DELTA DENTAL OF IOWA: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- DELTA DENTAL OF IOWA (EIN 42-0959302)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-09
- IRS object ID
- 201813139349301461
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-09T09:45:01-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 421229486 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BROOKS LODDEN PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1441 29TH STREET STE 305 | AddressLine1Txt |
| City | WEST DES MOINES | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 502661357 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420959302 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF IOWA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DELT | BusinessNameControlTxt |
| Phone | 5152615500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9000 NORTHPARK DRIVE | AddressLine1Txt |
| City | JOHNSTON | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50131 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHERRY PERKINS | PersonNm |
| Person Title | VICE PRES FINANCE & CONTROLLER | PersonTitleTxt |
| Phone | 5152615500 | PhoneNum |
| Signature | 2018-11-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BRENT L ALEXANDER | PreparerPersonNm |
| PTIN | P00075113 | PTIN |
| Phone | 5152237300 | PhoneNum |
| Preparation | 2018-11-06 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 38.87.33.4 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-06 | IPDt |
| IP Tm | 08:33:12 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 0796FCE7583AE90769CEF6CA2A629B61E6D445D2 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | C3444C4648654154EBF4172D883208D9409AA90E | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JEFFREY S RUSSELL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9000 NORTHPARK DRIVE | AddressLine1Txt |
| City | JOHNSTON | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50131 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $187,606,039 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.DELTADENTALIA.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1970 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | DENTAL HEALTH CARE: TO IMPROVE THE ORAL HEALTH OF THE PEOPLE WE SERVE. THIS IS ACCOMPLISHED THROUGH THE PROVISION OF DENTAL INSURANCE AND PUBLIC HEALTH CONTRIBUTIONS THAT FOCUS ON ACCESS TO ORAL HEALTH SERVICES AND EDUCATION RELATED TO GOOD ORAL HEALTH BEHAVIORS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 158 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $237,095 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$26,556 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $166,048,526 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $173,892,048 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,832,800 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,440,060 | CYInvestmentIncomeAmt |
| PY Other Revenue | $193,418 | PYOtherRevenueAmt |
| CY Other Revenue | $259,350 | CYOtherRevenueAmt |
| PY Total Revenue | $168,074,744 | PYTotalRevenueAmt |
| CY Total Revenue | $178,591,458 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $7,394,196 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,071,615 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $124,474,650 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $135,173,848 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,117,019 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,428,727 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $20,299,823 | PYOtherExpensesAmt |
| CY Other Expenses | $21,609,737 | CYOtherExpensesAmt |
| PY Total Expenses | $165,285,688 | PYTotalExpensesAmt |
| CY Total Expenses | $175,283,927 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,789,056 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,307,531 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $107,394,521 | TotalAssetsBOYAmt |
| Total Assets EOY | $107,956,531 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $33,934,865 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $31,195,810 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $73,459,656 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $76,760,721 | NetAssetsOrFundBalancesEOYAmt |
| Mission | DENTAL HEALTH CARE: TO IMPROVE THE ORAL HEALTH OF THE PEOPLE WE SERVE. THIS IS ACCOMPLISHED THROUGH THE PROVISION OF DENTAL INSURANCE AND PUBLIC HEALTH CONTRIBUTIONS THAT FOCUS ON ACCESS TO ORAL HEALTH SERVICES AND EDUCATION RELATED TO GOOD ORAL HEALTH BEHAVIORS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $167,101,910 | ExpenseAmt |
| Grant | $3,071,615 | GrantAmt |
| Revenue | $173,914,303 | RevenueAmt |
| Desc | SINCE 1970, DELTA DENTAL OF IOWA HAS EXPANDED ACCESS TO DENTAL CARE BY PROVIDING AFFORDABLE, NETWORK BASED DENTAL BENEFITS PLANS TO IOWA EMPLOYERS AND INDIVIDUALS THAT RESULT IN LONG-TERM COST SAVINGS AND SUPPORT GOOD ORAL HEALTH. DELTA DENTAL OF IOWA'S DENTAL BENEFIT PLANS STRIVE TO INCORPORATE THE CURRENT BEST PRACTICES IN DENTAL SCIENCE. DELTA DENTAL IS COMMITTED TO ITS VISION OF IMPROVING THE ORAL HEALTH OF THE PEOPLE AND COMMUNITIES IT SERVES. DELTA DENTAL FULFILLS ITS NOT-FOR-PROFIT VISION BY ACTIVELY PARTICIPATING IN THE COMMUNITIES IT SERVES AS A CHAMPION AND MAJOR FUNDER OF ORAL HEALTH INITIATIVES IN THE STATE OF IOWA. DELTA DENTAL INVESTS IN ORAL HEALTH PROJECTS THAT MEET THE NEEDS OF UNDERSERVED POPULATIONS AND THAT FOCUS ON ACCESS TO CARE, PREVENTION, EDUCATION AND RESEARCH. | Desc |
| Total Program Service Expenses | $167,101,910 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 18307 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 158 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHERRY PERKINS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5152615500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9000 NORTHPARK DRIVE | AddressLine1Txt |
| City | JOHNSTON | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50131 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| TOM ALLER | ||||||||
| DIRECTOR | 2.50 | Yes (X) | $24,400 | $0 | $0 | |||
| ANNE HENNESSEY DDS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $10,200 | $0 | $0 | |||
| JOHN KEARNS DDS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $31,042 | $0 | $6,300 | |||
| DONNA GRANT | ||||||||
| DIRECTOR | 1.60 | Yes (X) | $9,400 | $0 | $0 | |||
| WILLIAM WEVER DDS | ||||||||
| DIRECTOR | 1.60 | Yes (X) | $600 | $0 | $15,700 | |||
| CHARLES EDWARD BROWN | ||||||||
| DIRECTOR | 1.60 | Yes (X) | $18,900 | $0 | $0 | |||
| ROWENA CROSBIE | ||||||||
| DIRECTOR | 1.60 | Yes (X) | $600 | $600 | $14,700 | 0.50 | ||
| JOHN MALETTA DDS | ||||||||
| DIRECTOR | 1.60 | Yes (X) | $600 | $0 | $15,800 | |||
| TOM MAHONEY | ||||||||
| DIRECTOR | 1.60 | Yes (X) | $600 | $0 | $15,600 | |||
| KRISTA TANNER | ||||||||
| DIRECTOR | 1.60 | Yes (X) | $15,700 | $0 | $0 | |||
| JEFFREY S RUSSELL | ||||||||
| PRESIDENT AND CEO | 40.00 | Yes (X) | $807,127 | $0 | $93,755 | 0.39 | Yes (X) | |
| SHERRY PERKINS | ||||||||
| VICE PRESIDENT FINANCE & CONTROLLER | 40.00 | $302,825 | $0 | $40,660 | 0.67 | Yes (X) | ||
| SUZANNE HECKENLAIBLE | ||||||||
| VICE PRESIDENT PUBLIC AFFAIRS | 30.00 | $259,300 | $0 | $44,559 | 10.00 | Yes (X) | ||
| JEFF CHAFFIN | ||||||||
| DENTAL DIRECTOR | 40.00 | $306,913 | $0 | $52,475 | 1.17 | Yes (X) | ||
| APRIL SCHMALTZ | ||||||||
| VP MARKETING AND BUSINESS DEVELOPMENT | 40.00 | $270,321 | $0 | $42,769 | Yes (X) | |||
| TODD HERREN | ||||||||
| VP TECHNOLOGY | 40.00 | $360,605 | $0 | $50,665 | Yes (X) | |||
| ELIZABETH MYERS | ||||||||
| VICE-PRESIDENT, OPERATIONS | 40.00 | $317,899 | $0 | $64,586 | Yes (X) | |||
| MICHAEL ELAM | ||||||||
| VP SALES & CUSTOMER RELATIONS | 40.00 | $244,890 | $0 | $61,467 | Yes (X) | |||
| BRENDA JENSEN | ||||||||
| ACCOUNT EXECUTIVE | 40.00 | $216,975 | $0 | $29,200 | Yes (X) | |||
| RANAE CALVERT | ||||||||
| DIRECTOR, STRATEGIC BUSINESS SOLUTIONS | 40.00 | $184,177 | $0 | $29,212 | Yes (X) | |||
| JOHN FLEMING | ||||||||
| DIRECTOR, PRICING & UNDERWRITING | 40.00 | $184,369 | $0 | $28,227 | Yes (X) | |||
| RYAN BLACKARD | ||||||||
| MARKETING DIRECTOR | 40.00 | $173,805 | $0 | $30,443 | Yes (X) | |||
| GRETCHEN HAGEMAN | ||||||||
| DIRECTOR, GOVERNMENT PROGRAMS | 40.00 | $174,291 | $0 | $29,302 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,915,539 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $600 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $665,420 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 41 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| UNIVERSITY OF IOWA | |||||
| 322 DENTAL SCIENCE BLDG S | IOWA CITY | IA | 52242 | DENTAL SERVICES | $7,377,702 |
| APPLEWHITE DENTAL IOWA PC | |||||
| 1340 DELHI ST | DUBUQUE | IA | 52001 | DENTAL SERVICES | $5,171,306 |
| ORAL SURGEONS PC | |||||
| 7400 FLEUR DRIVE SUITE 200 | DES MOINES | IA | 50321 | DENTAL SERVICES | $1,959,254 |
| IOWA ORAL & MAXILL SURGEONS PC | |||||
| 1469 29TH ST | WEST DES MOINES | IA | 50266 | DENTAL SERVICES | $1,855,688 |
| CONSAMUS AND HAMPTON DENTAL CLINIC | |||||
| 3324 ORION DRIVE | AMES | IA | 50010 | DENTAL SERVICES | $1,842,605 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 686 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PREMIUMS EARNED | 524114 | $160,222,487 | $160,222,487 |
| ADMINISTRATIVE SERVICE REVENUE | 524292 | $13,669,561 | $13,669,561 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $173,892,048 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,845,188 | TotalRevenueColumnAmt |
| Exclusion | $1,845,188 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $11,609,453 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $9,014,581 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,594,872 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,594,872 | TotalRevenueColumnAmt |
| Exclusion | $2,594,872 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| MANAGEMENT FEES | 541610 | $237,095 | $237,095 | |
| OTHER INCOME | 900099 | $22,255 | $22,255 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $259,350 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $178,591,458 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $173,914,303 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $237,095 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,440,060 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,071,615 | TotalAmt |
| Program Services | $3,071,615 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,173,848 | TotalAmt |
| Program Services | $135,173,848 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,432,859 | TotalAmt |
| Program Services | $1,390,106 | ProgramServicesAmt |
| Management And General | $2,042,753 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,066,194 | TotalAmt |
| Program Services | $7,119,790 | ProgramServicesAmt |
| Management And General | $1,946,404 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $983,047 | TotalAmt |
| Program Services | $640,955 | ProgramServicesAmt |
| Management And General | $342,092 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,032,859 | TotalAmt |
| Program Services | $1,014,116 | ProgramServicesAmt |
| Management And General | $18,743 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $913,768 | TotalAmt |
| Program Services | $651,147 | ProgramServicesAmt |
| Management And General | $262,621 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,733 | TotalAmt |
| Program Services | $8,060 | ProgramServicesAmt |
| Management And General | $31,673 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,901 | TotalAmt |
| Program Services | $35,000 | ProgramServicesAmt |
| Management And General | $123,901 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,504 | TotalAmt |
| Management And General | $52,504 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $192,765 | TotalAmt |
| Management And General | $192,765 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,132,513 | TotalAmt |
| Program Services | $4,803,148 | ProgramServicesAmt |
| Management And General | $329,365 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $818,110 | TotalAmt |
| Program Services | $752,356 | ProgramServicesAmt |
| Management And General | $65,754 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,575,966 | TotalAmt |
| Program Services | $3,122,060 | ProgramServicesAmt |
| Management And General | $453,906 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $501,710 | TotalAmt |
| Program Services | $501,710 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $555,668 | TotalAmt |
| Management And General | $555,668 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $264,952 | TotalAmt |
| Program Services | $172,239 | ProgramServicesAmt |
| Management And General | $92,713 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,234 | TotalAmt |
| Program Services | $65,568 | ProgramServicesAmt |
| Management And General | $59,666 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,065,264 | TotalAmt |
| Program Services | $2,529,701 | ProgramServicesAmt |
| Management And General | $535,563 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,802 | TotalAmt |
| Management And General | $220,802 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BROKER COMMISSIONS | $4,984,089 | $4,984,089 | |
| PREMIUM TAXES | $859,999 | $859,999 | |
| DDPA DUES | $392,847 | $392,847 | |
| CIVIC AND CHARITABLE CO | $288,835 | $31,791 | $257,044 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $379,845 | TotalAmt |
| Program Services | $174,612 | ProgramServicesAmt |
| Management And General | $205,233 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,283,927 | TotalAmt |
| Program Services | $167,101,910 | ProgramServicesAmt |
| Management And General | $8,182,017 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,293,741 | BOYAmt |
| EOY | $11,961,241 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $607,368 | BOYAmt |
| EOY | $718,983 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,227,986 | BOYAmt |
| EOY | $16,860,381 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $447,844 | BOYAmt |
| EOY | $317,074 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $32,744,379 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $10,062,253 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,661,041 | BOYAmt |
| EOY | $22,682,126 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,025,827 | BOYAmt |
| EOY | $52,313,496 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $686,294 | BOYAmt |
| EOY | $1,807,225 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,444,420 | BOYAmt |
| EOY | $1,296,005 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $107,394,521 | BOYAmt |
| EOY | $107,956,531 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,150,373 | BOYAmt |
| EOY | $7,879,078 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,784,492 | BOYAmt |
| EOY | $23,316,732 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,934,865 | BOYAmt |
| EOY | $31,195,810 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $475,819 | BOYAmt |
| EOY | $475,819 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,983,837 | BOYAmt |
| EOY | $76,284,902 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,459,656 | BOYAmt |
| EOY | $76,760,721 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $107,394,521 | BOYAmt |
| EOY | $107,956,531 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,307,531 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$6,466 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,665,500 | OtherCostOrOtherBasisAmt |
| Book Value | $2,665,500 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,851,832 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,529,221 | DepreciationAmt |
| Book Value | $10,322,611 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,891,463 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,084,076 | DepreciationAmt |
| Book Value | $8,807,387 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,335,584 | OtherCostOrOtherBasisAmt |
| Depreciation | $448,956 | DepreciationAmt |
| Book Value | $886,628 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $22,682,126 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| UNEARNED PREMIUMS | $1,387,415 |
| CLAIMS UNPAID AND RESERVE | $18,319,958 |
| OTHER POLICY RESERVES | $540,125 |
| INCENTIVE POOL RESERVE | $1,103,770 |
| INTERCOMPANY PAYABLE | $248,164 |
| OTHER LONG TERM LIABILITIES | $1,717,300 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $23,316,732 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $363,871,186 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $185,709,587 | OtherRevenueAmt |
| Revenue Not Reported | $185,709,587 | RevenueNotReportedAmt |
| Revenue Subtotal | $178,161,599 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $192,764 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $237,095 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $429,859 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $178,591,458 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $360,563,655 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $185,709,587 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $185,709,587 | ExpensesNotReportedAmt |
| Expenses Subtotal | $174,854,068 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $192,764 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $237,095 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $429,859 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $175,283,927 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | DELTA DENTAL OF IOWA IS EXEMPT FROM FEDERAL INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS MADE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE COMPANY ACCOUNTS FOR INCOME TAXES OF TAXABLE CONSOLIDATED ENTITIES, WHEREBY DEFERRED TAXES ARE PROVIDED ON TEMPORARY DIFFERENCES ARISING FROM ASSETS AND LIABILITIES WHOSE BASES ARE DIFFERENT FOR FINANCIAL REPORTING AND INCOME TAX PURPOSES. DEFERRED TAXES WERE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIALS STATEMENTS. AS OF DECEMBER 31, 2017 AND 2016, THE COMPANY'S UNRECOGNIZED TAX BENEFITS WERE NOT SIGNIFICANT. THERE WERE NO SIGNIFICANT PENALTIES OR INTEREST RECOGNIZED OR ACCURED DURING 2017 AND 2016. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | ADMINISTRATIVE SERVICE CLAIMS (NETTED WITH REVENUE) 185,709,578. ROUNDING AMOUNTS 9. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | MANAGEMENT FEES (NETTED WITH EMPLOYEE BENEFITS) 237,095. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | ADMINISTRATIVE SERVICE CLAIMS (NETTED WITH REVENUE) 185,709,578. ROUNDING AMOUNTS 9. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | MANAGEMENT FEES - NETTED WITH EXPENSES FOR FINANCIALS 237,095. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| DELTA DENTAL OF IOWA FOUNDATION | |||||||
| 9000 NORTHPARK DRIVE | JOHNSTON | IA | 50131 | 260762771 | 501(C)(3) | $3,000,000 | CONTRIBUTION TO DELTA DENTAL OF IOWA FOUNDATION TO SUPPORT & IMPROVE THE ORAL HEALTH OF IOWANS. |
| PREVENT BLINDNESS IOWA | |||||||
| 1111 NINTH STREET STE 250 | DES MOINES | IA | 50314 | 426083207 | 501(C)(3) | $25,000 | PROVIDE SUPPORT FOR VISION SCREENING IN 20 IOWA SCHOOLS TARGETING UNDERSERVED CHILDREN. |
| VISION TO LEARN | |||||||
| 900 JACKSON STREET STE LL5-2C | DUBUQUE | IA | 52001 | 453457853 | 501(C)(3) | $25,000 | TO PROVIDE FOLLOW UP CARE TO CHILDREN SCREENED BY VISION TO LEARN BY PROVIDING THEM EYEGLASSES. |
| IOWA KIDSIGHT PROGRAM CO UNIVERSITY OF IOWA FOUNDATION | |||||||
| 2431 CORAL COURT 5 | CORALVILLE | IA | 52241 | 420796760 | 501(C)(3) | $10,000 | TO PROVIDE FREE VISION SCREENING TO CHILDREN 6 MONTHS OF AGE THROUGH KINDERGARTEN WHO ARE LIVING IN IOWA. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 4 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, QUESTION 2: | FormAndLineReferenceDesc |
| Explanation | IN 2017, NO GRANT FUNDS WERE GIVEN TO THE COMMUNITY FOUNDATION OF GREATER DES MOINES. HOWEVER, DELTA DENTAL OF IOWA MAINTAINS A DONOR ADVISED FUND AT THE COMMUNITY FOUNDATION OF GREATER DES MOINES FOR THE PURPOSE OF AWARDING LOAN REPAYMENT AWARDS TO DENTISTS WHO AGREE TO PRACTICE IN AN UNDERSERVED AREA IN THE STATE OF IOWA AND TO DEDICATE A PORTION OF THEIR PRACTICE TO LOW INCOME PATIENTS. DELTA DENTAL OF IOWA ADVISES THE COMMUNITY FOUNDATION OF GREATER DES MOINES ON HOW TO AWARD THIS MONEY AND THE COMMUNITY FOUNDATION OF GREATER DES MOINES ONLY GRANTS THIS MONEY TO DENTISTS IN THE STATE OF IOWA. THE COMMUNITY FOUNDATION OF GREATER DES MOINES AND DELTA DENTAL OF IOWA MAINTAIN RECORDS TO SUBSTANTIATE THE AMOUNT OF GRANTS, THE GRANTEES' ELIGIBILITY AND THE SELECTION CRITERIA. DELTA DENTAL OF IOWA ALSO MAKES GRANTS TO THE DELTA DENTAL OF IOWA FOUNDATION. THE DELTA DENTAL OF IOWA FOUNDATION MAINTAINS RECORDS TO SUBSTANTIATE THE AMOUNT OF GRANTS, THE GRANTEES' ELIGIBILITY AND THE SELECTION CRITERIA. ALL ORGANIZATIONS RECEIVING GRANTS ARE REQUIRED TO SUBMIT FINANCIAL INFORMATION. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFFREY S RUSSELL | ||||||||||||||
| PRESIDENT AND CEO | $539,851 | $0 | $249,896 | $0 | $17,380 | $0 | $76,327 | $0 | $17,428 | $0 | $900,882 | $0 | $0 | $0 |
| SHERRY PERKINS | ||||||||||||||
| VICE PRESIDENT FINANCE & CONTROLLER | $188,300 | $0 | $111,757 | $0 | $2,768 | $0 | $29,762 | $0 | $10,898 | $0 | $343,485 | $0 | $0 | $0 |
| SUZANNE HECKENLAIBLE | ||||||||||||||
| VICE PRESIDENT PUBLIC AFFAIRS | $182,193 | $0 | $75,111 | $0 | $1,996 | $0 | $27,131 | $0 | $17,428 | $0 | $303,859 | $0 | $0 | $0 |
| JEFF CHAFFIN | ||||||||||||||
| DENTAL DIRECTOR | $212,634 | $0 | $90,057 | $0 | $4,222 | $0 | $50,854 | $0 | $1,621 | $0 | $359,388 | $0 | $0 | $0 |
| APRIL SCHMALTZ | ||||||||||||||
| VP MARKETING AND BUSINESS DEVELOPMEN | $188,356 | $0 | $79,965 | $0 | $2,000 | $0 | $32,584 | $0 | $10,185 | $0 | $313,090 | $0 | $0 | $0 |
| TODD HERREN | ||||||||||||||
| VP TECHNOLOGY | $224,227 | $0 | $133,706 | $0 | $2,672 | $0 | $41,773 | $0 | $8,892 | $0 | $411,270 | $0 | $0 | $0 |
| ELIZABETH MYERS | ||||||||||||||
| VICE-PRESIDENT, OPERATIONS | $197,715 | $0 | $116,275 | $0 | $3,909 | $0 | $58,599 | $0 | $5,987 | $0 | $382,485 | $0 | $0 | $0 |
| MICHAEL ELAM | ||||||||||||||
| VP SALES & CUSTOMER RELATIONS | $176,237 | $0 | $65,718 | $0 | $2,935 | $0 | $59,726 | $0 | $1,741 | $0 | $306,357 | $0 | $0 | $0 |
| BRENDA JENSEN | ||||||||||||||
| ACCOUNT EXECUTIVE | $60,493 | $0 | $154,964 | $0 | $1,518 | $0 | $17,445 | $0 | $11,755 | $0 | $246,175 | $0 | $0 | $0 |
| RANAE CALVERT | ||||||||||||||
| DIRECTOR, STRATEGIC BUSINESS SOLUTIO | $144,065 | $0 | $38,594 | $0 | $1,518 | $0 | $14,923 | $0 | $14,289 | $0 | $213,389 | $0 | $0 | $0 |
| JOHN FLEMING | ||||||||||||||
| DIRECTOR, PRICING & UNDERWRITING | $143,501 | $0 | $39,150 | $0 | $1,718 | $0 | $15,138 | $0 | $13,089 | $0 | $212,596 | $0 | $0 | $0 |
| RYAN BLACKARD | ||||||||||||||
| MARKETING DIRECTOR | $136,175 | $0 | $36,112 | $0 | $1,518 | $0 | $14,136 | $0 | $16,307 | $0 | $204,248 | $0 | $0 | $0 |
| GRETCHEN HAGEMAN | ||||||||||||||
| DIRECTOR, GOVERNMENT PROGRAMS | $136,865 | $0 | $35,908 | $0 | $1,518 | $0 | $14,068 | $0 | $15,234 | $0 | $203,593 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | TRAVEL FOR THE SPOUSE OF THE PRESIDENT AND CEO IS PAID BY THE COMPANY. THE TOTAL AMOUNT OF THE TRAVEL IS INCLUDED IN TAXABLE WAGES FOR THE PRESIDENT AND CEO. TAX GROSS UP PAYMENTS ARE RELATED TO TAXABLE FRINGE BENEFITS INCLUDED AS COMPENSATION FOR ALL COMPANY EMPLOYEES INCLUDING THE PERSONS LISTED IN PART VII, SECTION A, LINE 1. THE PAYMENTS REPRESENT 1% OR LESS OF COMPENSATION FOR THE INDIVIDUALS. SOCIAL CLUB DUES FOR THE PRESIDENT & CEO ARE PAID BY THE COMPANY. THE AMOUNT OF PERSONAL USAGE OF THE CLUB IS INCLUDED IN TAXABLE WAGES FOR THE PRESIDENT & CEO. |
| PART I, LINE 4B | PRIOR TO JANUARY 1, 2016, THE OFFICERS OF THE COMPANY PARTICIPATED IN A NONQUALIFIED DEFERRED COMPENSATION PLAN AS SET FORTH IN SECTIONS 201(2), 301(A)(3), AND 401(A)(1) OF ERISA. THIS PLAN ENDED DECEMBER 31, 2015 AND PER THE PLAN DOCUMENT, VESTED EMPLOYEES ARE IN THE PROCESS OF BEING PAID BENEFITS DUE TO THEM. OFFICERS WHO RECEIVED PAYMENTS OF VESTED AMOUNTS IN 2017 AND THE AMOUNTS ARE: JEFFREY S. RUSSELL $ 43,455 SHERRY PERKINS $ 7,170 SUZANNE HECKENLAIBLE $ 6,202 EFFECTIVE JANUARY 1, 2016, THE OFFICERS OF THE COMPANY PARTICIPATE IN A SEC. 457(F) PLAN. DELTA DENTAL OF IOWA MAKES A CONTRIBUTION TO THE PLAN ANNUALLY ON BEHALF OF THE OFFICERS. THIS CONTRIBUTION IS A PERCENTAGE OF SALARY AND IS SET AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF DELTA DENTAL OF IOWA. THE PORTION OF A PARTICIPANT'S ACCOUNT BALANCE ALLOCATED TO A PARTICULAR PLAN YEAR'S AWARD BECOMES VESTED ON JANUARY 1ST OF THE FOURTH YEAR FOLLOWING THE PLAN YEAR FOR WHICH THE AWARD IS GRANTED. THAT AMOUNT IS THEN PAID TO THE OFFICER. OTHER THAN THE VESTING CRITERIA, THE OFFICERS CANNOT ACCESS THE FUNDS UNTIL RETIREMENT, LEAVING THE COMPANY, OR DEATH. OFFICERS WHO RECEIVED DEPOSITS IN 2017 FROM DELTA DENTAL OF IOWA AND THE AMOUNTS ARE: SHERRY PERKINS $ 8,162 SUZANNE HECKENLAIBLE $ 6,792 JEFFREY S. RUSSELL $ 54,727 JEFF CHAFFIN $ 29,254 APRIL SCHMALTZ $ 10,984 TODD HERREN $ 20,173 ELIZABETH MYERS $ 36,999 MICHAEL ELAM $ 39,298 THE OFFICERS OF DELTA DENTAL OF IOWA ALSO PARTICIPATE IN A LONG-TERM INCENTIVE PLAN. THE PLAN IS INTENDED AND AT ALL TIMES SHALL BE AN UNFUNDED AND UNSECURED PLAN THAT IS LIMITED TO KEY MANAGEMENT EMPLOYEES OF THE ORGANIZATION DESIGNED TO ENHANCE THE BOARD'S EFFORT AT RETENTION OF ITS EXECUTIVE STAFF. NO PAYMENTS WERE MADE IN 2017. |
| PART I, LINE 5 | TWO EMPLOYEES OF THE COMPANY HAVE COMPENSATION CONTINGENT ON REVENUES. THE INDIVIDUALS WORK IN THE SALES DEPARTMENT AND RECEIVE COMMISSIONS BASED ON SALES OF GROUP BUSINESS. THESE INDIVIDUALS ARE RESPONSIBLE FOR SELLING NEW BUSINESS. |
| PART I, LINE 6 | CONSISTENT WITH THE COMPANY'S TOTAL COMPENSATION POLICY, THE OFFICERS AND HIGHER COMPENSATED EMPLOYEES, ALONG WITH ALL EMPLOYEES OF THE COMPANY, PARTICIPATE IN A COMPANY INCENTIVE COMPENSATION PLAN. THIS PLAN CONTAINS EIGHT METRICS WHICH REPRESENT KEY GOALS FOR THE PLAN YEAR. AN OVERALL WEIGHTED SCORE IS CALCULATED. A BONUS WILL BE PAID IF THE COMPANY MEETS A RANGE OF GOAL ACCOMPLISHMENTS FOR THE YEAR. THE AMOUNT OF THE BONUS IS BASED ON THE TOTAL SCORE. ONE OF THESE METRICS IS PROFITABILITY, WHICH IS DEFINED AS "TOTAL NET GAIN IN DOLLARS PRIOR TO ORAL HEALTH CONTRIBUTIONS FOR THE FISCAL YEAR PER AUDITED FINANCIAL RESULTS." |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (8 entries)
| Sharing Of RevenuesSharingOfRevenuesInd | Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc |
|---|---|---|---|
| (no name) | |||
| 0 | |||
| DONNA GRANT | |||
| 0 | DIRECTOR | $169,806 | INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES |
| WILLIAM WEVER DDS | |||
| 0 | DIRECTOR | $132,368 | INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES |
| JOHN MALETTA DDS | |||
| 0 | DIRECTOR | $170,202 | INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES |
| CHARLES EDWARD BROWN | |||
| 0 | DDIA DIRECTOR & OFFICER OF EMPLOYER WHO PURCHASES DENTAL BENEFITS FROM DDIA | $478,950 | PAYMENTS BY EMPLOYER TO DDIA FOR DENTAL BENEFITS |
| TOM MAHONEY | |||
| 0 | DDIA DIRECTOR & OFFICER OF EMPLOYER WHO PURCHASES DENTAL BENEFITS FROM DDIA | $187,828 | PAYMENTS BY EMPLOYER TO DDIA FOR DENTAL BENEFITS |
| JOHN KEARNS DDS | |||
| 0 | DIRECTOR | $159,563 | INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES |
| ANNE HENNESSEY DDS | |||
| 0 | DIRECTOR | $119,807 | INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | E. BROWN AND J. MALETTA HAD A PROVIDER-RELATED BUSINESS RELATIONSHIP IN 2017. D. GRANT AND J. CHAFFIN HAD A PROVIDER-RELATED BUSINESS RELATIONSHIP IN 2017. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBERS OF THE CORPORATION CONSIST OF THE PROVIDERS (PARTICIPATING DENTISTS), AND SUBSCRIBERS WHO ARE ELECTED BY THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE DIRECTORS SHALL BE ELECTED BY THE MEMBERS. SUBSCRIBER MEMBERS MAY NOMINATE CANDIDATES FOR SUBSCRIBER DIRECTOR POSITIONS AND PROVIDER MEMBERS MAY NOMINATE CANDIDATES FOR THE PROVIDER DIRECTOR POSITIONS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 AND ALL RELATED SCHEDULES WERE REVIEWED BY BOTH THE MANAGEMENT OF THE COMPANY AND THE BOARD OF DIRECTORS PRIOR TO FILING. THE FORM 990 WAS REVIEWED BY MANAGEMENT OF THE COMPANY PRIOR TO PRESENTATION TO THE BOARD. THE MEMBERS OF THE MANAGEMENT TEAM WHO REVIEWED THE FORM 990 WERE THE CEO, COMPLIANCE DIRECTOR, AND VICE PRESIDENT FINANCE. AN ELECTRONIC DRAFT COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS. ALL MEMBERS OF THE BOARD REVIEWED THE FORM 990 AND RELATED SCHEDULES PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE COMPLIANCE DIRECTOR, ON BEHALF OF THE GOVERNANCE COMMITTEE, CONDUCTS AN ANNUAL CONFLICT OF INTEREST REVIEW FOR COMPLIANCE WITH FEDERAL AND STATE LAW AND THE GOVERNANCE POLICY. THE REVIEW INCLUDES ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES. COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES AND DISCLOSURES ARE COMPARED TO THE GROUP FOR POTENTIALLY CONFLICTING TRANSACTIONS, BUSINESS AND FAMILY RELATIONSHIPS, AND AFFILIATIONS. ANNUAL COMPENSATION, REIMBURSEMENTS, BENEFIT PAYMENTS, AND OTHER TRANSACTIONS ARE ALSO REVIEWED FOR APPROPRIATENESS. A WRITTEN REPORT OF THE FINDINGS IS PRESENTED TO THE GOVERNANACE COMMITTEE, BOARD OF DIRECTORS AND SENIOR MANAGEMENT. SOLUTIONS TO POTENTIAL CONFLICTS ARE DISCUSSED AND DOCUMENTED IN THE BOARD OF DIRECTOR'S MEETING MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15 | ON A BI-ANNUAL BASIS, DELTA DENTAL OF IOWA DOES A MARKET PRICE AND BENCHMARKING COMPARISON OF THE COMPENSATION OF THE LEADERSHIP TEAM AND THE STAFF. THIS ANALYSIS IS PERFORMED BY AN INDEPENDENT THIRD PARTY. THIS ANALYSIS INCLUDES THE USE OF DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THE DOCUMENTED RESULTS AND RECOMMENDATIONS OF THIS ANALYSIS ARE PRESENTED TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS REVIEWS THE DOCUMENTATION AND APPROVES THE COMPENSATION. THESE DECISIONS ARE DOCUMENTED IN THE MINUTES OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | DELTA DENTAL OF IOWA'S GOVERNING DOCUMENTS BECOME A MATTER OF PUBLIC RECORD WHEN THEY ARE FILED WITH THE IOWA SECRETARY OF STATE. THE FINANCIAL STATEMENTS BECOME A MATTER OF PUBLIC RECORD WHEN THEY ARE FILED WITH THE IOWA INSURANCE DIVISION. BOTH AGENCIES HAVE ONLINE PUBLIC VIEWING ACCESS. THE CONFLICT OF INTEREST POLICY IS NOT FILED WITH THE STATE AGENCIES; HOWEVER, IT WOULD BE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 2C: | THE ORGANIZATION HAS A FINANCE AND AUDIT COMMITTEE THAT HAS RESPONSIBILITY FOR SELECTION OF THE INDEPENDENT ACCOUNTANT AND OVERSIGHT OF THE AUDIT. THE BOARD OF DIRECTORS APPROVES THE ANNUAL APPOINTMENT OF THE INDEPENDENT ACCOUNTANT. |
| SCHEDULE R, PART I, COLUMN B: | VERATRUS INVESTMENTS, LLC IS A FOR PROFIT CORPORATION FORMED IN 2017 AND IS WHOLLY-OWNED BY VERATRUS HEALTH, INC. AND IS CONSIDERED A DISREGARDED ENTITY. ITS PRIMARY ACTIVITY IS INVESTING IN ORGANIZATIONS THAT FURTHER THE MISSION OF VERATRUS HEALTH, INC. |
| SCHEDULE R, PART II, COLUMN B: | DELTA DENTAL OF IOWA'S VISION IS TO IMPROVE THE ORAL HEALTH OF THOSE WE SERVE. AN AMOUNT IS SET ASIDE EACH YEAR TO FUND THIS MISSION. THE AMOUNT IS DETERMINED BY THE PERFORMANCE AND FINANCIAL STRENGTH OF THE COMPANY. AFTER THE AUDITED FINANCIALS ARE COMPLETE, AN AMOUNT IS PAID TO THE DELTA DENTAL OF IOWA FOUNDATION. THE DELTA DENTAL OF IOWA FOUNDATION IS A SEC. 501(C)(3) ORGANIZATION AND IS A TYPE 1 SUPPORTING ORGANIZATION UNDER SEC. 509(A)(3). IT IS THE RESPONSIBILITY OF THE FOUNDATION TO DISTRIBUTE THE MONIES CONSISTENT WITH IT'S MISSION AND FOUNDING DOCUMENTS. THE MISSION OF THE DELTA DENTAL OF IOWA FOUNDATION IS TO SUPPORT AND IMPROVE THE ORAL HEALTH OF IOWANS. THE FOUNDATION WILL PROVIDE FUNDS TO OTHER SEC. 501(C)(3) ORGANIZATIONS, GOVERNMENTS, OR ACADEMIC INSTITUTIONS THAT ARE UNDERTAKING PROJECTS THAT SUPPORT AND IMPROVE THE ORAL HEALTH OF IOWANS. THE FOUNDATION WILL PROVIDE FUNDS TO OTHER TAX-EXEMPT ORGANIZATIONS THROUGH THEIR GRANTS PROGRAM THAT ALIGN WITH THE PROJECTS OF ACCESS TO CARE, RESEARCH, EDUCATION AND PREVENTION. THE AMOUNT CONTRIBUTED TO THE FOUNDATION IN 2017 WAS $3,000,000. ADDITIONALLY, DELTA DENTAL OF IOWA PROVIDES MANAGEMENT SERVICES FOR THE FOUNDATION. THIS INCLUDES DUTIES PERFORMED BY THE CHIEF EXECUTIVE OFFICER AND THE VICE PRESIDENT, FINANCE. THE EXECUTIVE DIRECTOR OF THE FOUNDATION IS THE DIRECTOR OF GOVERNMENT AND COMMUNITY RELATIONS FOR DELTA DENTAL OF IOWA. ALSO, DELTA DENTAL OF IOWA PROVIDES SOME ACOUNTING FUNCTIONS. THE FOUNDATION REIMBURSES DELTA DENTAL OF IOWA FOR ALL STAFF CHARGES RELATED TO THE FOUNDATION. THE AMOUNT REIMBURSED TO DELTA DENTAL OF IOWA IN 2017 WAS $309,173 FOR MANAGEMENT FEES AND $13,720 FOR OTHER EXPENSES. |
| SCHEDULE R, PART IV, COLUMN B: | VERATRUS BENEFIT SOLUTIONS, INC. (VERATRUS) IS A FOR-PROFIT CORPORATION. PRIOR TO 2017, IT WAS A WHOLLY-OWNED SUBSIDIARY OF DELTA DENTAL OF IOWA. VERATRUS WAS ORGANIZED TO DISTRIBUTE THE DELTA VISION PRODUCT. DELTA DENTAL OF IOWA COLLECTS PREMIUMS FROM GROUPS FOR VISION COVERAGE AND TRANSFERS THIS PREMIUM TO VERATRUS. IN 2017, DELTA DENTAL OF IOWA TRANSFERRED $3,405,777 TO VERATRUS FOR PREMIUMS COLLECTED ON THEIR BEHALF. IN ADDITION, DELTA DENTAL OF IOWA PROVIDES MANAGEMENT SERVICES TO VERATRUS. VERATRUS REIMBURSES DELTA DENTAL OF IOWA FOR ALL STAFF CHARGES RELATED TO VERATRUS. THE AMOUNT REIMBURSED TO DELTA DENTAL OF IOWA IN 2017 WAS $237,095 FOR MANAGEMENT FEES AND $376,714 FOR OTHER EXPENSES. DELTA DENTAL OF IOWA ALSO PURCHASES VISION BENEFITS FROM VERATRUS FOR DDIA EMPLOYEES. THE AMOUNT PAID TO VERATRUS IN 2017 FOR VISION BENEFITS FOR DDIA EMPLOYEES WAS $20,307. VERATRUS HEALTH, INC. IS A FOR PROFIT CORPORATION FORMED IN 2017 AND IS WHOLLY-OWNED BY DELTA DENTAL OF IOWA. IN 2017 DELTA DENTAL OF IOWA CONTRIBUTED CAPITAL OF $1,050,000 TO FORM VERATRUS HEALTH, INC. IN 2017 DELTA DENTAL ALSO TRANSFERRED 100% OF THE OWNERSHIP OF VERATRUS BENEFIT SOLUTIONS TO VERATRUS HEALTH, INC., VALUED AT $624,541. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VERATRUS INVESTMENTS LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9000 NORTHPARK DRIVE | AddressLine1Txt |
| City | JOHNSTON | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50131 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 384028167 | EIN |
| Primary Activities | INVESTING IN ORGANIZATIONS THAT FURTHER THE MISSION OF VERATRUS HEALTH, INC. | PrimaryActivitiesTxt |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Total Income | $0 | TotalIncomeAmt |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VERATRUS HEALTH INC | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF IOWA FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9000 NORTHPARK DRIVE | AddressLine1Txt |
| City | JOHNSTON | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50131 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 260762771 | EIN |
| Primary Activities | CHARITABLE ORGANIZATION TO SUPPORT AND IMPROVE THE ORAL HEALTH OF IOWANS. | PrimaryActivitiesTxt |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF IOWA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VERATRUS HEALTH INC | ||||||||||||
| 9000 NORTHPARK DRIVE | JOHNSTON | IA | 50131 | 815414506 | HOLDING COMPANY | IA | DENTAL DENTAL OF IOWA | C | $3,511,650 | $1,837,935 | 1.00000 | Yes (1) |
| VERATRUS BENEFIT SOLUTIONS INC | ||||||||||||
| 9000 NORTHPARK DRIVE | JOHNSTON | IA | 50131 | 271584394 | FOR-PROFIT CORPORATION ORGANIZED TO DISTRIBUTE THE DELTA VISION PRODUCT. | IA | VERATRUS HEALTH INC | C | 0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (7 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| DELTA DENTAL OF IOWA FOUNDATION | ||
| B | $3,000,000 | SEE PART VII - SUPPLEMENTAL INFO. |
| DELTA DENTAL OF IOWA FOUNDATION | ||
| O | $309,173 | SEE PART VII - SUPPLEMENTAL INFO. |
| VERATRUS BENEFIT SOLUTIONS INC | ||
| O | $237,095 | SEE PART VII - SUPPLEMENTAL INFO. |
| VERATRUS BENEFIT SOLUTIONS INC | ||
| R | $3,405,777 | SEE PART VII - SUPPLEMENTAL INFO. |
| VERATRUS BENEFIT SOLUTIONS INC | ||
| Q | $376,714 | SEE PART VII - SUPPLEMENTAL INFO. |
| VERATRUS HEALTH INC | ||
| B | $1,050,000 | SEE PART VII - SUPPLEMENTAL INFO. |
| VERATRUS HEALTH INC | ||
| B | $624,541 | SEE PART VII - SUPPLEMENTAL INFO. |
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, SCHEDULE R, PART V, LINE 2(1), COLUMN D: | PERCENTAGE OF REVENUE BASED ON BOARD APPROVED POLICY |
| FORM 990, SCHEDULE R, PART V, LINE 2(2), COLUMN D: | MANAGEMENT FEES CHARGED TO DELTA DENTAL OF IOWA FOUNDATION BASED ON HOURS WORKED |
| FORM 990, SCHEDULE R, PART V, LINE 2(3), COLUMN D: | MANAGEMENT FEES CHARGED TO VERATRUS BENEFIT SOLUTIONS, INC. BASED ON HOURS WORKED |
| FORM 990, SCHEDULE R, PART V, LINE 2(4), COLUMN D: | VISION PREMIUMS BILLED AND COLLECTED BY DDIA ON BEHALF OF VERATRUS BENEFIT SOLUTIONS, INC. CASH WAS TRANSFERRED FROM DDIA TO VERATRUS FOR THESE PREMIUMS. |
| FORM 990, SCHEDULE R, PART V, LINE 2(5), COLUMN D: | ACTUAL COST OF INVOICES PAID BY DDIA ON BEHALF OF VERATRUS BENEFIT SOLUTIONS, INC. |
| FORM 990, SCHEDULE R, PART V, LINE 2(6), COLUMN D: | CAPITAL CONTRIBUTION TO VERATRUS HEALTH, INC. FOR FORMATION OF ENTITY. |
| FORM 990, SCHEDULE R, PART V, LINE 2(7), COLUMN D: | TRANSFER OF OWNERSHIP OF VERATRUS BENEFIT SOLUTIONS, INC. TO VERATRUS HEALTH, INC. BASED ON FAIR VALUE OF ASSETS. |
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