2018-11-13T11:02:13-06:00 2017-12-31 GRANT THORNTON LLP 171 N CLARK ST SUITE 200 CHICAGO IL 60601 990 2017-01-01 362612058 DELTA DENTAL OF ILLINOIS % TERRI BON DELT 6307184700 111 SHUMAN BOULEVARD NAPERVILLE IL 60563 TERRI BON VP FINANCE & CFO 6307184700 2018-11-13 true Bridget T Roche P00666837 3128560200 209.220.64.52 36941220183175000003 2018-11-13 P D1B5C914F8CB2B6646DC794151640C027123AE08 8570B2D8046878F456576E706BB8FB99030C32C0 2017 2019-02-21 02:37:17Z BERNARD GLOSSY 111 SHUMAN BOULEVARD NAPERVILLE IL 60563 885084898 false X WWW.DELTADENTALIL.COM X 1967 IL IMPROVE THE ORAL HEALTH OF ILLINOIS RESIDENTS BY PROVIDING DENTAL BENEFITS & OTHER SERVICES. 15 9 232 0 0 0 0 0 610938291 864849947 705405 1548935 37178 564251 611680874 866963133 2958120 4480367 544487658 794160635 22183552 23050510 0 0 0 31267890 34364016 600897220 856055528 10783654 10907605 145045252 221979821 44802487 108706865 100242765 113272956 IMPROVE THE ORAL HEALTH OF ILLINOIS RESIDENTS BY PROVIDING DENTAL BENEFITS & OTHER SERVICES. false false 835807542 4480367 864849947 DELTA DENTAL OF ILLINOIS (DDIL) IS A NOT-FOR-PROFIT CORPORATION WHICH MAINTAINS AND OPERATES A DENTAL CARE PLAN TO APPROXIMATELY 2,000,000 INDIVIDUALS. DDIL IS COMMITTED TO ITS MISSION TO DELIVER EXCEPTIONAL SERVICES TO OUR STAKEHOLDERS AND IMPROVE THE ORAL HEALTH OF THE COMMUNITIES WE SERVE. IN 2017, DDIL GRANTED $4,480,367 TO DELTA DENTAL OF ILLINOIS FOUNDATION, A 501(C)(3) CHARITABLE ORGANIZATION TO PROMOTE THE IMPROVEMENT OF DENTAL EDUCATION AND ACCESS TO DENTAL CARE IN ILLINOIS. 835807542 false false false true false false false false false true true false 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 70341 0 true 232 true false false false false false false X 15 9 false false false false true true true true true false false true true true true true true true true false X TERRI BON 6307184700 111 SHUMAN BOULEVARD NAPERVILLE IL 60563 JOHN MAPLES CHAIRMAN 5.0 0.0 X X 62619 0 0 DR FRANK MAGGIO VICE CHAIR 3.0 0.0 X X 51000 0 0 MICHAEL BUSSE COMMITTEE CHAIR 3.0 0.0 X 19210 0 18000 CRAIG C GRANNON DIRECTOR 2.0 0.0 X 14365 0 18000 JANE HAYS COMMITTEE CHAIR 3.0 0.0 X 42229 0 0 DR DAVID MILLER COMMITTEE CHAIR 3.0 0.0 X 37000 0 0 OMAR DUQUE DIRECTOR 2.0 0.0 X 33682 0 0 BRIAN SAMMARCO COMMITTEE CHAIR 3.0 0.0 X 40500 0 0 DR RICHARD PERRY IMMEDIATE PAST CHAIR 2.0 0.0 X 31500 0 0 DR RICHARD HESS DIRECTOR 2.0 0.0 X 28803 0 0 JOSEPH LEO COMMITTEE CHAIR 3.0 0.0 X 37602 0 0 DR DARRYLL BEARD DIRECTOR 2.0 0.0 X 28548 0 0 DR NANCY COZZI DIRECTOR 2.0 0.0 X 12364 0 18000 LORI GOLD PATTERSON DIRECTOR 2.0 0.0 X 28315 0 0 DR GENARO ROMO DIRECTOR 2.0 0.0 X 28000 0 0 BERNARD GLOSSY PRESIDENT & CEO 40.0 5.0 X 1367827 0 40900 STACEY BONN COO 40.0 5.0 X 616382 0 41745 TERRI BON VP FINANCE & CFO 40.0 5.0 X 464114 0 43838 CHARLES KOLKER VP OF IT - THRU 12/2017 40.0 0.0 X 415168 0 40542 KARYN GLOGOWSKI VP/DIRECTOR OF SALES 40.0 0.0 X 383033 0 34800 MICHAEL WHITE VP UNDERWRITING 40.0 0.0 X 300078 0 37689 KENT HUFFMAN SR. VP TRUASSURE SALES 40.0 0.0 X 295510 0 44490 ALEXANDRA KOTELON CORPORATE COUNSEL 40.0 0.0 X 222547 0 29807 TERRY MADDOX VP SERVICE OPERATIONS 40.0 0.0 X 206196 0 38460 ANN MARIE WALKER DIRECTOR CORP. COMMUNICATION 40.0 0.0 X 195740 0 19160 DANIEL BATTISTA SR. SALES EXECUTIVE 40.0 0.0 X 193096 0 31449 STACY BEITZEL MANAGER CLIENT RELATIONS 40.0 0.0 X 189830 0 36622 STEVE SOYKE SMALL BUSINESS SALES EXECUTIVE 40.0 0.0 X 188600 0 33885 ROBERT MAXWELL SR. SALES EXECUTIVE 40.0 0.0 X 184447 0 38547 5718305 0 565934 40 false true false Change Healthcare payment managemen 3055 Lebanon Pike suite 100 NASHVILLE TN 37214 invoice Printing 3453854 Advantech Inc 2801 Hoover Road STEVENS POINT WI 54481 Admin Systems 3109271 Interactive Business Systems inc 2625 Butterfield Rd 114 OAK BROOK IL 60523 IT Consulting 2457943 West Monroe Partners 222 W Adams St 11th Floor CHICAGO IL 60606 Mgmt Consulting 1912347 Ameridial Inc 4535 Strausser Street NW NORTH CANTON OH 44720 Call Center Services 887708 35 0 PREMIUMS 524114 864849947 864849947 864849947 303064 303064 0 0 526293 526293 0 526293 526293 19367636 18121765 1245871 1245871 1245871 0 0 0 0 0 0 0 0 0 OTHER INCOME 900099 37958 37958 37958 866963133 864849947 2113186 4480367 4480367 0 0 794160635 794160635 5172863 5172863 0 12894669 8698723 4195946 1241385 654197 587188 1143442 647735 495707 2598151 1618223 979928 0 330556 330556 222083 112720 109363 0 0 193649 193649 4796775 1801854 2994921 1590981 175219 1415762 1743760 1102022 641738 5748893 5840369 -91476 0 537733 537733 182179 47314 134865 0 76629 20208 56421 0 0 1116857 443650 673207 365173 365173 BROKERAGE COMMISSIONS 11395717 11395717 PRINTING & PUBLICATIONS 3683534 3406687 276847 INSURANCE DEPT. FEES 1028217 964742 63475 DDPA MEMBERSHIP DUES 640755 640755 710525 237160 473365 856055528 835807542 20247986 0 15538653 13452414 0 0 0 0 31293572 100368424 0 0 0 0 0 0 0 0 1280332 1357124 31070275 8330804 20229466 22739471 61600225 67162431 14757141 16532823 0 0 0 0 345863 367134 145045252 221979821 15014386 16287046 0 0 4231215 5415045 0 0 0 0 0 0 0 0 0 0 25556886 87004774 44802487 108706865 X 0 0 0 0 100242765 113272956 100242765 113272956 145045252 221979821 10907605 2122586 X false true X true false false true false 3625539 3625539 16066877 4898493 11168384 1707917 1340406 367511 9669942 2091905 7578037 22739471 CLOSELY-HELD EQUITY INTERESTS 13302762 F LIMITED PARTNERSHIP 3230061 F 16532823 0 SELF-INSURED UNPAID CLAIMS 70910238 UNPAID CLAIMS AND CLAIMS ADJUSTMENT EXPENSE 11800000 INTERCOMPANY PAYABLE 4294536 87004774 X 869085719 2122586 2122586 866963133 866963133 856055528 856055528 856055528 ASC 740 FOOTNOTE SCHEDULE D, PART X, LINE 2 DELTA DENTAL OF ILLINOIS HAS RECEIVED A FAVORABLE DETERMINATION LETER FROM THE IRS STATING THAT IT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(C)(4), EXCEPT FOR INCOME TAXES PERTAINING TO UNRELATED BUSINESS INCOME. THE COMPANY USES THE ASSET AND LIABILITY METHOD IN ACCOUNTING FOR DEFERRED INCOME TAXES. DEFERRED TAX ASSETS AND LIABILITIES ARE RECORDED FOR TEMPORARY DIFFERENCES BETWEEN THE TAX BASIS OF ASSETS AND LIABILITIES AND THEIR AMOUNTS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS USING STATUTORY TAX RATES IN EFFECT FOR THE YEAR IN WHICH THE DIFFERENCES ARE EXPECTED TO REVERSE. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN CHANGE IN NET ASSETS IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. A VALUATION ALLOWANCE IS RECORDED TO REDUCE THE CARRYING AMOUNTS OF DEFERRED TAX ASSETS UNLESS IT IS MORE LIKELY THAN NOT THAT SUCH ASSETS WILL BE REALIZED. THE COMPANY RECOGNIZES THE FINANCIAL STATEMENT BENEFIT OF A TAX POSITION ONLY AFTER DETERMINING THAT THE RELEVANT TAX AUTHORITY WOULD MORE LIKELY THAN NOT SUSTAIN THE POSITION FOLLOWING AN AUDIT. FOR TAX POSITIONS MEETING THE MORE-LIKELY-THAN-NOT THRESHOLD, THE AMOUNT RECOGNIZED IN THE FINANCIAL STATEMENTS IS THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT WITH THE RELEVANT TAX AUTHORITY. THE COMPANY HAS APPLIED THE UNCERTAIN TAX POSITION GUIDANCE TO ALL TAX POSITIONS FOR WHICH THE STATUTE OF LIMITATIONS REMAINS OPEN. TO DATE, THE COMPANY HAS NOT RECOGNIZED ANY ADDITIONAL LIABILITIES FOR UNRECOGNIZED TAX BENEFITS IN ANY OF THE PERIODS PRESENTED. THE COMPANY RECOGNIZES, IF NECESSARY, INTEREST ACCRUED RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND RECOGNIZES PENALTIES IN OPERATING EXPENSES. THERE WERE NO INTEREST OR PENALTIES RELATED TO INCOME TAXES THAT HAVE BEEN ACCRUED OR RECOGNIZED AS OF AND FOR THE YEARS ENDED DECEMBER 31, 2017 AND 2016. ON DECEMBER 22, 2017, THE UNITED STATES ENACTED TAX REFORM LEGISLATION COMMONLY KNOWN AS THE TAX CUTS AND JOBS ACT (THE ACT), RESULTING IN SIGNIFICANT MODIFICATIONS TO EXISTING LAW. THE COMPANY HAS COMPLETED THE ACCOUNTING FOR THE EFFECTS OF THE ACT DURING 2017. THE FINANCIAL STATEMENTS FOR THE YEAR ENDED DECEMBER 31, 2017, REFLECT CERTAIN EFFECTS OF THE ACT, WHICH PRIMARILY IS A REDUCTION IN THE CORPORATE TAX RATE FROM 35% TO 21%. TAX EXPENSE DURING THE YEAR ENDED DECEMBER 31, 2017, DID NOT CHANGE AS A RESULT OF THE CHANGES TO TAX LAWS AND TAX RATES UNDER THE ACT. true DELTA DENTAL OF ILLINOIS FOUNDATION 111 SHUMAN BOULEVARD NAPERVILLE IL 60563 262700504 501(C)(3) 4480367 0 PROMOTE ORAL HEALTH OF IL RESIDENTS 1 GRANTS AND OTHER ASSISTANCE SCHEDULE I, PART I, LINE 2 DELTA DENTAL OF ILLINOIS DIRECTORS AND OFFICERS HAVE THE MAJORITY OF SEATS ON THE DELTA DENTAL OF ILLINOIS FOUNDATION BOARD, AND THEREFORE MONITOR AND APPROVE HOW GRANT MONEY IS USED AND TRACKED. X X X true true X X X X X true false false false false false false true false BERNARD GLOSSY PRESIDENT & CEO 709132 0 527850 0 130845 0 24300 0 16600 0 1408727 0 0 0 STACEY BONN COO 395150 0 185334 0 35898 0 24300 0 17445 0 658127 0 0 0 TERRI BON VP FINANCE & CFO 313796 0 140760 0 9558 0 24300 0 19538 0 507952 0 0 0 CHARLES KOLKER VP OF IT - THRU 12/2017 166074 0 117300 0 131794 0 22949 0 17593 0 455710 0 0 0 KARYN GLOGOWSKI VP/DIRECTOR OF SALES 226731 0 150435 0 5867 0 24300 0 10500 0 417833 0 0 0 MICHAEL WHITE VP UNDERWRITING 196722 0 91494 0 11862 0 21530 0 16159 0 337767 0 0 0 KENT HUFFMAN SR. VP TRUASSURE SALES 169648 0 120000 0 5862 0 24300 0 20190 0 340000 0 0 0 ALEXANDRA KOTELON CORPORATE COUNSEL 183316 0 38709 0 522 0 20099 0 9708 0 252354 0 0 0 TERRY MADDOX VP SERVICE OPERATIONS 149044 0 47586 0 9566 0 18403 0 20057 0 244656 0 0 0 ANN MARIE WALKER DIRECTOR CORP. COMMUNICATION 159520 0 35659 0 561 0 15994 0 3166 0 214900 0 0 0 DANIEL BATTISTA SR. SALES EXECUTIVE 60720 0 127268 0 5108 0 17415 0 14034 0 224545 0 0 0 STACY BEITZEL MANAGER CLIENT RELATIONS 108751 0 75539 0 5540 0 17199 0 19423 0 226452 0 0 0 STEVE SOYKE SMALL BUSINESS SALES EXECUTIVE 63303 0 120812 0 4485 0 17205 0 16680 0 222485 0 0 0 ROBERT MAXWELL SR. SALES EXECUTIVE 88158 0 90785 0 5504 0 17171 0 21376 0 222994 0 0 0 FIRST CLASS OR CHARTER TRAVEL SCHEDULE J, PART I, LINE 1A OFFICERS ARE ALLOWED TO TRAVEL FIRST CLASS WHEN TRAVELING TO ORGANIZATIONAL EVENTS WHERE FLIGHTS ARE OVER 2 HOURS. THE BENEFIT IS CONSIDERED A TAXABLE BENEFIT. TRAVEL FOR COMPANIONS SCHEDULE J, PART I, LINE 1A IN ADDITION, OFFICERS COMPANION TRAVEL EXPENSES TO CERTAIN ORGANIZATIONAL EVENTS ARE REIMBURSED AS A TAXABLE BENEFIT. HEALTH AND SOCIAL DUES SCHEDULE J, PART I, LINE 1A THE OFFICERS OF THE ORGANIZATION ARE REIMBURSED FOR HEALTH CLUB MEMBERSHIP DUES UP TO $100 PER MONTH PER COMPANY POLICY. SEVERANCE PAYMENT SCHEDULE J, PART I, LINE 4A AN INDIVIDUAL LEFT THE ORGANIZATION IN 2017. THE INDIVIDUAL RECEIVED SEVERANCE IN 2017, WHICH IS INCLUDED ON SCHEDULE J, PART II, COLUMN B(III). DUE TO A CONFIDENTIALITY AGREEMENT, NEITHER THE NAME NOR THE AMOUNT WILL BE LISTED. NON-FIXED PAYMENTS SCHEDULE J, PART I, LINE 7 AS INDICATED IN SCHEDULE J, PART II, PERSONS LISTED ON FORM 990, PART VII, SECTION A RECEIVED A BONUS BASED ON PERFORMANCE AND THE FINANCIAL RESULTS OF THE ORGANIZATION. THIS BONUS WAS APPROVED BY THE BOARD. DR ALAN JURGENS FORMER DIRECTOR 325475 COMPENSATION false DR DARRYLL L BEARD DIRECTOR 131641 COMPENSATION false DR Richard HESS DIRECTOR 112673 COMPENSATION false DR GENARO ROMO DIRECTOR 179481 COMPENSATION false TRANSACTIONS WITH INTERESTED PERSONS SCHEDULE L, PART IV (A) NAME OF INTERESTED PERSON: DR. ALAN JURGENS THROUGH JURGENS AND KNEEZEL, LTD (D) DESCRIPTION OF TRANSACTION: PAYMENTS TO DENTAL PRACTICE FOR DENTAL SERVICES PROVIDED UNDER DENTAL INSURANCE POLICY. COMPENSATION WAS DETERMINED AT AN ARM'S LENGTH. (A) NAME OF PERSON: DR. DARRYLL L. BEARD DMD LTD (D) DESCRIPTION OF TRANSACTION: PAYMENTS TO DENTAL PRACTICE FOR DENTAL SERVICES PROVIDED UNDER DENTAL INSURANCE POLICY. COMPENSATION WAS DETERMINED AT AN ARM'S LENGTH. (A) NAME OF PERSON: DR. Richard Hess through J Michael Krisko DDS LTD (D) DESCRIPTION OF TRANSACTION: PAYMENTS TO DENTAL PRACTICE FOR DENTAL SERVICES PROVIDED UNDER DENTAL INSURANCE POLICY. COMPENSATION WAS DETERMINED AT AN ARM'S LENGTH. (A) NAME OF PERSON: DR. Genaro Romo through ROMO DENTAL PC (D) DESCRIPTION OF TRANSACTION: PAYMENTS TO DENTAL PRACTICE FOR DENTAL SERVICES PROVIDED UNDER DENTAL INSURANCE POLICY. COMPENSATION WAS DETERMINED AT AN ARM'S LENGTH. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, SECTION A, LINE 6 UNDER THE ENABLING STATUTE THAT GOVERNS THE ORGANIZATION - THE ILLINOIS DENTAL SERVICE PLAN ACT - THE MEMBERS OF DELTA DENTAL OF ILLINOIS ARE THE PARTICIPATING DENTISTS (DEFINED AS ANY DENTIST LICENSED IN ILLINOIS TO PRACTICE DENTISTRY WHO IS REPUTABLE AND IN GOOD STANDING AND HAS SIGNED AN AGREEMENT TO BECOME A PARTICIPATING DENTIST OF THE ORGANIZATION) AND THE GROUP SUBSCRIBERS WHO PURCHASE A DENTAL BENEFIT PROGRAM FROM THE ORGANIZATION. MEMBERS OR STOCKHOLDERS WHO MAY ELECT FORM 990, PART VI, SECTION A, LINES 7A AND 7B AT THE ANNUAL MEMBERSHIP MEETING OF THE ORGANIZATION, THE MEMBERS REFERENCED IN PART VI, LINE 6 ELECT THE MEMBERS OF THE GOVERNING BODY, I.E. DIRECTORS, WHOSE TERM OF DIRECTORSHIP HAS EXPIRED. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF THE ORGANIZATION RETAINS THE SERVICES OF AN INDEPENDENT CPA FIRM TO ASSIST IN THE PREPARATION OF THE ORGANIZATION'S FORM 990. THE CPA FIRM ASSISTS MANAGEMENT IN PREPARING AND FINALIZING FORM 990. THE DRAFT OF FORM 990, INCLUDING ALL SCHEDULES, IS REVIEWED BY THE AUDIT AND FINANCE COMMITTEE, AND THEN DISTRIBUTED TO ALL VOTING MEMBERS OF THE GOVERNING BODY, I.E. THE DIRECTORS. THE ORGANIZATION'S MANAGEMENT, AND IF NEEDED ITS CPA FIRM, ADDRESS ANY QUESTIONS OR COMMENTS SUBMITTED BY THE ORGANIZATION'S GOVERNING BODY BEFORE FILING ITS FORM 990. AFTER THE AUDIT AND FINANCE COMMITTEE'S REVIEW AND MANAGEMENT ADDRESSES QUESTIONS OR COMMENTS FROM THE DIRECTORS, THE DRAFT FORM 990 IS FINALIZED AND FILED WITH THE IRS. CONFLICT OF INTEREST POLICY MONITORING & ENFORCEMENT FORM 990, PART VI, SECTION B, LINE 12C LEGAL COUNSEL FOR THE ORGANIZATION REVIEWS THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ANNUALLY WITH THE OFFICERS, DIRECTORS (TRUSTEES) AND KEY EMPLOYEES. AFTER THIS REVIEW, THE INDIVIDUALS OCCUPYING THESE POSITIONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. POTENTIAL CONFLICTS ARE LOGGED WITH THE SECRETARY OF THE ORGANIZATION AND ANY CHANGES TO THE DISCLOSURE FORM ARE TO BE REPORTED TO THE CHIEF LEGAL OFFICER OF THE ORGANIZATION. PROCESS OF DETERMINING COMPENSATION FORM 990, PART VI, SECTION B, LINES 15A AND 15B CEO COMPENSATION IS REVIEWED BY THE BOARD OF DIRECTORS. THE BOARD PERIODICALLY ENGAGES AN INDEPENDENT CONSULTING FIRM TO ADVISE OF COMPENSATION LEVELS OF SIMILARLY SITUATED CEOS BASED UPON SURVEYS AND DATA PROVIDED BY OTHER ORGANIZATIONS AS LISTED ON THEIR FORM 990. THIS DATA, OR THE DATA REPRESENTED TO THE COMPENSATION COMMITTEE AT SCHEDULED MEETINGS AND MINUTES OF THESE MEETINGS ARE CONTEMPORANEOUSLY PREPARED. THE COMMITTEE MAKES A RECOMMENDATION TO THE BOARD FOR APPROVAL. THE LAST EXECUTIVE COMPENSATION REVIEW OCCURRED IN 2017. HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE THROUGH APPLICABLE GOVERNMENTAL AGENCIES; THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON WRITTEN REQUEST TO THE ORGANIZATION. DELTA DENTAL OF ILLINOIS FOUNDATION 111 SHUMAN BLVD NAPERVILLE IL 60563 262700504 ORAL HEALTH IL 501(C)(3) 07 DDIL true TRUASSURE INSURANCE COMPANY 111 SHUMAN BLVD NAPERVILLE IL 60563 363757528 DENTAL INS. IL DDIL C Corp -1869431 9415456 1.00000 true PROTEC INSURANCE COMPANY 111 SHUMAN BLVD NAPERVILLE IL 60563 320416457 HEALTH INS. IL DDIL C Corp 509124 4730093 1.00000 true TRUASSURE INSURANCE COMPANY OF COLORADO 111 SHUMAN BLVD NAPERVILLE IL 60563 812595283 DENTAL INS. CO DDIL C Corp 7506 2009087 1.00000 true false true false false false false false false false false false true true true true true true true true DELTA DENTAL OF ILLINOIS FOUNDATION b 4252561 FMV TRUASSURE INSURANCE COMPANY b 3000000 FMV PROTEC INSURANCE COMPANY m 202152 FMV DELTA DENTAL OF ILLINOIS FOUNDATION o 227806 FMV TRUASSURE INSURANCE COMPANY p 1079627 FMV PROTEC INSURANCE COMPANY p 97184 FMV PROTEC INSURANCE COMPANY r 3780500 FMV TRUASSURE INSURANCE COMPANY r 3064 FMV PROTEC INSURANCE COMPANY s 305310 FMV