2019-11-08T15:19:04-06:00 2018-12-31 381357951 PLANTE & MORAN PLLC 1111 MICHIGAN AVE STE 100 EAST LANSING MI 48823 990 2018-01-01 610659432 DELTA DENTAL OF KENTUCKY INC DELT 5027365000 10100 LINN STATION ROAD NO 700 LOUISVILLE KY 40223 J JUDE THOMPSON PRESIDENT, CEO 5027365000 2019-11-06 1 DAVID LOWENTHAL CPA P00378651 5173326200 2019-11-06 67.59.56.32 2019-11-06 13:39:12 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 AFBDF4DF54CCD05CFBA4AEDC275F7F3808ECB98B 2018 2020-03-31 21:24:44Z J JUDE THOMPSON 10100 LINN STATION ROAD NO 700 LOUISVILLE KY 40223 210784867 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. 9 7 84 0 0 0 0 0 180345619 194147209 1789279 1499200 -844847 -1034347 181290051 194612062 2905627 1890558 154500475 165381833 8929911 8775838 0 0 0 14033584 16547680 180369597 192595909 920454 2016153 103200156 99319564 19885803 18676804 83314353 80642760 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 189723889 1890558 194147209 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 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 FOUNDATION. SINCE THE INCEPTION OF THE FOUNDATION IN 2003, OUR CORPORATE PHILANTHROPIC GIVING HAS PROVIDED OVER $12 MILLION IN GRANTS TO OVER 160 ORGANIZATIONS. IN 2018, WE DONATED CLOSE TO $1.8 MILLION ACROSS 55 ORGANIZATIONS THROUGHOUT THE ENTIRE COMMONWEALTH. THESE DOLLARS FUNDED 21 DENTAL CLINICS ACROSS THE COMMONWEALTH AND NEARLY 70% OF THESE DOLLARS WERE GRANTED TO ORGANIZATIONS PROVIDING DIRECT DENTAL CARE TO VULNERABLE POPULATIONS. 189723889 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 21415 0 1 84 1 0 0 0 0 0 0 0 0 X 9 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X J JUDE THOMPSON CEO 5027365000 10100 LINN STATION ROAD STE 700 LOUISVILLE KY 40223 X J JUDE THOMPSON PRESIDENT, CEO 35.00 5.00 X X 360950 0 22939 MICHAEL CHILDERS DMD CHAIR 4.00 5.00 X X 38822 25000 0 BRUCE R SMITH VICE-CHAIR (THRU 6/2018) 8.00 11.00 X X 23500 92133 0 DIANE CORNWELL DIRECTOR 4.00 0.00 X 31269 0 0 RODNEY A JACKSON DMD DIRECTOR 2.00 0.00 X 24883 0 0 OLIVIA F KIRTLEY DIRECTOR 4.00 0.00 X 6800 0 18500 STEVE S REED DIRECTOR 2.00 0.00 X 23600 0 0 J DAVID SMITH DIRECTOR 2.00 0.00 X 26487 0 0 JOHN N WILLIAMS JR DMD DIRECTOR 2.00 0.00 X 24847 0 0 RANDALL F DYER JR DIRECTOR 2.00 0.00 X 6900 0 0 JOHN L WEEKS III VP/CLO/SECRETARY 40.00 0.00 X 326347 0 22436 ANGELA J NENNI VP/CAO 40.00 0.00 X 319632 0 15231 RUSSELL W SKAGGS VP/CFO 40.00 0.00 X 238651 0 22305 RONALD E STORY VP/CIO 40.00 0.00 X 193570 0 8138 BRIAN D HART VP/CRO 40.00 0.00 X 259189 0 22794 JEFFERY D DUES SENIOR ACCOUNT EXECUTIVE 40.00 0.00 X 198703 0 21412 TAUNYA L ESHENBAUGH SENIOR ACCOUNT EXECUTIVE 40.00 0.00 X 230861 0 7579 BRIAN E KRAINER DIRECTOR - SALES 40.00 0.00 X 149662 0 2367 CLIFFORD T MAESAKA FORMER CEO (THRU 3/2017) 0.00 0.00 X 726068 0 0 TAMARA L YORK-DAY FORMER VP (THRU 12/2017) 0.00 0.00 X 265655 0 0 3476396 117133 163701 11 1 1 0 DELTA DENTAL PLAN OF MICHIGAN PO BOX 30416 LANSING MI 48909 ADMINISTRATIVE SERVICES 3606660 MCGRIFF INSURANCE SERVICES INC 3605 GLENWOOD AVENUE STE 201 RALEIGH NC 27612 BENEFITS CONSULTING 1001112 RENAISSANCE LIFE & HEALTH INSURANCE COMP PO BOX 30416 LANSING MI 48909 ADMINISTRATIVE SERVICES 988071 ASSURED PARTNERS NL LLC 2305 RIVER ROAD LOUISVILLE KY 40206 BENEFITS CONSULTING 634647 PLANCHOICE INC 13257 OBANNON STATION LOUISVILLE KY 40223 BENEFITS CONSULTING 570382 27 DENTAL CARE REVENUE 524114 194141209 194141209 OTHER FEES 900099 6000 6000 194147209 1103865 1103865 510237 1544584 -1034347 -1034347 -1034347 15023556 14628109 112 395447 -112 395335 395335 194612062 194147209 0 464853 1890558 1890558 165381833 165381833 1995508 997754 997754 4967299 4967299 338120 338120 1056493 1056493 418418 322182 96236 391308 391308 105962 105962 40996 40996 124481 124481 1200389 1080350 120039 1388201 902331 485870 447236 447236 537344 467489 69855 650126 325063 325063 45146 27088 18058 113 113 103244 92920 10324 80891 80891 BROKER COMMISSIONS 7915018 7915018 PROCESSING FEES 2537753 2537753 POSTAGE & SHIPPING 518340 513157 5183 DUES & ASSESSMENTS 386478 386478 74654 74654 192595909 189723889 2872020 0 16342596 14610089 467748 246761 15387426 17709508 17270081 7769744 9864864 9500337 22109777 22819043 29860454 26396295 9167291 8037531 103200156 99319564 4013548 3430847 1956846 2299950 13915409 12946007 19885803 18676804 X 83314353 80642760 83314353 80642760 103200156 99319564 X 2016153 -3742928 -944818 X X 0 1 X 1 0 830000 830000 11727036 4027429 7699607 1485653 858223 627430 1794543 1471771 322772 1432849 1412321 20528 9500337 19660170 F INVESTMENT - DENTAL CHOICE, INC. 6736125 F 26396295 ACCRUED INVESTMENT INCOME 158403 457(B) PLAN 553219 INVESTMENT - RHC 7265909 SURPLUS NOTE RECEIVABLE 60000 8037531 CLAIMS CHECKS OUTSTANDING 5086633 ESTIMATED CLAIMS LIABILITY 7859374 12946007 1 COMMUNITY FOUNDATION OF LOUISVILLE 325 WEST MAIN STREET SUITE 1110 LOUISVILLE KY 40202 310997017 501(C)(3) 1700000 GENERAL DONATION LEADERSHIP LOUISVILLE FOUNDATION 732 W MAIN STREET LOUISVILLE KY 40202 310958491 501(C)(3) 10000 GENERAL DONATION KENTUCKY YOUTH ADVOCATES 11001 BLUEGRASS PKWY SUITE 100 LOUISVILLE KY 40299 610929390 501(C)(3) 15000 GENERAL DONATION CITIZENS OF LOUISVILLE ORGANIZED & UNITED TOGETHER 1113 SOUTH 4TH STREET LOUISVILLE KY 40202 611202173 501(C)(3) 5000 GENERAL DONATION FOUNDATION FOR A HEALTHY KENTUCKY 1640 LYNDON FARM COURT STE 100 LOUISVILLE KY 40223 311784753 501(C)(3) 5000 DONATION - SMOKE FREE TOMORROW MANNA INC 3309 COLLINS LANE LOUISVILLE KY 40245 611355719 5000 GM APPRECIATION EVENT MIDWAY UNIVERSITY 512 EAST STEPHENS STREET MIDWAY KY 40347 610444708 501(C)(3) 10000 CAMPAIGN OF OPPORTUNITIES KY SCIENCE & TECHNOLOGY CORP 200 W VINE STREET STE 420 LEXINGTON KY 40507 611135362 501(C)(3) 5000 LT GOVERNOR CHALLENGE LEADERSHIP KENTUCKY FOUNDATION INC 464 CHENAULT ROAD FRANKFORT KY 40601 311096215 501(C)(3) 5000 ELEVATE KY SPONSORSHIP UNIVERSITY OF LOUISVILLE 200 E BRANDEIS AVE LOUISVILLE KY 40292 237018461 501(C)(3) 10000 MBA ALUMNI COUNCIL SPONSORSHIP 9 1 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 295681 0 62194 0 3075 0 0 0 22939 0 383889 0 0 0 JOHN L WEEKS III VP/CLO/SECRETARY 218309 0 103116 0 4922 0 0 0 22436 0 348783 0 0 0 ANGELA J NENNI VP/CAO 222800 0 95155 0 1677 0 1350 0 13881 0 334863 0 0 0 RUSSELL W SKAGGS VP/CFO 165555 0 71587 0 1509 0 0 0 22305 0 260956 0 0 0 RONALD E STORY VP/CIO 170089 0 21962 0 1519 0 0 0 8138 0 201708 0 0 0 BRIAN D HART VP/CRO 227069 0 31615 0 505 0 0 0 22794 0 281983 0 0 0 JEFFERY D DUES SENIOR ACCOUNT EXECUTIVE 70627 0 127750 0 326 0 0 0 21412 0 220115 0 0 0 TAUNYA L ESHENBAUGH SENIOR ACCOUNT EXECUTIVE 55210 0 175168 0 483 0 0 0 7579 0 238440 0 0 0 BRIAN E KRAINER DIRECTOR - SALES 32589 0 0 0 117073 0 0 0 2367 0 152029 0 0 0 CLIFFORD T MAESAKA FORMER CEO (THRU 3/2017) 0 0 0 0 726068 0 0 0 0 0 726068 0 499117 0 TAMARA L YORK-DAY FORMER VP (THRU 12/2017) 0 0 0 0 265655 0 0 0 0 0 265655 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 2018, CLIFFORD T. MAESAKA, THE FORMER CEO, RECEIVED $295,036 IN SEVERANCE, $370,620 FOR 457(B), AND $128,497 FOR DEFERRED COMPENSATION. IN ADDITION, TAMARA L. YORK-DAY, THE FORMER COO, RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $265,655. LASTLY, BRIAN KRAINER, FORMER DIRECTOR OF SALES, RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $116,923. DELTA DENTAL OF KENTUCKY, HAS BOTH A 457(B) PLAN AS WELL AS A 457(F) SERP, A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. ONLY ONE POSITION, THE CEO, IS ELIGIBLE FOR THE SERP. ADDITIONALLY, ALL OTHER VPS AND BOARD MEMBERS ARE ELIGIBLE FOR THE 457(B) PLAN. IN 2018, THE ACCRUAL FOR CLIFFORD T. MAESAKA, THE FORMER CEO, SERP TOTALED $136,207. THE ACCRUAL FOR JUDE THOPMSON, CEO, SERP TOTALED $57,699. 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 12/31/2018, RHSC APPOINTED ONE MEMBER OF THE 9 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 VP-FINANCE, GENERAL COUNSEL AND CEO. A DRAFT IS THEN PRESENTED TO THE AUDIT AND FINANCE COMMITTEE FOR REVIEW. PRIOR TO FILING, A COPY OF THE FINAL FORM 990 IS DISTRIBUTED TO THE ENTIRE GOVERNING BODY. 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 P&C COMMITTEE IN THE FIRST QUARTER OF 2019. 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 -944,818. FORM 990, PART XII, LINE 2C: PROCESS IS THE SAME AS THE PRIOR YEAR. 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) 12A TYPE II 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 -516636 7866051 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 -480 1.00000 1 RENAISSANCE HOLDING COMPANY PO BOX 30381 LANSING MI 48909 412177193 HOLDING COMPANY MI DELTA DENTAL OF MICHIGAN C 69597 3120291 0.05900 0 RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA PO BOX 30381 LANSING MI 48909 470397286 INSURANCE IN RENAISSANCE HOLDING COMPANY C 447540 6126531 0.05900 0 RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF NEW YORK PO BOX 30381 LANSING MI 48909 134098096 INSURANCE NY RENAISSANCE HOLDING COMPANY C 31694 648841 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 1 0 0 1 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 DENTAL CHOICE INC L 325380 ACTUAL COST DELTA DENTAL OF NORTH CAROLINA D 60000 ACTUAL LOAN AMOUNT DELTA DENTAL PLAN OF MICHIGAN INC M 2608863 ACTUAL COST RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA M 997579 ACTUAL COST DELTA DENTAL OF NORTH CAROLINA S 69000 ACTUAL COST