DELTA DENTAL PLAN OF KANSAS INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL PLAN OF KANSAS INC (EIN 48-0793267)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-01
IRS object ID
201843059349301699
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)
Return2018-11-01T15:08:38-05:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14310 17TH AVE S PO BOX 2545AddressLine1Txt
CityFARGOCityNm
State AbbreviationNDStateAbbreviationCd
ZIP581082545ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN480793267EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Delta Dental of Kansas IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlDELTBusinessNameControlTxt
Phone3162641099PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11619 N Waterfront ParkwayAddressLine1Txt
CityWichitaCityNm
State AbbreviationKSStateAbbreviationCd
ZIP67206ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMichael EllisPersonNm
Person TitleExecutive VPPersonTitleTxt
Phone3162641099PhoneNum
Signature2018-10-25SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKIM C HUNWARDSENPreparerPersonNm
PTINP00484560PTIN
Phone7012398500PhoneNum
Preparation2018-10-25PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address216.147.170.229IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-10-25IPDt
IP Tm13:57:53IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id66CC91E6B7F11C4783FFFA5645E675327CB67316AtSubmissionCreationDeviceId
At Submission Filing Device IdB602D594AFD2B0B327E07A06F36CA6A7E42546D0AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2018-06-14 16:35:46ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMichael EllisPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11619 N Waterfront ParkwayAddressLine1Txt
CityWichitaCityNm
State AbbreviationKSStateAbbreviationCd
ZIP67206ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$314,462,237GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website Addresswww.deltadentalks.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1972FormationYr
Legal Domicile StateKSLegalDomicileStateCd
Activity Or MissionTo make possible and facilitate a wider and more timely availability of oral health care.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee138TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$296,109,181PYProgramServiceRevenueAmt
CY Program Service Revenue$303,515,482CYProgramServiceRevenueAmt
PY Investment Income$1,016,073PYInvestmentIncomeAmt
CY Investment Income$1,819,880CYInvestmentIncomeAmt
PY Other Revenue$7,562PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$297,132,816PYTotalRevenueAmt
CY Total Revenue$305,335,362CYTotalRevenueAmt
PY Grants And Similar Paid$636,225PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,221,911CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,005,338PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$11,576,495CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$282,888,435PYOtherExpensesAmt
CY Other Expenses$287,487,812CYOtherExpensesAmt
PY Total Expenses$294,529,998PYTotalExpensesAmt
CY Total Expenses$300,286,218CYTotalExpensesAmt
PY Revenues Less Expenses$2,602,818PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,049,144CYRevenuesLessExpensesAmt
Total Assets BOY$67,072,661TotalAssetsBOYAmt
Total Assets EOY$74,038,776TotalAssetsEOYAmt
Total Liabilities BOY$7,616,699TotalLiabilitiesBOYAmt
Total Liabilities EOY$7,778,216TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$59,455,962NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$66,260,560NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTo make possible and facilitate a wider and more timely availability of dental care, thereby advancing the public health and the science and art of dentistry in the state of Kansas, by establishing, maintaining, and operating a non-profit prepayment dental service plan or plans in the state of Kansas.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant ChangeYes (1)SignificantChangeInd
Expense$274,194,288ExpenseAmt
Revenue$293,196,376RevenueAmt
DescDental benefits (covered charges) provided to subscribers. Delta Dental served approximately 928,826 people this year.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$9,783,789ExpenseAmt
Revenue$10,319,106RevenueAmt
DescThe processing of dental benfit claims.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$1,221,911ExpenseAmt
Grant$1,221,911GrantAmt
DescGrants paid out to 501(c)(3) organizations.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$285,199,988TotalProgramServiceExpensesAmt
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 Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
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 EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
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 Document29061IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee138EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
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 Committees0MinutesOfCommitteesInd
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 Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Michael EllisBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3162641099PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11619 N Waterfront ParkwayAddressLine1Txt
CityWichitaCityNm
State AbbreviationKSStateAbbreviationCd
ZIP67206ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Nancy Zogleman
Chairperson0.680.08Yes (X)Yes (X)$16,450$0$510
Dr Alan Marcotte
Vice Chairperson0.570.18Yes (X)Yes (X)$19,606$0$1,481
Angie McClure
Director0.570.00Yes (X)$13,142$0$1,481
Dr Patrick Moriarty
Director0.510.00Yes (X)$11,865$0$1,481
Mark Philips
Director0.630.10Yes (X)$14,274$0$1,481
Dr Lucynda Raben
Director0.660.00Yes (X)$13,456$0$510
Dr Brick Scheer
Director0.560.00Yes (X)$11,935$0$0
Ruth Teichman
Director0.450.00Yes (X)$11,451$0$1,252
Bruce Witt
Director (partial year)0.390.00Yes (X)$9,422$0$987
Kimberly Borchers
Director (partial year)0.210.00Yes (X)$3,664$0$0
Gary Yager
Director0.600.00Yes (X)$12,456$0$0
Michael Herbert
President and CEO34.885.88Yes (X)$390,193$0$61,396
Michael Ellis
Executive VP/CFO/Treasurer38.391.56Yes (X)$293,776$0$53,061
Nancy Umholtz
Secretary37.060.99Yes (X)$106,113$0$20,370
Dean Newton
Managing Director & Executive VP39.843.00$290,404$0$61,974Yes (X)
James Tuttle
Chief Operating Officer39.200.80$188,946$0$7,615Yes (X)
Robert Ebenkamp
VP Information Technology39.950.17$207,041$0$32,754Yes (X)
Dr Jon Tilton
VP Professional Review/Dental Direct40.000.00$219,235$0$39,425Yes (X)
Junetta Everett
VP Professional Relations39.300.26$203,358$0$36,976Yes (X)
Keith Asplund
VP Product Management29.0114.58$195,242$0$30,742Yes (X)
Bryce Dougherty
Controller38.251.75$174,689$0$35,406Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,406,718TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$388,902TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K25IndivRcvdGreaterThan100KCnt
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
Jenkins & Leblanc PA
6810 Silverheel StShawneeKS66226Dental Services$1,853,777
Wichita Family Dental Partnership
9339 E 21ST ST NWichitaKS67206Dental Services$1,471,427
Gage Center Dental Group PA
1271 SW Woodhull StTopekaKS66604Dental Services$1,453,713
Martin and Frankenberry DDS PA
3101 N Cypress StWichitaKS67226Dental Services$1,390,242
Wichita Endodontics LLC
3535 E Central AveWichitaKS67208Dental Services$1,242,008
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K559CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescDental ServicesDesc
Business524298BusinessCd
Total Revenue Column$303,513,105TotalRevenueColumnAmt
Related Or Exempt Func Income$303,513,105RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,377TotalRevenueColumnAmt
Related Or Exempt Func Income$2,377RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$303,515,482TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,027,756TotalRevenueColumnAmt
Exclusion$1,027,756ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$9,918,999SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$9,126,875SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$792,124SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$792,124TotalRevenueColumnAmt
Exclusion$792,124ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$305,335,362TotalRevenueColumnAmt
Related Or Exempt Func Income$303,515,482RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,819,880ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,221,911TotalAmt
Program Services$1,221,911ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,632,864TotalAmt
Program Services$224,974ProgramServicesAmt
Management And General$1,407,890ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,477,833TotalAmt
Program Services$3,425,380ProgramServicesAmt
Management And General$4,052,453ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,045,212TotalAmt
Program Services$564,878ProgramServicesAmt
Management And General$480,334ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$831,697TotalAmt
Program Services$323,213ProgramServicesAmt
Management And General$508,484ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$588,889TotalAmt
Program Services$264,233ProgramServicesAmt
Management And General$324,656ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$39,677TotalAmt
Management And General$39,677ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$94,542TotalAmt
Management And General$94,542ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$48,134TotalAmt
Management And General$48,134ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$169,887TotalAmt
Management And General$169,887ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,702,244TotalAmt
Program Services$146,219ProgramServicesAmt
Management And General$4,556,025ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$907,716TotalAmt
Management And General$907,716ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,681,247TotalAmt
Program Services$1,483,552ProgramServicesAmt
Management And General$197,695ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$50,938TotalAmt
Program Services$34,323ProgramServicesAmt
Management And General$16,615ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$265,265TotalAmt
Management And General$265,265ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$463,660TotalAmt
Program Services$17,218ProgramServicesAmt
Management And General$446,442ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$81,740TotalAmt
Program Services$18,955ProgramServicesAmt
Management And General$62,785ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$479,635TotalAmt
Program Services$230,225ProgramServicesAmt
Management And General$249,410ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$123,082TotalAmt
Management And General$123,082ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Claims$275,218,294$275,218,294
State Premium Taxes$1,125,574$1,125,574
Clearing House Expense$403,302$382,557$20,745
Equipment Rental and Ma$347,609$316,116$31,493

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,285,266TotalAmt
Program Services$202,366ProgramServicesAmt
Management And General$1,082,900ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$300,286,218TotalAmt
Program Services$285,199,988ProgramServicesAmt
Management And General$15,086,230ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$800BOYAmt
EOY$800EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,209,180BOYAmt
EOY$5,833,195EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,198,094BOYAmt
EOY$5,380,630EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$401,663BOYAmt
EOY$331,911EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$12,338,923LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,976,201LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$7,762,773BOYAmt
EOY$7,362,722EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$41,954,935BOYAmt
EOY$45,434,046EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$8,121,760BOYAmt
EOY$9,239,675EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$423,456BOYAmt
EOY$455,797EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$67,072,661BOYAmt
EOY$74,038,776EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,256,318BOYAmt
EOY$7,057,109EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$360,381BOYAmt
EOY$721,107EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,616,699BOYAmt
EOY$7,778,216EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$59,455,962BOYAmt
EOY$66,260,560EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$59,455,962BOYAmt
EOY$66,260,560EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$67,072,661BOYAmt
EOY$74,038,776EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,049,144ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,605,300NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$150,154OtherChangesInNetAssetsAmt
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$1,401,415OtherCostOrOtherBasisAmt
Book Value$1,401,415BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,332,320OtherCostOrOtherBasisAmt
Depreciation$2,106,940DepreciationAmt
Book Value$5,225,380BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,605,188OtherCostOrOtherBasisAmt
Depreciation$2,869,261DepreciationAmt
Book Value$735,927BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$7,362,722TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescInv in Surency Life & HealthDesc
Book Value$9,239,675BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$9,239,675TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescUnearned PremiumsDesc
Amt$721,107Amt
FieldValueIRS element (for citing)
Total Liability$721,107TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$307,127,756TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$1,605,300NetUnrealizedGainsInvstAmt
Other Revenue$356,981OtherRevenueAmt
Revenue Not Reported$1,962,281RevenueNotReportedAmt
Revenue Subtotal$305,165,475RevenueSubtotalAmt
Investment Expenses Not Incld$169,887InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$169,887RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$305,335,362TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$300,323,136TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$300,323,136ExpensesSubtotalAmt
Investment Expenses Not Incld2$169,887InvestmentExpensesNotIncld2Amt
Other Expenses Not Included-$206,805OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt-$36,918ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$300,286,218TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X, Line 2:Delta Dental of Kansas, Inc. is tax exempt under Section 50l(c)(4) of the Internal Revenue Code and a similar provision of state law. The Company evaluates its tax positions that have been taken or are expected to be taken on income tax returns to determine if an accrual is necessary for uncertain tax positions. As of December 31, 2017 and 2016, the unrecognized tax benefits accrual was zero. The Company will recognize future accrued interest and penalities related to unrecognized tax benefits in income tax expense if incurred.
Part XI, Line 2d - Other Adjustments:Reclass Expense Reimbursement to Expenses on Form 990 206,805. Earnings of C Corp 150,176.
Part XII, Line 4b - Other Adjustments:Reclass Expense Reimbursement to Expenses on Form 990 -206,805.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (26 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
University of Kansas
1651 Naismith DrLawrenceKS66045481124839State of Kansas$25,000Williams Fund
Wichita Center for Arts
1307 N Rock RdWichitaKS67206480616251501(c)(3)$25,000Capital Campaign
Wichita Metro Chamber of Commerce
350 W Douglas AveWichitaKS67202480477290501(c)(3)$10,980Yearly Support/Centennial Sponsorship $6,980 and $4000
Kansas Insurance Educational Foundation
815 SW Topeka BoulevardTopekaKS66612480925186501(c)(3)$10,000Year 2 of 4 Year Commitment
United Way of KC
801 W 47th St Ste 500Kansas CityMO64112440545812501(c)(3)$18,5002017 Gift $10,000; Community Liaison Program $8,500
United Way of of the Plains
245 N Water StWichitaKS67202480547688501(c)(3)$33,5002107 gift $25,000; Loaned Executive Program $8,500
Juvenile Diabetes Research Foundation (JDRF)
215 West Pershing Road Suite 300Kansas CityMO64108231907729501(c)(3)$25,000Yearly Support
March of Dimes KC
4400 College BoulevardOverland ParkKS66211131846366501(c)(3)$10,000Yearly Support
Urban Neighborhood
2700 East 18th Street Suite 261Kansas CityMO64127454879810501(c)(3)$10,0002017 UNI Operations
Botanica
701 Amidon StWichitaKS67203481007736501(c)(3)$25,000Carousel - 1st year of 2 year Commitment for $30,000; Illuminations - $10,000
Ronald McDonald House Charities
1110 N EmporiaWichitaKS67214480918101501(c)(3)$15,000Capital Campaign ($10,000) - New House - 1st of 3 year Commitment for $30,000; Golf Tournament - $5,000
Dental Lifeline Network
PO Box 4266TopekaKS66604846129064501(c)(3)$6,971Kansas Donated Dental Services (DDS) Program
The Exploration Place
300 N McLean BlvdWichitaKS67203481000295501(c)(3)$26,633Your Big Mouth: Oral Health Education Programs for Rural Kansas Preschools
Heartspring
8700 E 29th St NWichitaKS67226481232409501(c)(3)$26,422Healthy Smiles for Children with Special Needs Program
Oral Health Kansas
800 SW Jackson St Suite 1120TopekaKS66612200337278501(c)(3)$10,0002017 Oral Health Kansas Conference
Valeo Behavioral Health Care
400 SW Oakley AveTopekaKS66606480730326501(c)(3)$12,000Valeo Oral Health Initiative to Reduce Dry Mouth for Those Experiencing Mental Illness
GraceMed
1122 N TopekaWichitaKS67214481159633501(c)(3)$6,17710,080 kits
Genesis Family Health
310 E Walnut St Ste LL5Garden CityKS67846481049519501(c)(3)$6,24310,080 kits
Sedgwick County Health Department
1900 E 9th StWichitaKS67214486000798Sedgwick County$6,17710,080 kits
First United Methodist Church-Wesley House
411 E 12thPittsburgKS66762480559096501(c)(3)$6,26310,080 kits
Marian Dental Clinic - SCL Health
3164 SE 6th AvenueTopekaKS66607481046905501(c)(3)$6,27110,080 kits
Kansas Food Bank
1919 E Douglas AveWichitaKS67211480959213501(c)(3)$21,00034,272 kits
YMCA
402 N MarketWichitaKS67202237128129501(c)(3)$6,26510,224 kits
Community Health Center of Southeast Kansas
3011 N MichiganPittsburgKS66762753002264501(c)(3)$5,160Smiles Across Southeast Kansas - 8,600 kits
Catholic Charities of Northeast Kansas
1708 Steel RoadKansas CityKS66106480623886501(c)(3)$7,800Food Pantry - 13,000 Kits
Johnson County Christmas Burea
9503 Johnson DrMerriamKS66203480884400Johnson County$7,2002017 Holiday Shop - 12,000 Kits
FieldValueIRS element (for citing)
Total501c3 Org26Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationDelta Dental of Kansas provided grants to public charities and governmental organizations to further the purpose of the organization. For each organization that receives a grant, Delta Dental of Kansas requires acceptance of the grant, the grant reporting requirements and the due date for reporting via a signed agreement letter. The Grant Reporting Package requires completion of a Narrative Report addressing the details of the project, Project Budget Summary Form (including submission of invoices if appropriate), Acknowledgement Plan and any additional Components as indicated in the agreement letter.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
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
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 Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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
Michael Herbert
President and CEO$263,037$0$110,780$0$16,376$0$47,896$0$20,518$0$458,607$0$0$0
Michael Ellis
Executive VP/CFO/Treasurer$230,227$0$61,680$0$1,869$0$40,312$0$14,044$0$348,132$0$0$0
Dean Newton
Managing Director & Executive VP$204,525$0$76,179$0$9,700$0$48,475$0$15,191$0$354,070$0$0$0
James Tuttle
Chief Operating Officer$177,420$0$10,871$0$655$0$0$0$8,749$0$197,695$0$0$0
Robert Ebenkamp
VP Information Technology$169,291$0$36,255$0$1,495$0$27,810$0$6,981$0$241,832$0$0$0
Dr Jon Tilton
VP Professional Review/Dental Direct$176,007$0$38,492$0$4,736$0$30,542$0$14,093$0$263,870$0$0$0
Junetta Everett
VP Professional Relations$165,241$0$35,873$0$2,244$0$27,598$0$12,158$0$243,114$0$0$0
Keith Asplund
VP Product Management$159,480$0$35,224$0$538$0$26,556$0$5,241$0$227,039$0$0$0
Bryce Dougherty
Controller$144,631$0$29,531$0$527$0$21,907$0$14,264$0$210,860$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 1aFormAndLineReferenceDesc
ExplanationDelta Dental of Kansas did pay for the companion travel for board of directors and leadership team members when they attended out of town business meetings. The companion travel amount was treated as taxable compensation and is included in the board of directors' 1099-MISC and the leadership team members' W-2.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Alan D Marcotte DDS
Board Member Dr. Marcotte > 35% owner$111,146Payment of Dental Services0
Patrick O Moriarty DDS Chartered
Board Member Dr. Moriarty > 35% owner$201,053Payment of Dental Services0
Raben DDS PA
Board Member Dr. Raben > 35% owner$137,897Payment of Dental Services0
Northrock Dental PA
Board Member Dr. Scheer > 35% owner$121,476Payment of Dental Services0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, line 3The organization dissolved the disregarded entity KSDD Properties LLC during 2016.
Form 990, Part VI, Section A, line 2Nancy Zogelman, Nancy Umholtz, Michael Herbert, Michael Ellis, Dean Newton, Dr. Alan Marcotte, and Mark Phillips have a business relationship with each other. They all serve as either officers or directors of Surency Life & Health Insurance Company, a related for-profit company. The officers and directors do not have stock ownership interest in the related for-profit company.
Form 990, Part VI, Section A, line 6The organization has members. The membership of Delta Dental of Kansas is comprised of the dentists who have current participating agreements with Delta Dental of Kansas. Each member is entitled, at every meeting of members, to one vote per person, but no member shall be entitled to vote by proxy.
Form 990, Part VI, Section A, line 7aThe board of directors are comprised of ten (10) members. Four (4) are elected by the membership and are among the corporation's participating dentists. Two (2) are appointed by the governor of the state of Kansas, and four (4) are appointed by the commissioner of insurance of the state of Kansas.
Form 990, Part VI, Section A, line 7bAny proposed changes to the by-laws are subject to member approval.
Form 990, Part VI, Section A, line 8bThere are no committees with the authority to act on behalf of the governing board.
Form 990, Part VI, Section B, line 11bAn independent accounting firm prepares the Form 990. The 990 is then reviewed by the organization's accounting personnel. Any questions or comments are addressed and any necessary changes are made. The Form 990 with all related schedules is then provided to the entire governing body for review prior to filing.
Form 990, Part VI, Section B, line 12cThe chairperson of the board and the governance committee monitor and enforce our conflict of interest policy. Each director, officer, and key employee of Delta Dental of Kansas annually files a statement regarding conflicts of interest which exist, or which might be expected to exist, within the upcoming year. The statement discloses as fully as possible the nature of potential conflicts and the nature of the director's, officer's, or key employee's interest in the potential transaction. All statements are reviewed by the president and chairperson and may be circulated to members of the board of directors. Each director, officer, and key employee agree to answer any questions about potential conflicts they may have. If a conflict is identified, voting may be restricted.
Form 990, Part VI, Section B, line 15The Delta Dental of Kansas process for determining compensation for the CEO, officers, and key employees does include an annual review by independent persons, comparability date, and contemporaneous substantiation of the deliberation and decision. Delta Dental of Kansas has contracted with a consulting group to provide compensation studies for our positions. The consultant uses published market data sources to identify the relevant duties and responsibilities provided. Market data is used as appropriate for each position, from local, regional, and national markets. They provide a complete report that documents the findings of the market review process for our positions and their recommendation regarding the grade level of placement of the position. Delta Dental of Kansas also has a compensation committee, comprised of selected board members. One of the purposes of the committee is to review, report, and make recommendations to the board regarding compensation of all officers and executive team employees. The committee is responsible to meet with the President/Chief Executive Officer annually to review his/her performance and employment contract, make recommendations to the board regarding the President/Chief Executive Officer's annual compensation and benefits package and to review the President/Chief Executive Officer's recommendations as to salary adjustments and incentive payments for officers, executives, and senior management.
Form 990, Part VI, Section C, line 19Delta Dental of Kansas annual report is available to the public through our website, www.deltadentalks.com. Our governing documents and conflict of interest policy are available to the public upon request.
Form 990, Part XI, line 9:Earnings from C Corp Subsidiary 150,176. Other changes in net assets due to rounding -22.

Schedule R IRS990ScheduleR

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Surency Life & Health CompanyBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11619 N Waterfront PkwyAddressLine1Txt
CityWichitaCityNm
State AbbreviationKSStateAbbreviationCd
ZIP67206ZIPCd
FieldValueIRS element (for citing)
EIN261969006EIN
Primary ActivitiesInsurancePrimaryActivitiesTxt
Legal Domicile StateKSLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1DDKSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income$150,174ShareOfTotalIncomeAmt
Share Of EOY Assets$12,010,126ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
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 Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Surency Life & Health Insurance Company
O$686,427cost
Surency Life & Health Insurance Company
N$266,109cost

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