39485 0 26402 0 18850 0 297010 0 JANE STANHAUS Director of Human Resources 174248 0 35654 0 4714 0 39930 0 29602 0 284148 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 2019 FOR THE FOLLOWING INDIVIDUALS WERE: BARBARA BENTRUP - $39,123 E.B. ROB GOREN - $56,453 KARL MUDRA - $8,960 EDWARD PATTAROZZI - $25,361 RONALD INGE - $26,083 JONATHAN JENNINGS - $5,447 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 2019 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 - $94,775 E.B. ROB GOREN - $(315) KARL MUDRA - $15,531 EDWARD PATTAROZZI - $75,868 JONATHAN JENNINGS - $11,749 RONALD INGE - $122,204 MARK R ZUST DDS LTD BOARD MEMBER AS OWNER 243080 DENTAL SERVICES PROVIDED false JAMES W RHEA DDS PC BOARD MEMBER AS OWNER 219221 DENTAL SERVICES PROVIDED false FINNANE-ROBISON DENTAL LLC FORMER BOARD MBR AS OWNER 116470 DENTAL SERVICES PROVIDED false WILLIAM A GRAY DMD LLC BOARD MEMBER AS OWNER 233942 DENTAL SERVICES PROVIDED false FLORISSANT DENTAL ASSOCIATES LLC FAMILY OF BOARD MEMBER 525060 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. FORMER BOARD MEMBER EDWARD ROBISON AND ELIZABETH FINNANE, DAUGHTER OF FORMER BOARD MEMBER EDWARD ROBISON, HAVE A REPORTABLE INTEREST IN FINNANE ROBISON DENTAL LLC 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 MISSOURIS 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 INIDIVDUALS. IN 2019, DELTA DENTAL OF MISSOURI AWARDED MORE THAN $1 MILLION IN GRANTS TO 26 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 MISSOURIS LAND OF SMILES IS A TOURING EDUCATIONAL PROGRAM THAT FEATURES TOOTH WIZARD, LITTLE SISTER TOOTH FAIRY AND THEIR ARCH ENEMY, PLAQUEMAN, WHO TEACH GRADESCHOOLERS GOOD DENTAL HEALTH HABITS. THIS YEAR, THE PROGRAM REACHED MORE THAN 82,000 MISSOURI AND SOUTH CAROLINA KINDERGARTEN-THROUGH-3rd-GRADE STUDENTS WITH 420 SCHOOL-BASED PERFORMANCES THAT FEATURE FUN, KID-FOCUSED ENTERTAINMENT. THE CHARACTERS EXPLAIN PROPER BRUSHING TECHNIQUES, FLOSSING, GOOD AND BAD FOODS FOR TEETH AND WHY IT IS IMPORTANT TO VISIT THE DENTIST REGULARLY. EACH CHILD RECEIVES A TAKE-HOME SMILE BAG FILLED WITH A TOOTHBRUSH, TOOTHPASTE, FLOSS, COLORING SHEET AND REMINDER MIRROR DECAL. TO REINFORCE PROGRAM MESSAGES AFTER PERFORMANCES, A CURRICULUM KIT IS GIVEN TO EACH SCHOOL. THE KIT INCLUDES AN EDUCATIONAL DVD AND CORRESPONDING CURRICULUM BOOKLET. TEACHERS AND SCHOOL NURSES CONSISTENTLY RATE THE PROGRAM AS EXCELLENT. THE LAND OF SMILES PROGRAM IS ALSO PERFORMED AT MORE THAN 20 AREA HEALTH FAIRS, WITH NEARLY 50,000 KIDS AND FAMILIES ATTENDING THROUGHOUT THE YEAR. 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 MISSOURIS COMMMUNITY GIVING PROGRAM, THE COMPANY SUPPORTS CHARITABLE ORGANIZATIONS AND PROGRAMS THAT ARE WORKING TO MAKE A DIFFERENCE IN MISSOURI AND SOUTH CAROLINA COMMUNITIES. 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 MISSOURIS 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 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 2019 WAS REVIEWED BY A THIRD PARTY COMPENSATION CONSULTANT AND THEN REVIEWED BY THE COMPENSATION COMMITTEE IN MARCH, 2019. 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. ADVANTICA ADMINISTRATIVE SERVICES INC 12399 GRAVOIS ROAD ST LOUIS MO 63127 431826684 THIRD PARTY ADMIN MO NA C-CORP 31010285 17772154 1.00000 true false false false false false false false false false false false false true true false false false false false ADVANTICA ADMINISTRATIVE SERVICES INC M 686909 ALLOCATIONS ADVANTICA ADMINISTRATIVE SERVICES INC N 878980 EXPENSE BASED