DELTA DENTAL PLAN OF KANSAS INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- DELTA DENTAL PLAN OF KANSAS INC (EIN 48-0793267)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-10-31
- IRS object ID
- 201703049349301620
- Schema version
- 2016v3.0
- 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 | 2017-10-31T13:47:24-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4310 17TH AVE S PO BOX 2545 | AddressLine1Txt |
| City | FARGO | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 581082545 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 480793267 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Delta Dental of Kansas Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DELT | BusinessNameControlTxt |
| Phone | 3162641099 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1619 N Waterfront Parkway | AddressLine1Txt |
| City | Wichita | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Michael Ellis | PersonNm |
| Person Title | Executive VP | PersonTitleTxt |
| Phone | 3162641099 | PhoneNum |
| Signature | 2017-10-25 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KIM C HUNWARDSEN | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 7012398500 | PhoneNum |
| Preparation | 2017-10-25 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 209.243.15.107 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-10-25 | IPDt |
| IP Tm | 08:07:07 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | D91E13DEA3BADDCECF099D1499B6B322FF7FE130 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 66CC91E6B7F11C4783FFFA5645E675327CB67316 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2018-03-14 21:41:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Michael Ellis | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1619 N Waterfront Pkwy | AddressLine1Txt |
| City | Wichita | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $309,340,959 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | www.deltadentalks.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Activity Or Mission | To make possible and facilitate a wider and more timely availability of oral health care. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 148 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $286,645,532 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $296,109,181 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,044,619 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,016,073 | CYInvestmentIncomeAmt |
| PY Other Revenue | $8,197 | PYOtherRevenueAmt |
| CY Other Revenue | $7,562 | CYOtherRevenueAmt |
| PY Total Revenue | $287,698,348 | PYTotalRevenueAmt |
| CY Total Revenue | $297,132,816 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,391,096 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $636,225 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,212,201 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,005,338 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $272,944,734 | PYOtherExpensesAmt |
| CY Other Expenses | $282,888,435 | CYOtherExpensesAmt |
| PY Total Expenses | $284,548,031 | PYTotalExpensesAmt |
| CY Total Expenses | $294,529,998 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,150,317 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,602,818 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $67,657,881 | TotalAssetsBOYAmt |
| Total Assets EOY | $67,072,661 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,634,989 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,616,699 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $56,022,892 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $59,455,962 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To 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 Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $269,503,516 | ExpenseAmt |
| Revenue | $286,041,469 | RevenueAmt |
| Desc | Dental benefits (covered charges) provided to subscribers. Delta Dental served approximately 919,203 people this year. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $9,567,517 | ExpenseAmt |
| Revenue | $10,067,712 | RevenueAmt |
| Desc | The processing of dental benfit claims. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $636,225 | ExpenseAmt |
| Grant | $636,225 | GrantAmt |
| Desc | Grants paid out to 501(c)(3) organizations. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $279,707,258 | 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 | Yes (1) | 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 | 0 | 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 | Yes (1) | 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 | 28960 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 148 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | 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 | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | 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 | Michael Ellis | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3162641099 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1619 N Waterfront Parkway | AddressLine1Txt |
| City | Wichita | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Nancy Zogleman | |||||||||
| Chairperson | 2.89 | 0.32 | Yes (X) | Yes (X) | $19,977 | $0 | $477 | ||
| Dr Alan Marcotte | |||||||||
| Vice Chairperson | 1.51 | 0.32 | Yes (X) | Yes (X) | $14,238 | $0 | $1,386 | ||
| Angie McClure | |||||||||
| Director | 1.66 | 0.00 | Yes (X) | $14,421 | $0 | $1,386 | |||
| Dr Patrick Moriarty | |||||||||
| Director | 1.08 | 0.00 | Yes (X) | $11,070 | $0 | $1,386 | |||
| Mark Philips | |||||||||
| Director | 1.31 | 0.00 | Yes (X) | $12,304 | $0 | $1,386 | |||
| Dr Lucynda Raben | |||||||||
| Director | 1.49 | 0.00 | Yes (X) | $12,233 | $0 | $477 | |||
| Dr Brick Scheer | |||||||||
| Director | 1.26 | 0.00 | Yes (X) | $10,294 | $0 | $0 | |||
| Ruth Teichman | |||||||||
| Director | 1.07 | 0.00 | Yes (X) | $9,969 | $0 | $1,157 | |||
| Bruce Witt | |||||||||
| Director | 1.66 | 0.00 | Yes (X) | $14,053 | $0 | $1,386 | |||
| Gary Yager | |||||||||
| Director | 1.33 | 0.00 | Yes (X) | $11,279 | $0 | $0 | |||
| Michael Herbert | |||||||||
| President and CEO | 34.88 | 5.12 | Yes (X) | $357,525 | $0 | $67,224 | |||
| Michael Ellis | |||||||||
| Executive VP/CFO/Treasurer | 38.39 | 1.61 | Yes (X) | $269,082 | $0 | $49,212 | |||
| Nancy Umholtz | |||||||||
| Secretary | 37.06 | 2.94 | Yes (X) | $103,388 | $0 | $21,459 | |||
| Dean Newton | |||||||||
| Managing Director & Executive VP | 39.84 | 0.16 | $313,975 | $0 | $60,960 | Yes (X) | |||
| Robert Ebenkamp | |||||||||
| VP Information Technology | 39.95 | 0.05 | $200,336 | $0 | $34,415 | Yes (X) | |||
| Dr Jon Tilton | |||||||||
| VP Professional Review/Dental Director | 40.00 | 0.00 | $213,591 | $0 | $46,067 | Yes (X) | |||
| Junetta Everett | |||||||||
| VP Professional Relations | 39.30 | 0.70 | $196,271 | $0 | $40,808 | Yes (X) | |||
| Jeanne Hughes | |||||||||
| VP Client Service | 37.31 | 2.69 | $188,941 | $0 | $40,817 | Yes (X) | |||
| Keith Asplund | |||||||||
| VP Product Management | 29.01 | 10.99 | $191,973 | $0 | $32,439 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,164,920 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $402,442 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 21 | 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 |
|---|---|---|---|---|---|
| Gage Center Dental Group PA | |||||
| 1271 SW WOODHULL ST | Topeka | KS | 66604 | Dental Services | $1,792,669 |
| Jenkins & Leblanc PA | |||||
| 6810 SILVERHEEL ST | Shawnee | KS | 66226 | Dental Services | $1,789,777 |
| Martin and Frankenberry DDS PA | |||||
| 101 N CYPRESS ST | Wichita | KS | 67226 | Dental Services | $1,413,744 |
| Wichita Family Dental Partnership | |||||
| 9339 E 21ST ST N | Wichita | KS | 67206 | Dental Services | $1,391,899 |
| Dental Assoc of West Wichita PA | |||||
| 444 N RIDGE RD | Wichita | KS | 67212 | Dental Services | $1,069,011 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 535 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Dental Services | Desc |
| Business | 524298 | BusinessCd |
| Total Revenue Column | $296,109,181 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $296,109,181 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $296,109,181 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,230,446 | TotalRevenueColumnAmt |
| Exclusion | $1,230,446 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $11,993,770 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $12,208,143 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$214,373 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$214,373 | TotalRevenueColumnAmt |
| Exclusion | -$214,373 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Other Income | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $7,562 | TotalRevenueColumnAmt |
| Exclusion | $7,562 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $7,562 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $297,132,816 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $296,109,181 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,023,635 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $636,225 | TotalAmt |
| Program Services | $636,225 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,411,953 | TotalAmt |
| Program Services | $318,294 | ProgramServicesAmt |
| Management And General | $1,093,659 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,235,769 | TotalAmt |
| Program Services | $2,977,794 | ProgramServicesAmt |
| Management And General | $4,257,975 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $992,345 | TotalAmt |
| Program Services | $434,541 | ProgramServicesAmt |
| Management And General | $557,804 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $819,124 | TotalAmt |
| Program Services | $355,533 | ProgramServicesAmt |
| Management And General | $463,591 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $546,147 | TotalAmt |
| Program Services | $232,897 | ProgramServicesAmt |
| Management And General | $313,250 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,090 | TotalAmt |
| Management And General | $56,090 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,003 | TotalAmt |
| Management And General | $150,003 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,430 | TotalAmt |
| Management And General | $36,430 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $214,166 | TotalAmt |
| Management And General | $214,166 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,386,605 | TotalAmt |
| Program Services | $870,585 | ProgramServicesAmt |
| Management And General | $4,516,020 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $804,604 | TotalAmt |
| Management And General | $804,604 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,575,070 | TotalAmt |
| Program Services | $1,469,030 | ProgramServicesAmt |
| Management And General | $106,040 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,453 | TotalAmt |
| Program Services | $27,719 | ProgramServicesAmt |
| Management And General | $25,734 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,809 | TotalAmt |
| Management And General | $183,809 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $411,984 | TotalAmt |
| Program Services | $12,638 | ProgramServicesAmt |
| Management And General | $399,346 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,916 | TotalAmt |
| Program Services | $4,352 | ProgramServicesAmt |
| Management And General | $62,564 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,714 | TotalAmt |
| Program Services | $84,706 | ProgramServicesAmt |
| Management And General | $76,008 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $498,882 | TotalAmt |
| Program Services | $262,940 | ProgramServicesAmt |
| Management And General | $235,942 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,302 | TotalAmt |
| Management And General | $107,302 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Claims | $269,503,500 | $269,503,500 | |
| State Premium Taxes | $1,117,821 | $1,117,821 | |
| Clearing House Expense | $380,784 | $361,749 | $19,035 |
| Equipment Rental and Ma | $253,437 | $253,437 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,926,865 | TotalAmt |
| Program Services | $783,497 | ProgramServicesAmt |
| Management And General | $1,143,368 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294,529,998 | TotalAmt |
| Program Services | $279,707,258 | ProgramServicesAmt |
| Management And General | $14,822,740 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $257,756 | BOYAmt |
| EOY | $800 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,020,061 | BOYAmt |
| EOY | $3,209,180 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,180,038 | BOYAmt |
| EOY | $5,198,094 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $475,342 | BOYAmt |
| EOY | $401,663 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $12,419,148 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,656,375 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,938,246 | BOYAmt |
| EOY | $7,762,773 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,910,707 | BOYAmt |
| EOY | $41,954,935 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,363,135 | BOYAmt |
| EOY | $8,121,760 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $512,596 | BOYAmt |
| EOY | $423,456 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,657,881 | BOYAmt |
| EOY | $67,072,661 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,749,046 | BOYAmt |
| EOY | $7,256,318 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,885,943 | BOYAmt |
| EOY | $360,381 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,634,989 | BOYAmt |
| EOY | $7,616,699 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,022,892 | BOYAmt |
| EOY | $59,455,962 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,022,892 | BOYAmt |
| EOY | $59,455,962 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,657,881 | BOYAmt |
| EOY | $67,072,661 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,602,818 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $671,813 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $158,439 | OtherChangesInNetAssetsAmt |
| 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 | $1,401,415 | OtherCostOrOtherBasisAmt |
| Book Value | $1,401,415 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,332,320 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,918,932 | DepreciationAmt |
| Book Value | $5,413,388 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,685,413 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,737,443 | DepreciationAmt |
| Book Value | $947,970 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,762,773 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Inv in Surency Life & Health | Desc |
| Book Value | $8,121,760 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $8,121,760 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Unearned Premiums | Desc |
| Amt | $360,381 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $360,381 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $298,272,765 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $671,813 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $682,302 | OtherRevenueAmt |
| Revenue Not Reported | $1,354,115 | RevenueNotReportedAmt |
| Revenue Subtotal | $296,918,650 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $214,166 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $214,166 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $297,132,816 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $294,839,695 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $644,548 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $644,548 | ExpensesNotReportedAmt |
| Expenses Subtotal | $294,195,147 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $214,166 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $120,685 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $334,851 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $294,529,998 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 records deferred income taxes using the liability method to reflect the tax consequences on future years of differences between the tax basis of assets and liabilities and their financial reporting amounts at each year-end. Deferred tax assets are recognized if management believes, based on available evidence, that it is more likely than not that they will be realized. The Company will recognize future accrued interest and penalties related to unrecognized tax benefits in income tax expense if incurred. Under normal circumstances, Delta Dental of Kansas, Inc. is no longer subject to federal and state examinations by tax authorities for years before 2013. |
| Part XI, Line 2d - Other Adjustments: | Earnings of C Corp Subsidiary 61,208. Reclass Expense Reimbursement to Expenses on Form 990 228,067. Rounding -14. Eliminating Entry for Equity in Disregarded Entity 393,041. |
| Part XII, Line 2d - Other Adjustments: | Eliminating Entry for Intercompany Transaction with Disregarded Entity 644,562. Rounding -14. |
| Part XII, Line 4b - Other Adjustments: | Disregarded Entity Expenses from Revenue on Financials 348,752. Reclass Expense Reimbursement from Revenue on Financials -228,067. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (28 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|
| United Way of the Plains | ||||||||
| 245 N Water | Wichita | KS | 67202 | 480547688 | 501(c)(3) | $9,355 | Loaned Executive Program $8,500; 1,500 toothbrush kits $855 | |
| Sedgwick County Zoo | ||||||||
| 5555 W Zoo Blvd | Wichita | KS | 67212 | 486120530 | 501(c)(3) | $32,500 | E is for Elephant | |
| Boys and Girls Club of Greater Kansas City | ||||||||
| Legacy Center 4001 Blue Parkway Ste | Kansas City | MO | 64130 | 436072065 | 501(c)(3) | $25,000 | Kid's Night Out | 102 |
| Juvenile Diabetes Research Foundation | ||||||||
| 215 W Pershing Road | Kansas City | MO | 64108 | 231907729 | 501(c)(3) | $25,000 | General Donation | |
| University of Kansas | ||||||||
| 1651 Naismith Dr | Lawrence | KS | 66045 | 481124839 | State of Kansas | $25,000 | Williams Fund | |
| Mark Arts | ||||||||
| 9112 E Central | Wichita | KS | 67206 | 480616251 | 501(c)(3) | $25,000 | Capital Campaign | |
| United Way of Kansas City | ||||||||
| 801 W 47th St Ste 500 | Kansas City | MO | 64112 | 440545812 | 501(c)(3) | $18,500 | 2016 Gift $10,000; Community Liaison Program $8,500 | |
| Make a Wish Kansas | ||||||||
| 1144 N St Francis | Wichita | KS | 67214 | 480984820 | 501(c)(3) | $10,500 | General Donation | |
| Kansas Insurance Education Foundation | ||||||||
| 815 SW Topeka Boulevard | Topeka | KS | 66612 | 480925186 | 501(c)(3) | $10,000 | Year one of 4 year commitment | |
| March of Dimes | ||||||||
| 4400 College Boulevard | Overland Park | KS | 66211 | 131846366 | 501(c)(3) | $10,000 | 2016 Kansas City Signature Chefs Auction | |
| Diamond Dreams NFP dba Topeka Golden Giants | ||||||||
| PO Box 883 | Topeka | KS | 66601 | 364473748 | 501(c)(3) | $5,000 | 2016 Diamond Dreams sponsorship | |
| KC Urban Neighborhood Initiative | ||||||||
| 2700 East 18th Street Suite 261 | Kansas City | MO | 64127 | 454879810 | 501(c)(3) | $5,000 | 2016 UNI Operations | |
| Exploration Place | ||||||||
| 300 N McLean Blvd | Wichita | KS | 67203 | 481000295 | 501(c)(3) | $17,385 | Your Big Mouth: Oral Health Education Programs for Preschool $17,385 - Program supplies and travel; Death by Chocolate tickets $1,020 | |
| Oral Health Kansas | ||||||||
| 800 SW Jackson St Suite 1120 | Topeka | KS | 66612 | 200337278 | 20-0337278 | $5,000 | 2016 Conference - Conference Supplies and expenses | |
| Community Health Center of Southeast Kansas | ||||||||
| 3011 N Michigan | Pittsburg | KS | 66762 | 753002264 | 501(c)(3) | $135,822 | Oral Health for Heroes | |
| Kansas Department of Health and Environment | ||||||||
| 1000 SW Jackson | Topeka | KS | 66601 | 486029925 | State of Kansas | $70,000 | Kansas Statewide School Screening Program - Supplies | |
| Wichita Area Technical College | ||||||||
| 4004 N Webb Road | Wichita | KS | 67226 | 201027060 | State of Kansas | $50,000 | WATC's 2016 Community Dental Health Grant - Equipment and Scholarships | |
| Marian Clinic Inc | ||||||||
| 3164 SE 6th Street | Topeka | KS | 66610 | 481046905 | 501(c)(3) | $30,000 | Increasing Access and Improving Quality of Care - Equipment and Capital Supplies | |
| Community Health Ministry | ||||||||
| 407 Ash Street | Wamego | KS | 66547 | 752974854 | 501(c)(3) | $25,054 | Fluoride Varnish in Schools & Dental Supplies - Supplies | |
| Southwest Boulevard Family Health Care | ||||||||
| 300 Southwest Blvd | Kansas City | KS | 66103 | 481067752 | 501(c)(3) | $13,000 | Equipment Needs for Family Health Care Dental Clinic - Equipment | |
| Salina Area Technical College | ||||||||
| 2562 Centennial Road | Salina | KS | 67401 | 273299216 | State of Kansas | $8,700 | Dental Assistant Program Equipment - Salina Tech - Equipment | |
| GraceMed Health Clinic | ||||||||
| 1122 N Topeka St | Wichita | KS | 67214 | 481159633 | 501(c)(3) | $8,550 | Oral Health Care Kits for Underserved - 15,000 kits $8550 | |
| United Methodist Western Kansas Mexican American Ministries dba Genesis F | ||||||||
| 401 E Spruce St | Garden City | KS | 67846 | 481049519 | 501(c)(3) | $8,550 | Lifetime Smiles - 15,000 kits | |
| KS Head Start Association | ||||||||
| 932 Massachusetts Ste 301 | Lawrence | KS | 66044 | 481195593 | 501(c)(3) | $8,123 | Head Start Smile Kits - 14,250 kits | |
| Health Partnership Clinic | ||||||||
| 407 S Clairborne Suite 104 | Olathe | KS | 66062 | 481115529 | 501(c)(3) | $7,667 | Toothbrushes for HPC - 13,450 kits | |
| Johnson County Christmas Bureau | ||||||||
| 9503 Johnson Drive | Merriam | KS | 66203 | 480884400 | Johnson County | $6,840 | 2016 Holiday Shop - 12,000 kits | |
| Sedgwick County Division of Health | ||||||||
| 1900 East 9th Street North | Wichita | KS | 67214 | 486000798 | Sedgwick County | $5,871 | Sedgwick County Department of Public Services Oral Health Initiative - 10,300 kits | |
| First United Methodist Church-Wesley House | ||||||||
| 411 E 12th | Pittsburg | KS | 66762 | 480559096 | 501(c)(3) | $5,130 | Operation Smile - 9,000 kits | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 28 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | Delta 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| 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 |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Michael Herbert | ||||||||||||||
| President and CEO | $230,234 | $0 | $102,245 | $0 | $25,046 | $0 | $46,329 | $0 | $20,895 | $0 | $424,749 | $0 | $0 | $0 |
| Michael Ellis | ||||||||||||||
| Executive VP/CFO/Treasurer | $201,302 | $0 | $49,075 | $0 | $18,705 | $0 | $36,129 | $0 | $13,083 | $0 | $318,294 | $0 | $0 | $0 |
| Dean Newton | ||||||||||||||
| Managing Director & Executive VP | $189,674 | $0 | $97,301 | $0 | $27,000 | $0 | $45,149 | $0 | $15,811 | $0 | $374,935 | $0 | $0 | $0 |
| Robert Ebenkamp | ||||||||||||||
| VP Information Technology | $155,739 | $0 | $34,622 | $0 | $9,975 | $0 | $28,136 | $0 | $6,278 | $0 | $234,750 | $0 | $0 | $0 |
| Dr Jon Tilton | ||||||||||||||
| VP Professional Review/Dental Direct | $152,572 | $0 | $36,846 | $0 | $24,173 | $0 | $30,982 | $0 | $15,085 | $0 | $259,658 | $0 | $0 | $0 |
| Junetta Everett | ||||||||||||||
| VP Professional Relations | $137,759 | $0 | $34,439 | $0 | $24,073 | $0 | $28,082 | $0 | $12,725 | $0 | $237,078 | $0 | $0 | $0 |
| Jeanne Hughes | ||||||||||||||
| VP Client Service | $123,646 | $0 | $41,195 | $0 | $24,100 | $0 | $30,591 | $0 | $10,226 | $0 | $229,758 | $0 | $0 | $0 |
| Keith Asplund | ||||||||||||||
| VP Product Management | $140,182 | $0 | $33,791 | $0 | $18,000 | $0 | $27,094 | $0 | $5,345 | $0 | $224,412 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 1a | FormAndLineReferenceDesc |
| Explanation | Delta 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 DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Alan D Marcotte DDS | |||
| Board Member Dr. Marcotte > 35% owner | $126,402 | Payment of Dental Services | 0 |
| Patrick O Moriarty DDS Chartered | |||
| Board Member Dr. Moriarty > 35% owner | $203,537 | Payment of Dental Services | 0 |
| Raben DDS PA | |||
| Board Director Dr. Raben > 35% owner | $140,161 | Payment of Dental Services | 0 |
| Northrock Dental PA | |||
| Board Member Dr. Scheer > 35% owner | $135,363 | Payment of Dental Services | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Michael Herbert, Michael Ellis, Dean Newton, Dr. Alan Marcotte, and Nancy Zogleman 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 6 | The 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 7a | The 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 7b | Any proposed changes to the by-laws are subject to member approval. |
| Form 990, Part VI, Section A, line 8b | There are no committees with the authority to act on behalf of the governing board. |
| Form 990, Part VI, Section B, line 11b | An 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 12c | The 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 15 | The 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 19 | Delta 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: | Mark-to-mark adjustment not included on return 97,231. Earnings from subsidiary not on return - Surency 61,208. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KSDD Properties LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1619 N Waterfront Parkway | AddressLine1Txt |
| City | Wichita | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 480793267 | EIN |
| Primary Activities | Real estate | PrimaryActivitiesTxt |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Total Income | $644,562 | TotalIncomeAmt |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Delta Dental | BusinessNameLine1Txt |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Surency Life & Health Company | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1619 N Waterfront Pkwy | AddressLine1Txt |
| City | Wichita | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 261969006 | EIN |
| Primary Activities | Insurance | PrimaryActivitiesTxt |
| Legal Domicile State | KS | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DDKS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $61,208 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $11,216,164 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | 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 | 0 | 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 | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Surency Life & Health Insurance Company | ||
| O | $774,228 | cost |
| Surency Life & Health Insurance Company | ||
| N | $225,961 | cost |
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