DELTA DENTAL OF KENTUCKY INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL OF KENTUCKY INC (EIN 61-0659432)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-13
IRS object ID
201833179349304283
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-11-13T13:07:34-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN381357951PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11111 MICHIGAN AVE STE 100AddressLine1Txt
CityEAST LANSINGCityNm
State AbbreviationMIStateAbbreviationCd
ZIP48823ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN610659432EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF KENTUCKY INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlDELTBusinessNameControlTxt
Phone5027365000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110100 LINN STATION ROAD NO 700AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP40223ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRUSSELL W SKAGGSPersonNm
Person TitleVP - FINANCEPersonTitleTxt
Phone5027365000PhoneNum
Signature2018-11-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDAVID LOWENTHAL CPAPreparerPersonNm
PTINP00378651PTIN
Phone5173326200PhoneNum
Preparation2018-11-12PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.59.56.31IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-11-12IPDt
IP Tm13:03:36IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device IdD3994C8C0EED3DC07268D0E06E8E0D044B4248A2AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJ JUDE THOMPSONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line110100 LINN STATION ROAD NO 700AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP40223ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$228,324,057GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressWWW.DELTADENTALKY.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1966FormationYr
Legal Domicile StateKYLegalDomicileStateCd
Activity Or MissionDELTA 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.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee82TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$180,112,897PYProgramServiceRevenueAmt
CY Program Service Revenue$180,345,619CYProgramServiceRevenueAmt
PY Investment Income$865,309PYInvestmentIncomeAmt
CY Investment Income$1,789,279CYInvestmentIncomeAmt
PY Other Revenue-$504,249PYOtherRevenueAmt
CY Other Revenue-$844,847CYOtherRevenueAmt
PY Total Revenue$180,473,957PYTotalRevenueAmt
CY Total Revenue$181,290,051CYTotalRevenueAmt
PY Grants And Similar Paid$2,546,334PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,905,627CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$153,626,635PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$154,500,475CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,558,170PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$8,929,911CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$14,235,508PYOtherExpensesAmt
CY Other Expenses$14,033,584CYOtherExpensesAmt
PY Total Expenses$178,966,647PYTotalExpensesAmt
CY Total Expenses$180,369,597CYTotalExpensesAmt
PY Revenues Less Expenses$1,507,310PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$920,454CYRevenuesLessExpensesAmt
Total Assets BOY$100,780,501TotalAssetsBOYAmt
Total Assets EOY$103,200,156TotalAssetsEOYAmt
Total Liabilities BOY$21,846,927TotalLiabilitiesBOYAmt
Total Liabilities EOY$19,885,803TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$78,933,574NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$83,314,353NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE 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.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$177,483,965ExpenseAmt
Grant$2,905,627GrantAmt
Revenue$180,345,619RevenueAmt
DescTHE CORE MISSION FOR DELTA DENTAL OF KENTUCKY IS TO ENHANCE ORAL HEALTH CARE FOR KENTUCKIANS AND OUR MEMBERS AROUND THE COUNTRY. WE STRIVE TO PROVIDE SUPERIOR CUSTOMER SERVICE BY UTILIZING THE MOST CURRENT TECHNOLOGY, WHILE AT THE SAME TIME MANAGING OVERALL COSTS FOR THE BEST VALUE. THROUGH OUR DENTAL BENEFITS PROGRAMS AND COMMUNITY INVOLVEMENT WE ARE MAKING A DIFFERENCE IN THE MARKETS WE SERVE. IN 2017 WE PROCESSED AND PAID OVER $153 MILLION IN CLAIMS FOR 684,000 MEMBERS.SEE SCHEDULE O FOR CONTINUATIONPROVIDING VALUE TO OUR CUSTOMERSDELTA DENTAL IS DEDICATED TO MEMBERS RECEIVING QUALITY DENTISTRY, WHILE ALSO SAVING GROUPS AND MEMBERS MONEY. OUR DENTIST CREDENTIALING, COST MANAGEMENT POLICIES AND FEE REDUCTION AGREEMENTS WITH DENTISTS HELP OUR MEMBERS RECEIVE THE BEST DENTAL OUTCOMES. FOR FIVE DECADES, DELTA DENTAL HAS HELPED PROMOTE ORAL HEALTH BY DESIGNING AND ADMINISTERING INNOVATIVE, COST-EFFECTIVE DENTAL BENEFIT PROGRAMS. EXPERTS AT PLAN DESIGN, DELTA DENTAL HAS CREATED DENTAL BENEFIT PROGRAMS THAT MEET CUSTOMER COST-OBJECTIVES WHILE HELPING TO IMPROVE AND MAINTAIN ORAL HEALTH.THE PROGRAMS FEATURE LARGE PANELS OF PARTICIPATING DENTISTS. IN FACT, 3 OUT OF 4 DENTISTS NATIONWIDE PARTICIPATE WITH DELTA DENTAL. THIS KIND OF REACH HAS ENABLED MILLIONS OF PEOPLE TO RECEIVE COST-EFFECTIVE DENTAL CARE.DELTA DENTAL'S MEMBERS ARE AFFORDED 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 WILL BE BILLED. THIS LOWERS CLAIM COSTS FOR CUSTOMERS AND REDUCES OUT-OF-POCKET COSTS FOR MEMBERS.WITH TWO NETWORKS OF PARTICIPATING DENTISTS IN ONE INTEGRATED CLAIMS SYSTEM, DELTA DENTAL CAN DELIVER TO CUSTOMERS AND GROUP MEMBERS, THE GREATEST ACCESS AT THE BEST COST.COMMUNITY INVOLVEMENTDELTA DENTAL OF KENTUCKY IS COMMITTED TO IMPROVING THE ORAL HEALTH AND OVERALL HEALTH FOR ALL CITIZENS ACROSS KENTUCKY. THROUGH TWO CHARITABLE ENDEAVORS, THE DELTA DENTAL OF KENTUCKY FOUNDATION AND MAKING SMILES HAPPEN, DELTA DENTAL IS ABLE TO COMMIT TIME AND RESOURCES TO FURTHER OUR MISSION OF ENHANCING THE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE. IN 2017, DELTA DENTAL AWARDED OVER $3 MILLION IN FUNDS ACROSS KENTUCKY REACHING OVER 140 CHARITABLE ORGANIZATIONS.DELTA DENTAL OF KENTUCKY PARTNERED WITH KENTUCKY YOUTH ADVOCATES TO CONDUCT A SURVEY OF CHILDREN'S ORAL HEALTH IN KENTUCKY. A STUDY HAD NOT BEEN COMPLETED IN OVER 15 YEARS AND OVER 2,000 STUDENTS IN 60 PUBLIC SCHOOLS ACROSS THE COMMONWEALTH WERE SURVEYED. THE MAKING SMILES HAPPEN: 2016 STUDY OF ORAL HEALTH OF KENTUCKY'S YOUTH: WHERE ARE WE? WHAT CAN BE DONE? WHO CAN HELP? WAS PUBLISHED IN THE FALL 2015 AND HIGHLIGHTED KEY FINDINGS AND RECOMMENDATION FOR ORAL HEALTH IMPROVEMENT PLANS MOVING FORWARD. IN 2017, AN ADDITIONAL $1 MILLION WAS PLEDGED TO IMPROVE THE ORAL HEALTH OF KENTUCKY IN FIVE DIFFERENT REGIONS THROUGHOUT THE STATE. IN 2017, DELTA DENTAL MADE A FIVE YEAR COMMITMENT TO THE OPEN ARMS DENTAL CLINIC AT HOME OF THE INNOCENTS. HOME OF THE INNOCENTS PROVIDES CARE TO CHILDREN WHO HAVE BEEN ABUSED, ABANDONED, AND NEGLECTED; CARE TO MEDICALLY FRAGILE CHILDREN; AND CHILDREN WITH OTHER SPECIAL NEEDS THROUGH RESIDENTIAL AND COMMUNITY-BASED SERVICES. THE HOME OPERATES OPEN ARMS CHILDREN'S HEALTH WHICH INCLUDES THE OPEN ARMS DENTAL CLINIC PROVIDING DENTAL TREATMENT FOR NOT ONLY RESIDENTS OF THE HOME BUT ALSO CHILDREN IN NEED FROM AROUND THE REGION. DELTA DENTAL OF KENTUCKY IS THE MAIN FUNDER OF THE CURRENT DENTAL PRACTICE WITHIN OPEN ARMS. THIS DENTAL PRACTICE CONSISTS OF FOUR STATE-OF-THE-ART DENTAL SUITES, INCLUDING A "QUIET ROOM", DIGITAL INTRA ORAL AND PANORAMIC X-RAY, CEILING-MOUNTED LIFTS TO FACILITATE TRANSFERS FROM WHEELCHAIRS, AND CUSTOM MADE DENTAL CHAIR BEAN BAGS TO IMPROVE COMFORT FOR CHILDREN WITH DISABILITIES. BEHAVIORAL HEALTH THERAPISTS ARE ON-SITE TO HELP CHILDREN FOR THEIR DENTAL VISIT AND CAN ACCOMPANY CHILDREN TO APPOINTMENTS. CHILDREN WITH MEDICALLY COMPLEX CONDITIONS THAT WERE PREVIOUSLY REFERRED TO AN OPERATING ROOM AT THE CHILDREN'S HOSPITAL CAN BE TREATED AT THE HOME INSTEAD, WHICH FOR MANY OF THEM IS THEIR HOME. REFUGEE FAMILIES FIND LANGUAGE AND CULTURAL DIFFERENCES ARE ACCEPTED WITH AS MANY BARRIERS AS POSSIBLE REMOVED. LAST YEAR, ALMOST 2,000 CHILDREN RECEIVED DENTAL SERVICES. CHILDREN OF REFUGEE FAMILIES, MANY WHO HAVE NEVER SEEN A DENTIST, ACCOUNT FOR ALMOST 50% OF OPEN ARMS PATIENTS. DELTA DENTAL OF KENTUCKY HAS MADE A 5 YEAR COMMITMENT TO HOME OF THE INNOCENTS OPEN ARMS DENTAL CLINIC AND WILL RECEIVE NAMING RIGHTS IN 2018. OTHER 2017 FUNDING INITIATIVES INCLUDE THE UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY MOBILE DENTAL CLINIC, THE WESTERN KENTUCKY UNIVERSITY MOBILE HEALTH VAN, AND "TEETH ON THE GO", OUR ORAL HEALTH EDUCATION PROGRAM FOR STUDENTS K THROUGH 6TH GRADE. HUNDREDS OF TEACHERS HAVE USED THESE KITS TO EDUCATE OVER 100,000 STUDENTS AROUND THE STATE.Desc
Total Program Service Expenses$177,483,965TotalProgramServiceExpensesAmt
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document21588IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee82EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1RUSSELL W SKAGGS VP - FINANCEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5027365000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110100 LINN STATION ROAD STE 700AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP40223ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
J JUDE THOMPSON
PRESIDENT, CEO35.005.00Yes (X)Yes (X)$222,949$0$6,058
CLIFFORD T MAESAKA
PRESIDENT, CEO - THRU 3/1735.005.00Yes (X)Yes (X)$421,356$0$39,272
BRUCE R SMITH
CHAIR8.0016.00Yes (X)Yes (X)$38,900$139,512$0
MICHAEL CHILDERS DMD
DIRECTOR4.005.00Yes (X)$33,200$25,008$0
MARY M CORBETT
DIRECTOR - THRU 12/172.000.00Yes (X)$9,100$0$0
DIANE CORNWELL
DIRECTOR4.000.00Yes (X)$37,500$0$0
RODNEY A JACKSON DMD
DIRECTOR2.000.00Yes (X)$25,400$0$0
OLIVIA F KIRTLEY
DIRECTOR4.000.00Yes (X)$11,200$0$18,000
STEVE S REED
DIRECTOR2.000.00Yes (X)$19,500$0$0
J DAVID SMITH
DIRECTOR2.000.00Yes (X)$25,700$0$0
JOHN N WILLIAMS JR DMD
DIRECTOR2.000.00Yes (X)$25,400$0$0
STEPHEN C DAY
VP/CMO - THRU 4/1740.000.00Yes (X)$316,225$0$22,437
JOHN L WEEKS III
VP/CLO/SECRETARY40.000.00Yes (X)$296,112$0$23,542
ANGELA J NENNI
VP/CAO40.000.00Yes (X)$269,567$0$14,719
TAMARA L YORK-DAY
VP/COO - THRU 12/1740.000.00Yes (X)$525,274$0$16,784
RUSSELL W SKAGGS
VP/CFO40.000.00Yes (X)$204,931$0$22,897
RONALD E STORY
VP/CIO40.000.00Yes (X)$189,858$0$8,778
BRIAN D HART
VP/CRO40.000.00Yes (X)$138,821$0$17,616
JEFFERY D DUES
SENIOR ACCOUNT EXECUTIVE40.000.00$160,231$0$21,742Yes (X)
TAUNYA L ESHENBAUGH
SENIOR ACCOUNT EXECUTIVE40.000.00$172,548$0$7,702Yes (X)
BRIAN E KRAINER
DIRECTOR - SALES40.000.00$201,751$0$15,039Yes (X)
TAMMY W CANNON
MANAGER - UNDERWRITING40.000.00$101,800$0$13,076Yes (X)
GINA R WHITLOW
EXECUTIVE ASSISTANT40.000.00$109,741$0$22,928Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,557,064TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$164,520TotReportableCompRltdOrgAmt
Total Other Compensation$270,590TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K14IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
DELTA DENTAL PLAN OF MICHIGAN
PO BOX 30416LANSINGMI48909ADMINISTRATIVE SERVICES$3,557,914
MCGRIFF INSURANCE SERVICES INC
3605 GLENWOOD AVENUE STE 201RALEIGHNC27612BENEFITS CONSULTING$972,491
RENAISSANCE LIFE & HEALTH INSURANCE COMP
PO BOX 30416LANSINGMI48909ADMINISTRATIVE SERVICES$912,777
ASSURED PARTNERS NL LLC
2305 RIVER ROADLOUISVILLEKY40206BENEFITS CONSULTING$644,512
PLANCHOICE INC
13257 OBANNON STATIONLOUISVILLEKY40223BENEFITS CONSULTING$600,851
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K31CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
DENTAL CARE REVENUE524114$180,333,599$180,333,599
OTHER FEES900099$12,020$12,020
FieldValueIRS element (for citing)
Total Program Service Revenue$180,345,619TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$836,956TotalRevenueColumnAmt
Exclusion$836,956ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$664,990RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,509,837RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$844,847RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$844,847TotalRevenueColumnAmt
Exclusion-$844,847ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$46,476,492SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$45,524,169SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$952,323SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$952,323TotalRevenueColumnAmt
Exclusion$952,323ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$181,290,051TotalRevenueColumnAmt
Related Or Exempt Func Income$180,345,619RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$944,432ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$2,905,627TotalAmt
Program Services$2,905,627ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$154,500,475TotalAmt
Program Services$154,500,475ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$3,001,096TotalAmt
Program Services$1,500,548ProgramServicesAmt
Management And General$1,500,548ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,462,777TotalAmt
Program Services$4,462,777ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$165,563TotalAmt
Program Services$165,563ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$887,867TotalAmt
Program Services$887,867ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$412,608TotalAmt
Program Services$317,708ProgramServicesAmt
Management And General$94,900ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$428,340TotalAmt
Management And General$428,340ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$123,748TotalAmt
Management And General$123,748ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$76,980TotalAmt
Management And General$76,980ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$972,178TotalAmt
Program Services$874,960ProgramServicesAmt
Management And General$97,218ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$319,432TotalAmt
Program Services$207,631ProgramServicesAmt
Management And General$111,801ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$450,382TotalAmt
Program Services$450,382ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$511,302TotalAmt
Program Services$444,833ProgramServicesAmt
Management And General$66,469ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$562,684TotalAmt
Program Services$281,342ProgramServicesAmt
Management And General$281,342ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$44,997TotalAmt
Program Services$26,998ProgramServicesAmt
Management And General$17,999ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$111TotalAmt
Program Services$111ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$86,415TotalAmt
Program Services$77,774ProgramServicesAmt
Management And General$8,641ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$75,601TotalAmt
Management And General$75,601ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BROKER COMMISSIONS$7,445,071$7,445,071
PROCESSING FEES$2,321,913$2,321,913
DUES & ASSESSMENTS$366,429$366,429
POSTAGE & SHIPPING$204,538$202,493$2,045

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$43,463TotalAmt
Program Services$43,463ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$180,369,597TotalAmt
Program Services$177,483,965ProgramServicesAmt
Management And General$2,885,632ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$18,919,846BOYAmt
EOY$16,342,596EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$815,158BOYAmt
EOY$467,748EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$15,708,032BOYAmt
EOY$15,387,426EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$32,000BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$17,039,667LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,174,803LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$10,510,368BOYAmt
EOY$9,864,864EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$21,143,410BOYAmt
EOY$22,109,777EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$25,449,726BOYAmt
EOY$29,860,454EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$8,201,961BOYAmt
EOY$9,167,291EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$100,780,501BOYAmt
EOY$103,200,156EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,196,894BOYAmt
EOY$4,013,548EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$2,346,198BOYAmt
EOY$1,956,846EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,303,835BOYAmt
EOY$13,915,409EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$21,846,927BOYAmt
EOY$19,885,803EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$78,933,574BOYAmt
EOY$83,314,353EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$78,933,574BOYAmt
EOY$83,314,353EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$100,780,501BOYAmt
EOY$103,200,156EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$920,454ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$3,283,477NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$176,848OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$830,000OtherCostOrOtherBasisAmt
Book Value$830,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,727,036OtherCostOrOtherBasisAmt
Depreciation$3,653,418DepreciationAmt
Book Value$8,073,618BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,382,981OtherCostOrOtherBasisAmt
Depreciation$710,390DepreciationAmt
Book Value$672,591BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,669,695OtherCostOrOtherBasisAmt
Depreciation$1,407,746DepreciationAmt
Book Value$261,949BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,429,955OtherCostOrOtherBasisAmt
Depreciation$1,403,249DepreciationAmt
Book Value$26,706BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$9,864,864TotalBookValueLandBuildingsAmt

Closely Held Equity Interests CloselyHeldEquityInterestsGrp

FieldValueIRS element (for citing)
Book Value$21,557,741BookValueAmt
Method ValuationFMethodValuationCd

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescINVESTMENT - DENTAL CHOICE, INC.Desc
Book Value$8,302,713BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$29,860,454TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
ACCRUED INVESTMENT INCOME$205,274
457(B) PLAN$1,049,135
INVESTMENT - RHC$7,632,882
SURPLUS NOTE RECEIVABLE$280,000
FieldValueIRS element (for citing)
Total Book Value Other Assets$9,167,291TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
CLAIMS CHECKS OUTSTANDING$4,688,286
ESTIMATED CLAIMS LIABILITY$9,227,123
FieldValueIRS element (for citing)
Total Liability$13,915,409TotalLiabilityAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
KENTUCKY STATE POLICE FOUNDATION
1303 US HWY 127FRANKFORTKY40601474712245501(C)(3)$50,000THE TROOPER PROJECT
LOUISVILLE DENTAL SOCIETY INC
1920 NELSON MILLER PKWYLOUISVILLEKY40223610726110501(C)(6)$75,000METRO DENTAL VAN PROJECT
COMMUNITY FOUNDATION OF LOUISVILLE
325 WEST MAIN STREET SUITE 1110LOUISVILLEKY40202310997017501(C)(3)$2,250,000GENERAL DONATION
LEADERSHIP LOUISVILLE FOUNDATION
732 W MAIN STREETLOUISVILLEKY40202310958491501(C)(3)$10,000GENERAL DONATION
GREATER LOUISVILLE INC
614 W MAIN STREETLOUISVILLEKY40202611131064501(C)(6)$10,000GENERAL DONATION
FieldValueIRS element (for citing)
Total501c3 Org3Total501c3OrgCnt
Total Other Org2TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationGRANTS 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.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
J JUDE THOMPSON
PRESIDENT, CEO$52,192$0$0$0$170,757$0$6,058$0$0$0$229,007$0$0$0
CLIFFORD T MAESAKA
PRESIDENT, CEO - THRU 3/17$63,547$0$141,225$0$216,584$0$20,178$0$19,094$0$460,628$0$0$0
BRUCE R SMITH
CHAIR$0$139,512$0$0$38,900$0$0$0$0$0$38,900$139,512$0$0
STEPHEN C DAY
VP/CMO - THRU 4/17$64,644$0$63,852$0$187,729$0$0$0$22,437$0$338,662$0$0$0
JOHN L WEEKS III
VP/CLO/SECRETARY$219,666$0$73,524$0$2,922$0$0$0$23,542$0$319,654$0$0$0
ANGELA J NENNI
VP/CAO$201,848$0$66,189$0$1,530$0$0$0$14,719$0$284,286$0$0$0
TAMARA L YORK-DAY
VP/COO - THRU 12/17$264,232$0$104,466$0$156,576$0$0$0$16,784$0$542,058$0$0$0
RUSSELL W SKAGGS
VP/CFO$152,570$0$51,043$0$1,318$0$0$0$22,897$0$227,828$0$0$0
RONALD E STORY
VP/CIO$156,982$0$31,512$0$1,364$0$0$0$8,778$0$198,636$0$0$0
BRIAN D HART
VP/CRO$138,632$0$0$0$189$0$0$0$17,616$0$156,437$0$0$0
JEFFERY D DUES
SENIOR ACCOUNT EXECUTIVE$72,796$0$87,116$0$319$0$0$0$21,742$0$181,973$0$0$0
TAUNYA L ESHENBAUGH
SENIOR ACCOUNT EXECUTIVE$55,434$0$117,041$0$73$0$0$0$7,702$0$180,250$0$0$0
BRIAN E KRAINER
DIRECTOR - SALES$107,843$0$93,469$0$439$0$0$0$15,039$0$216,790$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1AFOR 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-BDURING 2017, A SEVERANCE PAYMENT WAS MADE TO CLIFFORD T. MAESAKA, THE FORMER CEO, IN THE AMOUNT OF $215,745. IN ADDITION, TAMARA L. YORK-DAY, FORMER COO RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $131,127. LASTLY, STEPHEN C. DAY FORMER CMO RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $186,751. 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 2017, THE ACCRUAL FOR CLIFFORD T. MAESAKA, THE FORMER CEO, SERP TOTALED $20,178. THE ACCRUAL FOR JUDE THOPMSON, CEO STARTING IN MARCH 2017, SERP TOTALED $6,058. THE RELATED ORGANIZATION, DELTA DENTAL PLAN OF MICHIGAN, HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). IN ORDER TO BE ELIGIBLE FOR THE SERP, AN EMPLOYEE MUST BE A SENIOR VICE PRESIDENT OR HIGHER. AN OUTSIDE INDEPENDENT ACTUARY CALCULATES THE VALUE ON AN ANNUAL BASIS. IN 2017, GORAN JURKOVIC, CFO, PARTICIPATED IN THE SERP BUT DID NOT RECEIVE A DISTRIBUTION.
PART I, LINE 7AS 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.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 4DURING THE 2017 CALENDAR YEAR, DDKY AMENDED ITS ARTICLES OF INCORPORATION TO ALLOW VISION INSURANCE. AT 12/31/2017 THE VISION PRODUCT WAS STILL UNDER DEVELOPMENT.
FORM 990, PART VI, SECTION A, LINE 6EFFECTIVE JULY 1, 2009 RENAISSANCE HEALTH SERVICE CORPORATION BECAME THE SOLE CORPORATE MEMBER OF DELTA DENTAL OF KENTUCKY.
FORM 990, PART VI, SECTION A, LINE 7ARHSC 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 12/31/2017, RHSC APPOINTED ONE MEMBER OF THE 9 MEMBER DDKY BOARD.
FORM 990, PART VI, SECTION A, LINE 7BTHE 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 11BTHE 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 12COFFICERS, 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 15CEO 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 KENTUCKYS P&C COMMITTEE IN FEBRUARY 2017. 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 MICHIGANS HR EXECUTIVE COMPENSATION PROCESS DURING 2016. THE REPORT BASED ON THIS REVIEW WAS THEN ISSUED BY THE CONSULTANTS IN JUNE OF 2017.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING 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 VIICERTAIN 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 176,848.
FORM 990, PART XII, LINE 2C:PROCESS IS THE SAME AS THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1DENTAL CHOICE PROPERTIES LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line110100 LINN STATION RD SUITEAddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP40223ZIPCd
FieldValueIRS element (for citing)
EIN610659432EIN
Primary ActivitiesNO BUSINESS ACTIVITYPrimaryActivitiesTxt
Legal Domicile StateKYLegalDomicileStateCd
Total Income$0TotalIncomeAmt
End Of Year Assets$0EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF KENTUCKYBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
RENAISSANCE HEALTH SERVICE CORPORATION
PO BOX 30416LANSINGMI489097916381675667PROMOTING DENTAL CAREMI501(C)(4)N/AN/A0
DELTA DENTAL PLAN OF MICHIGAN INC
4100 OKEMOS ROADOKEMOSMI48864381791480PROVIDE DENTAL SERVICE PLANSMI501(C)(4)N/A0RENAISSANCE HEALTH SERVICE CORPORATION
DELTA DENTAL OF TENNESSEE INC
240 VENTURE CIRCLENASHVILLETN37228620812197PROVIDE DENTAL SERVICE PLANSTN501(C)(4)N/A0RENAISSANCE HEALTH SERVICE CORPORATION
DELTA DENTAL PLAN OF NEW MEXICO INC
2500 LOUISIANA BLVD NEALBUQUERQUENM87110850224562PROVIDE DENTAL SERVICE PLANSNM501(C)(4)N/A0RENAISSANCE HEALTH SERVICE CORPORATION
DELTA DENTAL OF NORTH CAROLINA
4242 SIX FORKS ROADRALEIGHNC27609561018068PROVIDE DENTAL SERVICE PLANSNC501(C)(4)N/A0RENAISSANCE HEALTH SERVICE CORPORATION
DELTA DENTAL PLAN OF OHIO INC
PO BOX 30416LANSINGMI489097916310685339PROVIDE DENTAL SERVICE PLANSOH501(C)(4)N/A0DELTA DENTAL PLAN OF MICHIGAN INC
DELTA DENTAL PLAN OF INDIANA INC
PO BOX 30416LANSINGMI489097916351545647PROVIDE DENTAL SERVICE PLANSIN501(C)(4)N/A0DELTA DENTAL PLAN OF MICHIGAN INC
DELTA DENTAL FUND
PO BOX 30416LANSINGMI489097916382337000SUPPORT DENTAL EDUCATION AND RESEARCH PROGRAMSMI501(C)(3)12A TYPE II0DELTA DENTAL PLAN OF MICHIGAN INC
DELTA DENTAL PLAN OF ARKANSAS INC
1513 COUNTRY CLUB RDSHERWOODAR72120710561140PROVIDE DENTAL SERVICE PLANSAR501(C)(4)NA0RENAISSANCE HEALTH SERVICE CORPORATION
DELTA DENTAL OF ARKANSAS FOUNDATION INC
1513 COUNTRY CLUB RDSHERWOODAR72120261569324PROVIDE DENTAL SERVICE PLANSAR501(C)(3)PF0RENAISSANCE HEALTH SERVICE CORPORATION
RENAISSANCE FAMILY FOUNDATION INC
4100 OKEMOS ROADOKEMOSMI48864461376165EMPHASIZE DENTAL HEALTH IN COMMUNITIESIN501(C)(3)PF0RENAISSANCE HOLDING COMPANY
SMILE 180 FOUNDATION
240 VENTURE CIRCLENASHVILLETN37228471654054EMPHASIZE DENTAL HEALTH IN COMMUNITIESTN501(C)(3)LINE 12A, I0DELTA DENTAL OF TENNESSEE INC

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CHESME LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1124 N BRIDGE STAddressLine1Txt
CityDEWITTCityNm
State AbbreviationMIStateAbbreviationCd
ZIP48820ZIPCd
FieldValueIRS element (for citing)
EIN200061957EIN
Primary ActivitiesCAPITAL MANAGEMENTPrimaryActivitiesTxt
Legal Domicile StateMILegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1GLM HOLDING COMPANYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
DENTAL CHOICE INC
10100 LINN STATION RD SUITE 700LOUISVILLEKY40223611105118PROVIDE DENTAL SERVICE PLANSKYDELTA DENTAL OF KENTUCKYC$258,253$8,995,6961.00000Yes (1)
DENTAL CHOICE AGENCY INC
10100 LINN STATION RD SUITE 700LOUISVILLEKY40223611336003PRIMARY GENERAL AGENCY FOR DDKY & DENTAL CHOICEKYDELTA DENTAL OF KENTUCKYC-$7401.00000Yes (1)
RENAISSANCE HOLDING COMPANY
PO BOX 30381LANSINGMI48909412177193HOLDING COMPANYMIRENAISSANCE HEALTH SERVICE CORPORATIONC-$66,285$3,851,1420.059000
RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA
PO BOX 30381LANSINGMI48909470397286INSURANCEINRENAISSANCE HOLDING COMPANYC$399,460$5,969,9580.059000
RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF NEW YORK
PO BOX 30381LANSINGMI48909134098096INSURANCENYRENAISSANCE HOLDING COMPANYC$33,934$614,4230.059000
FORE HOLDING CORPORATION
240 VENTURE CIRCLENASHVILLETN37228204116122EMPLOYEE BENEFITSTNDELTA DENTAL OF TENNESSEEC0
OMEGA ADMINISTRATORS INC
1513 COUNTRY CLUB ROADSHERWOODAR72120043740469PROVIDE THIRD-PARTY ADMINISTRATIVE SERVICESARDELTA DENTAL OF ARKANSASC0
GLM HOLDING COMPANY
4100 OKEMOS ROADOKEMOSMI48864472557772INVESTMENT IN SUBSIDIARIESMIDELTA DENTAL OF MICHIGANC0
DEWPOINT INC
300 S WASHIGNTON SQUARELANSINGMI48933383300595COMPUTER CONSULTINGMIGLM HOLDING COMPANYC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
DENTAL CHOICE INC
L$308,184ACTUAL COST
DELTA DENTAL OF NORTH CAROLINA
D$280,000ACTUAL COST
DELTA DENTAL PLAN OF MICHIGAN INC
M$2,297,726ACTUAL COST
RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA
M$919,265ACTUAL COST
DELTA DENTAL OF NORTH CAROLINA
A$60,000ACTUAL COST

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