2019-11-15T14:13:57-06:00 2018-12-31 BKD LLP 312 WALNUT STREET SUITE 3000 CINCINNATI OH 45202 990 2018-01-01 430908349 DELTA DENTAL OF MISSOURI % BARBARA C BENTRUP DELT 3146563000 12399 GRAVOIS ROAD ST LOUIS MO 631271702 BARBARA C BENTRUP CFO & CORP. COUNSEL 3146563000 2019-11-01 true AARON HERSHBERGER P00961884 5136218300 167.68.126.162 31025420193195000031 2019-11-15 P 5ECFD7F4488FEC6F6ABE53B187DEB4499E915412 FDEAFD0406FF7141BFF80F52237CA5777F98C136 2018 2020-03-31 21:24:44Z E B ROB GOREN 12399 GRAVOIS ROAD ST LOUIS MO 631271702 623776597 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 12 269 0 0 0 0 613828257 624799099 2435965 2660072 1416565 -3701104 617680787 623758067 1581570 1641734 557605516 567017828 25594022 32626927 0 0 0 24483053 20638121 609264161 621924610 8416626 1833457 177600088 182550863 51238964 58018399 126361124 124532464 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 608437696 1341733 624799099 DELTA DENTAL OF MISSOURI IS A PREPAID DENTAL INSURANCE COMPANY. IN 2018, DELTA DENTAL PROCESSED 3,283,177 CLAIMS FOR DENTAL SERVICES. 300000 DENTAL HEALTH THEATER - SEE SCHEDULE O 580130 LAND OF SMILES - SEE SCHEDULE O 101006 100000 0 609418832 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 58380 0 true 269 true false false false false false false false false false false true false X 15 12 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 OLADIPUPO ADEFALA DIRECTOR 2.0 0.0 X 1050 0 0 WILLIAM J BENDER TREASURER/DIRECTOR 2.0 0.0 X X 24550 0 0 BRIAN BERGLUND DIRECTOR 2.0 0.0 X 24550 0 0 ROSEMARY BISHOP SECRETARY/DIRECTOR 2.0 0.0 X X 32950 0 0 RICHARD W BRAUN DIRECTOR 2.0 0.0 X 21650 0 0 ROBERT E BUTLER BOARD CHAIRMAN/DIRECTOR 2.0 0.0 X X 45200 0 0 JOHNNY CUSTARDO DIRECTOR 2.0 0.0 X 20600 0 0 WILLIAM EDWARDS DIRECTOR 2.0 0.0 X 21650 0 0 WILLIAM A GRAY DIRECTOR 2.0 0.0 X 1050 0 0 MARK S MANCIN DIRECTOR 2.0 0.0 X 23750 0 0 DEBORAH PATTERSON DIRECTOR 2.0 0.0 X 26650 0 0 MICK REDOHL DIRECTOR - LEFT BOARD NOV 2018 2.0 0.0 X 23750 0 0 JAMES W RHEA FIRST VICE CHAIRMAN/DIRECTOR 2.0 0.0 X X 27850 0 0 EDWARD C ROBISON DIRECTOR - LEFT BOARD NOV 2018 2.0 0.0 X 14300 0 0 TIMOTHY S TAYLOR DIRECTOR 2.0 0.0 X 25850 0 0 GARY R WILLIAMS DIRECTOR 2.0 0.0 X 22700 0 0 MARK R ZUST 2ND VICE CHAIRMAN/DIRECTOR 2.0 0.0 X X 21000 0 0 BARBARA C BENTRUP CFO & Corporate Counsel 60.0 0.0 X 1018181 0 225501 E B ROB GOREN President & CEO 60.0 0.0 X 1012971 0 190374 RONALD INGE CHIEF DENTAL OFFICER 60.0 0.0 X 524693 0 172329 JONATHAN JENNINGS CHIEF ACTUARY/VP UNDERWRITING 60.0 0.0 X 326284 0 95885 KARL MUDRA CIO 60.0 0.0 X 367464 0 99488 EDWARD PATTAROZZI CHIEF SALES/MARKETING OFFICER 60.0 0.0 X 511425 0 167622 VICKI KATZFEY NATIONAL ACCOUNT EXECUTIVE 40.0 0.0 X 236022 0 61519 HENRY S LAFFITTE VP SALES & ACCOUNT MANAGEMENT 40.0 0.0 X 391453 0 70162 ELLEN R SAMUELS MANAGER, CORPORATE COMPLIANCE 40.0 0.0 X 215296 0 80776 JANE STANHAUS DIRECTOR OF HUMAN RESOURCES 40.0 0.0 X 234202 0 73854 ROBERT WOZNIAK ACCOUNT EXECUTIVE 40.0 0.0 X 207374 0 52531 5424465 0 1290041 59 false true false MISSOURI DENTAL PROFESSIONALS 1100 SPUR DR STE 30 MARSHFIELD MO 65706 DENTAL SERVICES 6981467 M FERNANDEZ DDS D AUTRY DMD E BROWN 3555 SUNSET OFFICE DR STE 103 SAINT LOUIS MO 63127 DENTAL SERVICES 3221522 JAY F HAUSER DDS PC PO BOX 503094 SAINT LOUIS MO 63150 DENTAL SERVICES 2822312 RED CARD 744 OFFICE PARKWAY SAINT LOUIS MO 63141 PRINT & MAIL SERVICE 2142506 IKHLAQ ROSINSKI DENTAL PARTNERS DDS 677 N NEW BALLAS RD STE 207 SAINT LOUIS MO 63141 DENTAL SERVICES 2111529 878 0 DENTAL PREMIUMS 524114 624799099 624799099 624799099 2824640 2824640 0 0 125850 18530 107320 0 107320 107320 -164568 -164568 -164568 -164568 0 0 0 0 0 0 0 0 0 MISCELLANEOUS INCOME 900099 328646 328646 INVESTMENT IN SUBSIDIARY 900003 -4137070 -4137070 -3808424 623758067 624799099 -1041032 1641734 1641734 0 0 567017828 567017828 5091317 5091317 0 18874060 16629190 2244870 3351446 2182338 1169108 3827561 3372312 455249 1482543 1306210 176333 0 309336 236709 72627 165821 126889 38932 0 0 207690 207690 3196659 2446135 750524 2266729 1997125 269604 3544979 3123341 421638 127225 112092 15133 0 1188362 1047019 141343 766969 675746 91223 0 355346 313081 42265 0 0 2069992 1823789 246203 347156 347156 BOARD AND BUREAU DUES 854725 753064 101661 SERVICE BUREAU FEES 2802847 2469478 333369 PUBLIC RELATIONS 572765 504640 68125 SERVICE AGREEMENTS 1672343 1473435 198908 189177 166677 22500 621924610 609418832 12505778 0 0 0 24161674 36654529 0 0 38687202 40354044 0 0 0 0 0 0 0 0 571925 1004141 22835249 12926048 6561502 9909201 78329174 79707584 0 0 26756470 11427922 0 0 2532141 3493442 177600088 182550863 13206886 14400911 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38032078 43617488 51238964 58018399 X 0 0 0 0 126361124 124532464 126361124 124532464 177600088 182550863 1833457 -3662117 X false true X true false 1350000 1350000 7899248 3621582 4277666 1145351 926560 218791 5035191 3246848 1788343 7405459 5131058 2274401 9909201 INVEST. IN ADVANTICA ADMIN. 11427922 C 11427922 0 INCURRED BUT UNREPORTED CLAIMS 33436609 ESTIMATE UNPAID CLAIM PROCESS 1109755 UNEARNED PREMIUMS 6722911 RETENTION RESERVES 150306 ADVANCE DEPOSITS 2197907 43617488 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 BASIS 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 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 LOSS TOTALING $4,281,022 AND AN OPERATING GAIN TOTALING $1,246,804 DURING 2018 AND 2017, RESPECTIVELY. AT DECEMBER 31, 2018 AND 2017, ADVANTICA ADMINISTRATIVE HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $19,829,000 AND $27,421,000, RESPECTIVELY. ADVANTICA ADMINISTRATIVE AND ITS SUBSIDIARIES HAD DEFERRED TAX ASSETS OF APPROXIMATELY $5,408,000 AND $4,883,000 AT DECEMBER 31, 2018 AND 2017, 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, 2018 AND 2017. 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, 2015 THROUGH 2018. ON DECEMBER 22, 2017, THE UNITED STATES ENACTED TAX REFORM LEGISLATION THROUGH THE TAX CUTS AND JOBS ACT, WHICH SIGNIFICANTLY CHANGES THE EXISTING U.S. TAX LAWS, INCLUDING A REDUCTION IN THE CORPORATE TAX RATE FROM 35% TO 21%, AS WELL AS OTHER CHANGES. THE TAX CUTS AND JOBS ACT OF 2017 PROVIDED FOR A CHANGE IN THE METHODOLOGY EMPLOYED TO CALCULATED RESERVES FOR TAX PURPOSES. BEGINNING JANUARY 1, 2018, A HIGHER INTEREST RATE ASSUMPTION AND LONGER PAYOUT PATTERNS ARE USED TO DISCOUNT THESE RESERVES. IN ADDITION, COMPANIES ARE NO LONGER ABLE TO ELECT TO USE THEIR OWN EXPERIENCE TO DISCOUNT RESERVES, BUT INSTEAD ARE REQUIRED TO USE THE INDUSTRY-BASED TABLES PUBLISHED BY THE IRS ANNUALLY. DURING 2017, THE ORGANIZATION COULD NOT REASONABLY ESTIMATE THE PROVISIONAL TAX IMPACTS RELATED TO THE CHANGE IN METHODOLOGY. DURING 2018, THE IRS PUBLISHED THE DISCOUNT FACTOR TABLES AND THE ORGANIZATION CALCULATED THE TAX IMPACT OF THE METHODOLOGY CHANGE AND RECORDED AN ADDITIONAL DEFERRED TAX ASSET AND OFFSETTING DEFERRED TAX LIABILITY AT DECEMBER 31, 2018. THE DEFERRED TAX LIABILITY WAS AMORTIZED INTO INCOME DURING 2018 PER THE 8-YEAR INCLUSION DESCRIBED IN THE TCJA. true Missouri Dept of Health & Senior Service PO Box 570 Jefferson City MO 65102 446000987 State of MO 225000 General Support Missouri Dental Association Foundation 3340 American Ave Jefferson City MO 65109 431133855 501(C)(3) 200000 General Support Give Kids a Smile 10 Worthington Dr MD Heights MO 63043 201287939 501(C)(3) 100000 1006 BOOK SUPPLIES/SERVICES General Support Jordan Valley Community Health Center 440 E Tampa St Springfield MO 65806 431602701 501(C)(3) 75000 General Support MYRTLE HILLIARD DAVIS COMP HEALTH CENTER 5471 DR MLK Dr St Louis MO 63112 430917230 501(C)(3) 63794 General Support Medical University of South Carolina 19 HAGOOD AVE CHARLESTON SC 29425 576000722 501(C)(3) 50000 General Support Roy J Rinehart Foundation 650 E 25th Street Kansas City MO 64108 436041456 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 St Louis Regional Public Media Inc 3655 Olive Street Saint Louis MO 63108 430685345 501(C)(3) 50000 General Support Palmetto Health Foundation 1600 Marion St Columbia SC 29201 570725699 501(C)(3) 42500 General Support CATHOLIC CHARITIES DIOCESE OF CHARLESTON 901 Orange Grove Rd Charleston SC 29407 570314369 501(C)(3) 40000 General Support Dental Lifeline Network 1800 15TH ST DENVER CO 80202 846129064 501(C)(3) 40000 General Support Healthy Smiles of Spartanburg Inc PO Box 1441 Spartanburg SC 29304 030529473 501(C)(3) 37500 General Support Lift Up Someone Today LLC 3259 E SUNSHINE ST SPRINGFIELD MO 65804 811243560 501(C)(3) 36000 General Support OUR LADY OF MERCY COMMUNITY OUTREACH SVCS PO Box 607 Johns Island SC 29457 570905488 501(C)(3) 30000 General Support Columbia Oral Health Clinic PO Box 3206 Columbia SC 29230 571073100 501(C)(3) 25000 General Support Family Health Center of Boone County 1001 W Worley Columbia MO 65203 431709422 501(C)(3) 25000 General Support Girl Scouts of Eastern Missouri Inc 2300 Ball Drive St Louis MO 63146 430662471 501(C)(3) 24000 General Support Cass Community Health Foundation 2316 E Meyer Blvd Kansas City MO 64132 431349495 501(C)(3) 20000 General Support Community Clinic of Southwest Missouri 701 South Joplin Ave Joplin MO 64801 431643962 501(C)(3) 15000 General Support RONALD MCDONALD HOUSE CHARITIES 949 E Primrose St STE 1100N Springfield MO 65807 431371143 501(C)(3) 15000 General Support YWCA Metro St Louis 3820 West Pine Blvd St Louis MO 63108 430653618 501(C)(3) 12075 General Support EdVenture Inc 211 Gervals Street Columbia SC 29201 571013857 501(C)(3) 10000 General Support Epworth Children's Home 2900 Millwood Ave Columbia SC 29205 570314389 501(C)(3) 10000 General Support HERBER HOOVER BOYS & GIRLS CLUB OF ST LOUIS 2901 N Grand Ave St Louis MO 63107 436061693 501(C)(3) 10000 General Support Miles of Smiles Inc 5416 NE Antioch Rd Kansas City MO 64119 203664224 501(C)(3) 10000 General Support St Louis County Library Foundation 1640 S Lindbergh Blvd St Louis MO 63131 431863977 501(C)(3) 10000 General Support American Lung Association 55 W Wacker Dr Chicago IL 60601 131632524 501(C)(3) 9210 General Support Greenville Free Medical Clinic Inc PO Box 8993 Greenville SC 29604 570855205 501(C)(3) 8000 GENERAL SUPPORT Missouri Highlands Health Care 110 S 2nd St Ellington MO 63638 431068291 501(C)(3) 7550 GENERAL SUPPORT 30 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 458023 0 140797 0 419361 0 204657 0 20844 0 1243682 0 E B ROB GOREN President & CEO 539222 0 200500 0 273249 0 160312 0 30062 0 1203345 0 RONALD INGE CHIEF DENTAL OFFICER 364038 0 111611 0 49044 0 151976 0 20353 0 697022 0 JONATHAN JENNINGS CHIEF ACTUARY/VP UNDERWRITING 241045 0 71277 0 13962 0 68930 0 26955 0 422169 0 KARL MUDRA CIO 252305 0 84471 0 30688 0 72184 0 27304 0 466952 0 EDWARD PATTAROZZI CHIEF SALES/MARKETING OFFICER 352962 0 116054 0 42409 0 145374 0 22248 0 679047 0 VICKI KATZFEY NATIONAL ACCOUNT EXECUTIVE 92825 0 132886 0 10311 0 34395 0 27124 0 297541 0 HENRY S LAFFITTE VP SALES & ACCOUNT MANAGEMENT 221076 0 160788 0 9589 0 41250 0 28912 0 461615 0 ELLEN R SAMUELS MANAGER, CORPORATE COMPLIANCE 162502 0 48612 0 4182 0 52087 0 28689 0 296072 0 JANE STANHAUS DIRECTOR OF HUMAN RESOURCES 173468 0 53043 0 7691 0 43731 0 30123 0 308056 0 ROBERT WOZNIAK ACCOUNT EXECUTIVE 83181 0 112162 0 12031 0 30220 0 22311 0 259905 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 2018 FOR THE FOLLOWING INDIVIDUALS WERE: BARBARA BENTRUP - $31,569 E.B. ROB GOREN - $48,556 KARL MUDRA - $8,878 EDWARD PATTAROZZI - $22,986 RONALD INGE - $17,346 JONATHAN JENNINGS - $48 THE ORGANIZATION HAS AN UNFUNDED NONQUALIFIED, DEFINED BENEFIT DEFERRED COMPENSATION PLAN (DBDCP) FOR ITS SENIOR LEVEL EXECUTIVES, WITH VESTING OVER 10 TO 15 YEARS OF SERVICE TO THE ORGANIZATION. THE ACTUARIALLY DETERMINED LIABILITY IS BASED UPON ASSUMPTIONS FOR REMAINING YEARS OF SERVICE UNTIL RETIREMENT, PROJECTED SALARIES FOR THE FINAL THREE YEARS OF SERVICE, AND A PREDETERMINED BENEFIT PERCENTAGE BASED UPON THE PARTICIPANT'S POSITION. INDIVIDUALS WHO PARTICIPATED IN THIS PLAN DURING 2018 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 IN 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 - $163,407 E.B. ROB GOREN - $119,062 KARL MUDRA - $30,934 EDWARD PATTAROZZI - $104,124 JONATHAN JENNINGS - $27,680 RONALD INGE - $110,726 MARK R ZUST DDS LTD BOARD MEMBER AS OWNER 224415 DENTAL SERVICES PROVIDED false JAMES W RHEA DDS PC BOARD MEMBER AS OWNER 216147 DENTAL SERVICES PROVIDED false FINNANE-ROBISON DENTAL LLC BOARD MEMBER AS OWNER 173253 DENTAL SERVICES PROVIDED false CURRY TAYLOR DDS LTD BOARD MEMBER AS OWNER 134909 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. BOARD MEMBER EDWARD ROBISON AND ELIZABETH FINNANE, DAUGHTER OF 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 TIMOTHY TAYLOR HAS A REPORTABLE INTEREST IN CURRY TAYLOR DDS LLC WHICH PROVIDES DENTAL SERVICES TO SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION. FORM 990, PART III, LINE 4B DESCRIPTION OF OTHER PROGRAM SERVICES DENTAL HEALTH THEATRE - HEALTHWORKS! KIDS' MUSEUM ST. LOUIS CO-SPONSORS/COALITIONS INVOLVED: ST. LOUIS OFFICE FOR DEVELOPMENTAL DISABILITY RESOURCES AND VARIOUS CHARITABLE DONORS. PROGRAM DESCRIPTION: IN SPRING 2016, AFTER MORE THAN 38 YEARS OF PROVIDING ORAL HEALTH AND OVERALL HEALTH EDUCATION TO HUNDREDS OF THOUSANDS OF CHILDREN IN THE ST. LOUIS METRO, THE DENTAL HEALTH THEATRE RELOCATED AND EXPANDED TO BECOME PART OF THE HEALTHWORKS! KIDS' MUSEUM ST. LOUIS. THE MUSEUM'S MISSION IS TO EDUCATE AND INSPIRE CHILDREN AND THE COMMUNITY TO MAKE POSITIVE ORAL HEALTH AND OVERALL HEALTH CHOICES TO ACHIEVE OPTIMUM HEALTH. IT IS THE ONLY FREESTANDING CHILDREN'S MUSEUM IN ST. LOUIS DEDICATED SOLELY TO HEALTH EDUCATION, WHICH IS COMBINED WITH PLAY TO HELP KIDS LEARN HEALTHY HABITS FOR HEALTHIER LIVES. THE MUSEUM HOSTS ONSITE HEALTH EDUCATION PROGRAMS AND HANDS-ON EXHIBITS ACCESSIBLE TO INDIVIDUALS OF ALL AGES. WITHIN THE MUSEUM, THE DELTA DENTAL HEALTH THEATRE SERVES AS AN INTERACTIVE LEARNING CENTER WITH HIGH-ENERGY, EDUCATOR-LED PROGRAMMING THAT ENCOURAGES POSITIVE HEALTH PRACTICES AND INCREASES INDIVIDUAL KNOWLEDGE ABOUT THE MOUTH-BODY CONNECTION TO OVERALL HEALTH AND THE IMPACT OF PERSONAL CHOICES ON HEALTH. APPROXIMATELY 37,000 CHILDREN, TEACHERS AND PARENTS VISITED THE MUSEUM THIS YEAR. LONGEVITY: DELTA DENTAL HEALTH THEATRE OPERATED FROM 1977 TO SPRING 2016, WHEN IT BECAME PART OF HEALTHWORKS! KIDS' MUSEUM ST. LOUIS. DELTA DENTAL OF MISSOURI SPONSORED DELTA DENTAL HEALTH THEATRE FROM 2002 THROUGH 2015, AND HAS SPONSORED HEALTHWORKS! KIDS' MUSEUM ST. LOUIS SINCE 2016. BECAUSE OF THE SUPPORT OF DELTA DENTAL OF MISSOURI, MORE THAN 135,000 CHILDREN AND CAREGIVERS HAVE RECEIVED HEALTH EDUCATION IN THE ST. LOUIS COMMUNITY. FORM 990, PART III, LINE 4C DESCRIPTION OF OTHER PROGRAM SERVICES LAND OF SMILES TOURING THEATRICAL EDUCATION PROGRAM DESCRIPTION: LAND OF SMILES IS A TOURING THEATRICAL PROGRAM THAT FEATURES TOOTH WIZARD, LITTLE SISTER TOOTH FAIRY AND THEIR ARCH ENEMY PLAQUEMAN. THE SHOW TRAVELED TO 569 SCHOOLS AND PROVIDED ORAL HEALTH EDUCATION FOR 126,608 K-3RD GRADE STUDENTS THROUGHOUT THE STATES OF MISSOURI AND SOUTH CAROLINA IN 2018. AN ASSEMBLY-STYLE LIVE PERFORMANCE WITH AUDIENCE PARTICIPATION, THE PROGRAM CAPTURES EACH STUDENT'S ATTENTION THROUGH FUN, KID-FOCUSED ENTERTAINMENT. CHARACTERS EXPLAIN PROPER BRUSHING TECHNIQUES, HOW TO FLOSS, GOOD AND BAD FOODS FOR THE TEETH AND WHY IT IS IMPORTANT TO VISIT THE DENTIST TWICE A YEAR. EACH CHILD IS GIVEN A TAKE-HOME SMILE BAG FILLED WITH A TOOTHBRUSH, TOOTHPASTE, FLOSS, A COLORING SHEET, AND A REMINDER MIRROR DECAL. TO REINFORCE THE MESSAGES OF THE PROGRAM AFTER THE PERFORMANCE, DDMO DISTRIBUTES A CURRICULUM KIT THAT INCLUDES AN EDUCATIONAL DVD AND CORRESPONDING CURRICULUM BOOKLET. THE PROGRAM WEBSITE, WWW.LANDOFSMILESVIDEO.COM, PROVIDES ANOTHER SOURCE TO VIEW THE EDUCATIONAL VIDEO ONLINE. 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 THROUGH THE YEAR. LONGEVITY: THIS PROGRAM HAS BEEN IN PLACE SINCE 2002. FORM 990, PART III, LINE 4D DESCRIPTION OF OTHER PROGRAM SERVICES GIVE KIDS A SMILE ("GKAS") IN ST. LOUIS PROGRAM DESCRIPTION: ONE OF OUR MOST SUCCESSFUL OUTREACH INITIATIVES, GKAS WAS LAUNCHED IN ST. LOUIS, MISSOURI, IN FEBRUARY OF 2002 IN PARTNERSHIP WITH GSLDS. IN 2018, GKAS IN ST. LOUIS PROVIDED MORE THAN 6,000 CHILDREN WITH MORE THAN $1 MILLION WORTH OF FREE DENTAL CARE AND ORAL HEALTH EDUCATION AT ITS TWO CLINICS AND OTHER COMMUNITY PROGRAMS. AT THE TWO-DAY CLINICS, SEVERAL HUNDRED LOCAL DENTISTS, HYGIENISTS AND ASSISTANTS, SUPPORTED BY LAY VOLUNTEERS AND SPONSORS, SUCH AS DELTA DENTAL, PROVIDE CHILDREN WITH FREE, COMPREHENSIVE DENTAL CARE, INCLUDING EXAMS, SEALANTS, X-RAYS, PROFESSIONAL CLEANINGS, FLUORIDE TREATMENTS, RESTORATIONS AND MORE. GKAS HAS TREATED ALMOST 16,000 CHILDREN SINCE THE FIRST CLINIC IN 2002. IN 2003, GKAS WAS ADOPTED BY THE AMERICAN DENTAL ASSOCIATION AS A NATIONAL CAMPAIGN. IN 2006, GKAS WAS RECOGNIZED BY CONGRESS AS AN EXEMPLARY GRASSROOTS EFFORT. THE GKAS PROGRAM WAS EXPANDED TO THE GREATER KANSAS CITY AREA IN 2013. LONGEVITY: THIS PROGRAM HAS BEEN IN PLACE SINCE 2002. 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 SIGNED A 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 SIGNED A 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 COMMITTEE AND BOARD OF DIRECTORS. REVIEWS ARE CONDUCTED AND APPROVED BY THE COMPENSATION COMMITTEE ON AN ANNUAL BASIS. THE ANNUAL COMPENSATION FOR 2018 WAS REVIEWED BY A THIRD PARTY COMPENSATION CONSULTANT AND THEN REVIEWED BY THE COMPENSATION COMMITTEE IN MARCH, 2018. 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 THRID PARTY ADMIN MO NA C-CORP 71534286 14905490 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 653832 ALLOCATIONS ADVANTICA ADMINISTRATIVE SERVICES INC N 2395993 EXPENSE BASED