2018-11-13T13:25:53-06:00 2017-12-31 381357951 PLANTE & MORAN PLLC 1111 MICHIGAN AVE STE 100 EAST LANSING MI 48823 990 2017-01-01 850224562 DELTA DENTAL PLAN OF NEW MEXICO INC DELT 5058557114 2500 LOUISIANA BLVD NE NO 600 ALBUQUERQUE NM 87110 AMY BASEL CHIEF FINANCIAL OFFICER 5058557114 2018-11-08 1 DAVID LOWENTHAL CPA P00378651 5173326200 2018-11-07 67.59.56.31 2018-11-08 12:09:44 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 D3994C8C0EED3DC07268D0E06E8E0D044B4248A2 2017 2019-02-21 02:37:17Z EDWARD J LOPEZ JR 2500 LOUISIANA BLVD NE NO 600 ALBUQUERQUE NM 87110 125799799 0 X HTTP://WWW.DELTADENTALNM.COM X 1971 NM DELTA DENTAL OF NEW MEXICO'S MISSION IS TO ADVANCE AND PROMOTE THE IMPROVEMENT OF ORAL HEALTH THROUGH PREPAID DENTAL SERVICES, SUPPORT FOR RESEARCH AND EDUCATION, AND COMMUNITY OUTREACH DIRECTED TOWARD SECURING ACCESS TO QUALITY DENTAL CARE FOR ALL. 8 8 40 0 0 0 0 0 109138634 110955061 1269580 1283111 35579 25655 110443793 112263827 17000 113727 0 0 3249135 3006550 0 0 0 103637306 105351067 106903441 108471344 3540352 3792483 49931405 54172245 7133597 6058416 42797808 48113829 X DELTA DENTAL OF NEW MEXICO'S MISSION IS TO ADVANCE AND PROMOTE THE IMPROVEMENT OF ORAL HEALTH THROUGH PREPAID DENTAL SERVICES, SUPPORT FOR RESEARCH AND EDUCATION, AND COMMUNITY OUTREACH DIRECTED TOWARD SECURING ACCESS TO QUALITY DENTAL CARE FOR ALL. 0 0 106492102 113727 110980716 PROMOTING DENTAL CAREDELTA DENTAL PLAN OF NEW MEXICO, INC. IS A LEADING PREPAID DENTAL BENEFITS PROVIDER. THE PURPOSE OF THE ORGANIZATION IS TO ADVANCE AND PROMOTE THE IMPROVEMENT OF ORAL HEALTH. THIS IS DONE BY OFFERING INNOVATIVE, COST-EFFECTIVE PRODUCTS THAT MEET THE NEEDS OF CUSTOMERS. THIS WAS DEMONSTRATED IN 2017 BY PAYING OUT OVER $97 MILLION IN CLAIMS AND BY PROVIDING DENTAL BENEFITS FOR THE PUBLIC AND ADVANCING THE SCIENCE OF DENTISTRY. IN ADDITION, OVER 600,000 CLAIMS WERE PROCESSED FOR OVER 155,000 SUBSCRIBERS.SEE SCHEDULE O FOR CONTINUATIONCOST SAVING STRATEGIESDELTA DENTAL BENEFIT PLANS ARE COMMITTED TO SAVING GROUPS AND SUBSCRIBERS MONEY. THE DELTA DIFFERENCE IS AN INTEGRATION OF ACTIVITIES; SUCH AS COST MANAGEMENT POLICIES, FEE REDUCTION AGREEMENTS WITH DENTISTS, AND AN ANTI-FRAUD HOTLINE, PUT TO WORK ENSURING QUALITY, COST-EFFECTIVE DENTAL BENEFIT DELIVERY. IN 2017, THE DELTA DIFFERENCE SAVED GROUPS AND SUBSCRIBERS APPROXIMATELY $2.1 BILLION. IN ADDITION, THE DELTA DIFFERENCE HELPS KEEP OUR TREND BELOW THE NATIONAL INFLATIONARY TREND IN DENTAL BENEFITS.DELTA DENTAL'S INDUSTRY LEADING TECHNOLOGY PLATFORM, ENTERPRISE TECHNOLOGY SOLUTIONS (ETS), HAS BEEN INTERNATIONALLY RECOGNIZED AS PROVIDING THE BEST IN FAST, FLEXIBLE SERVICE INCLUDING ONLINE, REAL-TIME CLAIMS PROCESSING. DELTA DENTAL'S CONTINUED PRIORITY IS TO REDUCE COSTS AND IMPROVE SERVICE BY INCREASING THE VOLUME OF CLAIMS THAT ARE SUBMITTED ELECTRONICALLY. QUALITY SERVICE IS ALSO MEASURED THROUGH INTERNAL AUDITS. RESULTS INDICATE OVER 99 PERCENT OF CLAIMS ARE PROCESSED WITHIN 10 WORKING DAYS.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 FULL-TIME PARTICIPATING DENTISTS. THIS KIND OF REACH HAS ENABLED MILLIONS OF PEOPLE TO RECEIVE COST-EFFECTIVE DENTAL CARE.DELTA DENTALS GROUP 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 SUBSCRIBERS.WITH TWO NETWORKS OF FULL-TIME PARTICIPATING DENTISTS IN ONE INTEGRATED CLAIMS SYSTEM, DELTA DENTAL CAN DELIVER TO CUSTOMERS AND GROUP MEMBERS, THE GREATEST ACCESS AT THE BEST COST. 106492102 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 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 0 1 1 1 0 1 4673 0 1 40 1 0 0 0 0 0 0 X 8 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X AMY BASEL CHIEF FINANCIAL OFFICER 5173496000 4100 OKEMOS ROAD OKEMOS MI 48864 X THOMAS J FLESZAR DDS MS BOARD OBSERVER 5.00 12.00 X 14000 118508 0 JAMES TRUJILLO VICE CHAIRPERSON 5.00 0.00 X 11951 0 0 MICHAEL BLOMKER SECRETARY/TREASURER 5.00 0.00 X 15539 0 0 EDWARD J LOPEZJR PRESIDENT & CEO 50.00 0.00 X X 319956 0 20399 MICHELE M BISHOP DDS IMMEDIATE PAST CHAIRPERSON 5.00 0.00 X X 7200 0 0 STEPHEN B CHREIST IMMEDIATE PAST CHAIRPERSON 5.00 5.00 X X 16105 27504 0 RALPH MCELMURRY DDS DIRECTOR 5.00 0.00 X 10100 0 0 CHRISTINE N NATHE RDH MS DIRECTOR 5.00 0.00 X 12678 0 0 LOUIS VOLK III DIRECTOR 5.00 0.00 X 2000 0 0 DAVID JAMES MARTINEZ DDS DIRECTOR 5.00 0.00 X 3500 0 0 ROBERT L SIMMONS CHAIRPERSON 5.00 0.00 X X 16287 0 0 JONATHAN S GROAT THRU 417 GENERAL COUNSEL 1.00 49.00 X 0 394956 20610 GORAN JURKOVIC CPA CFO 1.00 49.00 X 0 2322178 1625591 AMY BASEL VP OF FINANCE 1.00 49.00 X 0 388627 58377 MICHAEL GILMORE VP-CHIEF INVESTMENT OFFICER 1.00 49.00 X 0 394187 73029 JOLOU TRUJILLO-OTTINO VP SALES AND MARKETING 50.00 0.00 X 131247 0 28766 CYNTHIA LUCERO-ALI DIRECTOR, OPERATIONS 50.00 0.00 X 108638 0 19488 NICHOLAS VELAQUEZ DIRECTOR, SALES & ACCT MGT 50.00 0.00 X 105076 0 25181 WALTER BOLIC FORMER PRESIDENT & CEO 0.00 0.00 X 51280 0 0 825557 3645960 1871441 4 1 1 0 DEWPOINT 300 WASHINGTON SQUARE LANSING MI 48933 IT CONSULTING 447345 HUB INTERNATIONAL INSURANCE SERVICE 9990 JEFFERSON NE SUITE 101 ALBUQUERQUE NM 87190 COMMISSIONS 303160 MCKEE WALLWORK & COMPANY LLC 1030 18TH ST NEW ALBUQUERQUE NM 87104 ADVERTISING 197641 MONTGOMERY & ANDREWS PA PO BOX 2307 SANTA FE NM 87504 LEGAL SERVICES 136496 WEST MONROE PARTNERS LLC 222 W ADAMS ST CHICAGO IL 60606 CONSULTING 134257 9 DENTAL CARE REVENUE 524114 110955061 110955061 110955061 846809 846809 13972274 13535972 436302 436302 436302 DISCOUNT CARD INCOME 900099 25655 25655 25655 112263827 110980716 0 1283111 X 113727 113727 459346 298575 160771 1865961 1700539 165422 178364 144232 34132 349232 316827 32405 153647 140752 12895 333089 333089 142325 142325 109834 109834 98970126 98618848 351278 321437 248982 72455 493724 437248 56476 224621 179944 44677 208598 135589 73009 266493 196591 69902 15184 14394 790 56016 36975 19041 40154 40154 COMMISSIONS 1799727 1799727 PROCESSING FEES 1197936 1197936 PREMIUM TAXES 764421 764421 MEMBERSHIP DUES & ASSOC 287091 35123 251968 120291 111672 8619 108471344 106492102 1979242 0 2437207 2077442 2034048 3774165 5883222 5193092 56062 170728 1306117 1160368 188723 145749 33474899 36270885 4740015 5410808 1117229 1129376 49931405 54172245 1700419 1590740 1364821 792383 4068357 3675293 7133597 6058416 X 42797808 48113829 42797808 48113829 49931405 54172245 X 3792483 1482001 41537 X X 0 1 X 1 0 149500 136755 12745 1108992 1001147 107845 47625 22466 25159 145749 5210808 C SURPLUS NOTE RECEIVABLE 200000 C 5410808 CLAIMS RESERVES 3362582 DUE TO AFFILIATE 312711 3675293 112295947 32120 32120 112263827 0 112263827 108471344 0 108471344 0 108471344 PART XI, LINE 2D - OTHER ADJUSTMENTS: GAIN ON RENAISSANCE HOLDING COMPANY INVESTMENT 32,120. 1 SPECIAL OLYMPICS NEW MEXICO INC 6600 PALOMAS NE ALBUQUERQUE NM 87109 850268084 501(C)(3) 10000 CHARITABLE DONATION BLESSINGS IN A BACKPACK 4121 SHELBYVILLE RD LOUISVILLE KY 40207 261964620 501(C)(3) 30227 CHARITABLE DONATION NEW MEXICO DENTAL FOUNDATION 9201 MONTGOMERY BLVD NE ALBUQUERQUE NM 87111 743146433 501(C)(3) 25000 MISSION OF MERCY ALBUQUERQUE HEALTH CARE FOR THE HOMELESS PO BOX 25445 ALBUQUERQUE NM 87125 850368993 501(C)(3) 18000 CHARITABLE DONATION UNIVERSITY OF NEW MEXICO FOUNDATION INC TWO WOODWARD CENTER ALBUQUERQUE NM 87102 850275408 501(C)(3) 30500 CHARITABLE DONATION 5 0 PART I, LINE 2: CONTRIBUTIONS ARE MADE AT THE ORGANIZATION'S DISCRETION TO ORGANIZATIONS THAT SUPPORT DELTA DENTAL PLAN OF NEW MEXICO'S MISSION. IN ORDER FOR FUNDS TO BE DISBURSED, VOUCHER RECORDS MUST PASS THROUGH THE APPROVAL PROCESS, SIMILAR TO ANY OTHER EXPENDITURE MADE BY DELTA DENTAL PLAN OF NEW MEXICO. X 1 1 X X 0 1 0 0 0 0 0 1 0 EDWARD J LOPEZJR PRESIDENT & CEO 250008 0 58800 0 11148 0 12173 0 8226 0 340355 0 0 0 JONATHAN S GROAT THRU 417 GENERAL COUNSEL 0 187582 0 109028 0 98346 0 15706 0 4904 0 415566 0 0 GORAN JURKOVIC CPA CFO 0 1006745 0 1291683 0 23750 0 1603585 0 22006 0 3947769 0 0 AMY BASEL VP OF FINANCE 0 277872 0 106856 0 3899 0 36371 0 22006 0 447004 0 0 MICHAEL GILMORE VP-CHIEF INVESTMENT OFFICER 0 269018 0 124363 0 806 0 51023 0 22006 0 467216 0 0 JOLOU TRUJILLO-OTTINO VP SALES AND MARKETING 123776 0 6614 0 857 0 3509 0 25257 0 160013 0 0 0 WALTER BOLIC FORMER PRESIDENT & CEO 0 0 0 0 51280 0 0 0 0 0 51280 0 0 0 PART I, LINE 1A TRAVEL FOR COMPANIONS RELATED TO TRAVEL FOR A SPOUSE. THIS AMOUNT WAS TREATED AS TAXABLE TO THE BOARD MEMBER OR EMPLOYEE ON A 1099. PART I, LINE 4B 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 7 AS INDICATED IN SCHEDULE J, PART II, TOP MANAGEMENT OFFICIALS RECEIVED A BONUS BASED ON PERFORMANCE AND THE FINANCIAL RESULTS OF THE ORGANIZATION. THIS BONUS WAS APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 6 DELTA DENTAL PLAN OF NEW MEXICO, INC. HAS A SOLE MEMBER, RENAISSANCE HEALTH SERVICE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A BOARD MEMBERS ARE ELECTED BY THE PRESENT BOARD AND ARE APPROVED BY RENAISSANCE HEALTH SERVICE CORPORATION, THE SOLE CORPORATE MEMBER OF DELTA DENTAL PLAN OF NEW MEXICO, INC. FORM 990, PART VI, SECTION A, LINE 7B AS STATED, THE PRESENT BOARD IS ELECTED BY THE CURRENT BOARD MEMBERS, BUT MUST BE APPROVED BY RHSC. FORM 990, PART VI, SECTION B, LINE 11B THE INFORMATION PRESENTED ON THE FORM 990 IS GATHERED BY THE SENIOR TAX ADMINISTRATOR FOR THE ORGANIZATION. THE CFO REVIEWS THE INFORMATION. ONCE APPROVED THE INFORMATION IS GIVEN TO OUTSIDE TAX PREPARERS WHO PREPARE AND REVIEW THE FORM 990. ONCE COMPLETE, A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD TO REVIEW PRIOR TO FILING FORM 990 WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ENTERPRISE'S VICE PRESIDENT AND GENERAL COUNSEL IS CHARGED WITH REVIEWING AND MONITORING ANY POTENTIAL CONFLICT OF INTEREST TRANSACTIONS. ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO REVIEW AND EXECUTE A CONFLICT OF INTEREST POLICY. THIS POLICY REQUIRES THAT ANY CONFLICTS OF INTEREST BE DISCLOSED ON AN ANNUAL BASIS, OR AT ANY OTHER TIME THAT THE PERSON EXECUTING THE POLICY BECOMES AWARE OF A SITUATION OR TRANSACTION THAT ACTUALLY OR POTENTIALLY CREATES A CONFLICT OF INTEREST. ALL CONFLICT OF INTEREST DISCLOSURE FORMS ARE INITIALLY REVIEWED BY THE VICE PRESIDENT AND GENERAL COUNSEL. IF A PROHIBITED TRANSACTION WERE IDENTIFIED, THE MATTER WOULD BE BROUGHT TO THE CHAIRPERSON OF THE BOARD FOR FURTHER REVIEW AND APPROPRIATE ACTION. IN THE EVENT OF A CONFLICT OF INTEREST INVOLVING A MEMBER OF THE BOARD OF DIRECTORS, SUCH AS A CONFLICT IN WHICH A MEMBER HAD AN INTEREST, THE MEMBER IS REQUIRED TO DISCLOSE THE POTENTIAL CONFLICT AND ABSTAIN FROM ANY VOTE ON THE MATTER. WHETHER FURTHER PRECAUTIONS ARE REQUIRED (E.G., PROHIBITING THE INTERESTED PARTY FROM ENGAGING IN DISCUSSIONS) WOULD DEPEND UPON THE SPECIFIC NATURE AND BACKGROUND OF THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 OUTSIDE COMPENSATION CONSULTANTS ARE USED TO DETERMINE MARKET DATA FOR THE EXECUTIVE POSITIONS AND FOR OTHER OFFICERS AND KEY EMPLOYEES. THE POSITIONS COVERED ARE THE CEO AND CFO. THE ORGANIZATION CONTRACTS WITH TOWERS WATSON TO DO A COMPENSATION AND REASONABLENESS ANALYSIS EVERY TWO YEARS. THE FINAL DETERMINATION OF COMPENSATION IS DONE BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, WHICH IS MADE UP OF INDEPENDENT PERSONS, AND IS BASED ON THE COMPARABILITY DATA PROVIDED BY THE COMPENSATION CONSULTANTS. THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARE CONTEMPORANEOUSLY DOCUMENTED IN THE COMMITTEE MINUTES AND APPROVED BY THE BOARD. THE COMPENSATION WAS LAST REVIEWED UNDER THIS PROCESS DURING 2016. THE REPORT BASED ON THIS REVIEW WAS THEN ISSUED BY THE CONSULTANTS IN 2017. FORM 990, PART VI, SECTION C, LINE 19 DELTA DENTAL PLAN OF NEW MEXICO, INC. (DDNM) FILES ON A QUARTERLY AND ANNUAL BASIS COMPREHENSIVE FINANCIAL DOCUMENTS WITH THE NEW MEXICO OFFICE OF INSURANCE SUPERINTENDENT (OSI). OSI AND THE NEW MEXICO SECRETARY OF STATE HAVE ON FILE ALL GOVERNING DOCUMENTS. THE DDNM'S 990 FORM IS AVAILABLE TO THE PUBLIC UPON 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 IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 871,656. MANAGEMENT AND GENERAL EXPENSES 351,278. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,222,934. PURCHASED DENTAL SERVICES: PROGRAM SERVICE EXPENSES 97,747,192. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 97,747,192. FORM 990, PART XI, LINE 9: GAIN ON INVESTMENT IN RENAISSANCE HOLDING COMPANY 32,120. OTHER 9,417. FORM 990, PART XII, LINE 2C: IN REGARDS TO THE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT, THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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 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 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 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 OF KENTUCKY INC 10100 LINN STATION ROAD NO 700 LOUISVILLE KY 40223 610659432 PROVIDE DENTAL SERVICE PLANS KY 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 0 DELTA DENTAL FUND PO BOX 30416 LANSING MI 489097916 382337000 SUPPORT DENTAL EDUCATION AND RESEARCH PROGRAMS MI 501(C)(3) LINE 12B, II DELTA DENTAL PLAN OF MICHIGAN INC 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 ARKANSAS INC 1513 COUNTRY CLUB RD SHERWOOD AR 72120 710561140 PROVIDE DENTAL SERVICE PLANS AR 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 0 DELTA DENTAL OF ARKANSAS FOUNDATION INC 1513 COUNTRY CLUB RD SHERWOOD AR 72120 261569324 EMPHASIZE DENTAL HEALTH IN COMMUNITIES AR 501(C)(3) PF DELTA DENTAL OF ARKANSAS 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 GLM HOLDING COMPANY RELATED 0 0 RENAISSANCE HOLDING COMPANY PO BOX 30381 LANSING MI 48909 412177193 HOLDING COMPANY MI RENAISSANCE HEALTH SERVICE CORPORATION C -44939 2610944 0.04000 0 RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA PO BOX 30381 LANSING MI 48909 470397286 INSURANCE IN RENAISSANCE HOLDING COMPANY C 270820 4047429 0 RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF NEW YORK PO BOX 30381 LANSING MI 48909 134098096 INSURANCE NY RENAISSANCE HOLDING COMPANY C 23006 416558 0 FORE HOLDING CORPORATION 240 VENTURE CIRCLE NASHVILLE TN 37228 204116122 HOLDING COMPANY TN DELTA DENTAL OF TENNESSEE C 0 DENTAL CHOICE INC 10100 LINN STATION RD 700 LOUISVILLE KY 402233861 611105118 PROVIDE DENTAL SERVICE PLANS KY DELTA DENTAL OF KENTUCKY C 0 DENTAL CHOICE AGENCY INC 10100 LINN STATION RD 700 LOUISVILLE KY 402233861 611336003 PRIMARY GENERAL AGENCY FOR DDKY AND DENTAL CHOICE KY DELTA DENTAL OF KENTUCKY C 0 OMEGA ADMINISTRATORS INC 1513 COUNTRY CLUB ROAD SHERWOOD AR 72120 043740469 PROVIDING THIRD-PARTY ADMINISTRATIVE SERVICES AR DELTA DENTAL OF ARKANSAS C 0 GLM HOLDING COMPANY 4100 OKEMOS ROAD OKEMOS MI 48864 472557772 INVESTMENT IN SUBSIDIARIES MI DELTA DENTAL OF MICHIGAN C 0 DEWPOINT INC 300 S WASHINGTON SQUARE LANSING MI 48933 383300595 IT CONSULTING MI GLM HOLDING COMPANY C 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 DELTA DENTAL PLAN OF MICHIGAN INC M 1445503 ACTUAL COST DELTA DENTAL OF NORTH CAROLINA D 200000 ACTUAL COST DELTA DENTAL OF NORTH CAROLINA A 27333 ACTUAL COST