DELTA DENTAL OF MISSOURI: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL OF MISSOURI (EIN 43-0908349)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-14
IRS object ID
201733189349309608
Schema version
2016v3.1
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)
Return2017-11-14T15:49:04-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1312 WALNUT STREET SUITE 3000AddressLine1Txt
CityCINCINNATICityNm
State AbbreviationOHStateAbbreviationCd
ZIP45202ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN430908349EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF MISSOURIBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% BARBARA C BENTRUPInCareOfNm
Business Name ControlDELTBusinessNameControlTxt
Phone3146563000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line112399 GRAVOIS ROADAddressLine1Txt
CityST LOUISCityNm
State AbbreviationMOStateAbbreviationCd
ZIP631271702ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBARBARA C BENTRUPPersonNm
Person TitleCFO & CORP. COUNSELPersonTitleTxt
Phone3146563000PhoneNum
Signature2017-10-30SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAaron HershbergerPreparerPersonNm
PTINP00961884PTIN
Phone5136218300PhoneNum
Preparation2017-10-30PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.126.162IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id31025420173185000024FederalOriginalSubmissionId
Federal Original Submission Id2017-11-14FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdF85720E79B4496D59D84219F9206D7A4D25B73B6AtSubmissionCreationDeviceId
At Submission Filing Device IdB985028A542B2775CCE13DD3ACBBCA85F654F7D0AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerEB ROB GORENPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line112399 GRAVIOS ROADAddressLine1Txt
CityST LOUISCityNm
State AbbreviationMOStateAbbreviationCd
ZIP631271702ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$579,026,298GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressWWW.DELTADENTALMO.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1958FormationYr
Legal Domicile StateMOLegalDomicileStateCd
Activity Or MissionOUR PURPOSE IS TO IMPROVE THE DENTAL HEALTH OF THE PUBLIC BY PROMOTING PREVENTIVE DENTISTRY AND PROVIDING COMPREHENSIVE DENTAL CARE AND MAINTENANCE ON A PREPAID BASIS.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee241TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$536,864,679PYProgramServiceRevenueAmt
CY Program Service Revenue$575,301,572CYProgramServiceRevenueAmt
PY Investment Income$2,571,063PYInvestmentIncomeAmt
CY Investment Income$2,118,861CYInvestmentIncomeAmt
PY Other Revenue$1,314,753PYOtherRevenueAmt
CY Other Revenue$1,519,903CYOtherRevenueAmt
PY Total Revenue$540,750,495PYTotalRevenueAmt
CY Total Revenue$578,940,336CYTotalRevenueAmt
PY Grants And Similar Paid$1,196,413PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$570,850CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$485,977,171PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$518,709,004CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$20,963,881PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$23,737,180CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$23,951,695PYOtherExpensesAmt
CY Other Expenses$24,930,660CYOtherExpensesAmt
PY Total Expenses$532,089,160PYTotalExpensesAmt
CY Total Expenses$567,947,694CYTotalExpensesAmt
PY Revenues Less Expenses$8,661,335PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$10,992,642CYRevenuesLessExpensesAmt
Total Assets BOY$148,371,610TotalAssetsBOYAmt
Total Assets EOY$162,941,822TotalAssetsEOYAmt
Total Liabilities BOY$46,963,331TotalLiabilitiesBOYAmt
Total Liabilities EOY$48,841,806TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$101,408,279NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$114,100,016NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE ORGANIZATION'S PRIMARY PURPOSE IS TO IMPROVE THE DENTAL HEALTH OF THE PUBLIC BY PROMOTING PREVENTIVE DENTISTRY AND PROVIDING COMPREHENSIVE DENTAL CARE AND MAINTENANCE ON A PREPAID BASIS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$558,085,533ExpenseAmt
Grant$607,550GrantAmt
Revenue$575,301,572RevenueAmt
DescDELTA DENTAL OF MISSOURI IS A PREPAID DENTAL INSURANCE COMPANY. IN 2016, DELTA DENTAL PROCESSED 3,072,213 CLAIMS FOR DENTAL SERVICES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$380,802ExpenseAmt
DescDENTAL HEALTH THEATER - SEE SCHEDULE ODesc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$484,338ExpenseAmt
DescLAND OF SMILES - SEE SCHEDULE ODesc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$243,417TotalOtherProgSrvcExpenseAmt
Total Program Service Expenses$559,194,090TotalProgramServiceExpensesAmt
Described In Section501c3falseDescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstYes (true)ReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntYes (true)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document56015IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee241EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountYes (true)ForeignFinancialAccountInd
Foreign CountryTKForeignCountryCd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsYes (true)ChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersYes (true)LocalChaptersInd
Policies Reference ChaptersYes (true)PoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBARBARA C BENTRUPPersonNm
Phone3146563000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line112399 GRAVOIS ROADAddressLine1Txt
CityST LOUISCityNm
State AbbreviationMOStateAbbreviationCd
ZIP631271702ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
William J Bender
DIRECTOR / TREASURER2.00.0Yes (X)Yes (X)$26,650$0$0
Brian Berglund
DIRECTOR2.00.0Yes (X)$27,700$0$0
Richard W Braun
DIRECTOR2.00.0Yes (X)$26,900$0$0
Rosemary A Bishop
DIRECTOR / SECRETARY2.00.0Yes (X)Yes (X)$31,100$0$0
Robert E Butler
DIRECTOR / BOARD CHAIRMAN2.00.0Yes (X)Yes (X)$51,000$0$0
Johnny Custardo
DIRECTOR2.00.0Yes (X)$20,600$0$0
Mark S Mancin
DIRECTOR2.00.0Yes (X)$18,900$0$0
Deborah J Patterson
DIRECTOR - EFFECTIVE 11/4/162.00.0Yes (X)$0$0$0
HR Redohl
DIRECTOR2.00.0Yes (X)$31,100$0$0
James W Rhea
DIRECTOR / 1ST VICE CHAIRMAN2.00.0Yes (X)Yes (X)$27,950$0$0
Edward C Robison
DIRECTOR / 2ND VICE CHAIRMAN2.00.0Yes (X)Yes (X)$17,450$0$0
Timothy S Taylor
DIRECTOR2.00.0Yes (X)$24,800$0$0
Gary R Williams
DIRECTOR - EFFECTIVE 11/4/162.00.0Yes (X)$3,150$0$0
Joshua Whitford
DIRECTOR - TERM ENDED 11/4/162.00.0Yes (X)$23,500$0$0
Mark R Zust
DIRECTOR - EFFECTIVE 11/4/162.00.0Yes (X)$0$0$0
William M Edwards
DIRECTOR - EFFECTIVE 11/4/162.00.0Yes (X)$3,150$0$0
E B ROB GOREN
PRESIDENT & CEO55.00.0Yes (X)$552,685$0$127,112
BARBARA C BENTRUP
CFO & CORPORATE COUNSEL55.00.0Yes (X)$489,073$0$174,040
RONALD E INGE
CHIEF DENTAL OFFICER55.00.0Yes (X)$236,164$0$19,603
JONATHAN R JENNINGS
CHIEF ACTUARY/VP UNDERWRITING55.00.0Yes (X)$203,837$0$28,689
PAMELA A MARTIN
VP & COO55.00.0Yes (X)$314,186$0$101,746
KARL A MUDRA
CHIEF INFORMATION OFFICER55.00.0Yes (X)$347,221$0$93,956
EDWARD A PATTAROZZI
CHIEF SALES/MARKETING OFFICER55.00.0Yes (X)$475,950$0$148,908
JANICE M LEES
VP BOARD RELATIONS50.00.0$196,123$0$72,981Yes (X)
HENRY S LAFFITTE
VP, SALES & ACCOUNT MANAGEMENT50.00.0$396,087$0$54,506Yes (X)
VICKI L KATZFEY
NATIONAL ACCOUNT EXECUTIVE50.00.0$209,939$0$57,073Yes (X)
ROBERT WOZNIAK
ACCOUNT EXECUTIVE50.00.0$207,144$0$52,277Yes (X)
ELLEN R SAMUELS
MANAGER, CORPORATE COMPLIANCE50.00.0$213,425$0$58,655Yes (X)
DAVID W HAYNES
PRESIDENT & CEO (FORMER)0.00.0$339,846$0$39,750Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,515,630TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$1,029,296TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K44IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MISSOURI DENTAL PROFESSIONALS
1100 SPUR DR STE 30MARSHFIELDMO65706DENTAL SERVICES$7,261,094
E BROWN DDS C HOLLANDER DDS M FER
3555 SUNSET OFFICE DR STE 210SAINT LOUISMO63127DENTAL SERVICES$2,629,398
JAY F HAUSER DDS PC
PO BOX 503094SAINT LOUISMO63150DENTAL SERVICES$2,464,132
MICHAEL K PARSONS DDS PC
17300 OUTER FORTY RD N STE 103CHESTERFIELDMO63005DENTAL SERVICES$1,462,316
MCKINSEY COMPANY
PO BOX 7247-7255PHILADELPHIAPA19170CONSULTING SERVICES$1,329,666
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K809CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescDENTAL PREMIUMSDesc
Business524114BusinessCd
Total Revenue Column$575,301,572TotalRevenueColumnAmt
Related Or Exempt Func Income$575,301,572RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$575,301,572TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,020,903TotalRevenueColumnAmt
Exclusion$2,020,903ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$164,639RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$85,962RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$78,677RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$78,677TotalRevenueColumnAmt
Exclusion$78,677ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$97,958SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$97,958SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$97,958TotalRevenueColumnAmt
Exclusion$97,958ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
MISCELLANEOUS INCOME900099$155,976$155,976
INVESTMENT IN SUBSIDIARY900003$1,285,250$1,285,250
FieldValueIRS element (for citing)
Other Revenue Total$1,441,226OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$578,940,336TotalRevenueColumnAmt
Related Or Exempt Func Income$575,301,572RelatedOrExemptFuncIncomeAmt
Exclusion$3,638,764ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$570,850TotalAmt
Program Services$570,850ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$518,709,004TotalAmt
Program Services$518,709,004ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$3,848,276TotalAmt
Program Services$3,155,586ProgramServicesAmt
Management And General$692,690ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$13,424,098TotalAmt
Program Services$11,007,758ProgramServicesAmt
Management And General$2,416,340ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,665,948TotalAmt
Program Services$2,186,077ProgramServicesAmt
Management And General$479,871ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,732,222TotalAmt
Program Services$2,240,422ProgramServicesAmt
Management And General$491,800ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,066,636TotalAmt
Program Services$874,642ProgramServicesAmt
Management And General$191,994ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$249,458TotalAmt
Program Services$204,556ProgramServicesAmt
Management And General$44,902ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$344,084TotalAmt
Program Services$282,149ProgramServicesAmt
Management And General$61,935ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$203,017TotalAmt
Program Services$166,474ProgramServicesAmt
Management And General$36,543ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,188,722TotalAmt
Program Services$2,614,752ProgramServicesAmt
Management And General$573,970ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,738,431TotalAmt
Program Services$1,425,513ProgramServicesAmt
Management And General$312,918ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,490,968TotalAmt
Program Services$2,862,594ProgramServicesAmt
Management And General$628,374ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$629,919TotalAmt
Program Services$516,534ProgramServicesAmt
Management And General$113,385ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$746,334TotalAmt
Program Services$611,994ProgramServicesAmt
Management And General$134,340ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$179,368TotalAmt
Program Services$147,082ProgramServicesAmt
Management And General$32,286ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$365,962TotalAmt
Program Services$300,089ProgramServicesAmt
Management And General$65,873ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$338,120TotalAmt
Program Services$277,258ProgramServicesAmt
Management And General$60,862ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BOARD AND BUREAU DUES$567,911$465,687$102,224
SERVICE BUREAU FEES$11,074,356$9,080,972$1,993,384
PUBLIC RELATIONS$580,583$476,078$104,505
SERVICE AGREEMENTS$519,704$426,157$93,547

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$713,723TotalAmt
Program Services$591,862ProgramServicesAmt
Management And General$121,861ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$567,947,694TotalAmt
Program Services$559,194,090ProgramServicesAmt
Management And General$8,753,604ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$14,123,784BOYAmt
EOY$22,240,520EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$32,640,505BOYAmt
EOY$33,618,520EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$251,105BOYAmt
EOY$399,074EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$14,748,096LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$8,540,724LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,777,095BOYAmt
EOY$6,207,372EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$68,885,123BOYAmt
EOY$72,383,598EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$24,259,016BOYAmt
EOY$25,544,265EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,434,982BOYAmt
EOY$2,548,473EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$148,371,610BOYAmt
EOY$162,941,822EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$13,113,155BOYAmt
EOY$13,188,370EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$33,850,176BOYAmt
EOY$35,653,436EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$46,963,331BOYAmt
EOY$48,841,806EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$101,408,279BOYAmt
EOY$114,100,016EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$101,408,279BOYAmt
EOY$114,100,016EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$148,371,610BOYAmt
EOY$162,941,822EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$10,992,642ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,699,095NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,350,000OtherCostOrOtherBasisAmt
Book Value$1,350,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,035,736OtherCostOrOtherBasisAmt
Depreciation$2,902,998DepreciationAmt
Book Value$4,132,738BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,755,945OtherCostOrOtherBasisAmt
Depreciation$1,433,465DepreciationAmt
Book Value$322,480BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,661,594OtherCostOrOtherBasisAmt
Depreciation$1,575,675DepreciationAmt
Book Value$85,919BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,944,821OtherCostOrOtherBasisAmt
Depreciation$2,628,586DepreciationAmt
Book Value$316,235BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$6,207,372TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

FieldValueIRS element (for citing)
DescINVEST. IN ADVANTICA HLDG CODesc
Book Value$25,544,265BookValueAmt
Method ValuationCMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Program Rltd$25,544,265TotalBookValueProgramRltdAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
INCURRED BUT UNREPORTED CLAIMS$29,493,873
ESTIMATE UNPAID CLAIM PROCESS$984,130
UNEARNED PREMIUMS$4,731,306
EXPERIENCE RATED CREDIT LIAB$121,050
ADVANCE DEPOSITS$323,077
FieldValueIRS element (for citing)
Total Liability$35,653,436TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PART X, TEXT OF FIN 48 FOOTNOTEFormAndLineReferenceDesc
ExplanationFIN 48 FOOTNOTE THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. ADVANTICA HOLDING COMPANY AND ITS WHOLLY-OWNED SUBSIDIARIES ARE SUBJECT TO BOTH FEDERAL AND STATE INCOME TAXES AND ACCOUNT FOR INCOME TAXES IN ACCORDANCE WITH INCOME TAX ACCOUNTING GUIDANCE (ASC 740 INCOME TAXES). THE INCOME TAX ACCOUNTING GUIDANCE RESULTS IN TWO COMPONENTS OF INCOME TAX EXPENSE: CURRENT AND DEFERRED. CURRENT INCOME TAX EXPENSE REFLECTS TAXES TO BE PAID OR REFUNDED FOR THE CURRENT PERIOD BY APPLYING THE PROVISIONS OF THE ENACTED TAX LAW TO THE TAXABLE INCOME OR EXCESS OF DEDUCTIONS OVER REVENUES. THE COMPANY DETERMINES DEFERRED INCOME TAXES USING THE LIABILITY (OR BALANCE SHEET) METHOD. UNDER THIS METHOD, THE NET DEFERRED TAX ASSET OR LIABILITY IS BASED ON THE TAX EFFECTS OF THE DIFFERENCES BETWEEN THE BOOK AND TAX BASES OF ASSETS AND LIABILITIES, AND ENACTED CHANGES IN TAX RATES AND LAWS ARE RECOGNIZED IN THE PERIOD IN WHICH THEY OCCUR. DEFERRED INCOME TAX EXPENSE RESULTS FROM CHANGES IN DEFERRED TAX ASSETS AND LIABILITES BETWEEN PERIODS. DEFERRED TAX ASSETS ARE REDUCED BY A VALUATION ALLOWANCE IF, BASED ON THE WEIGHT OF EVIDENCE AVAILABLE, IT IS MORE LIKELY THAN NOT THAT SOME PORTION OR ALL OF A DEFERRED TAX ASSET WILL NOT BE REALIZED. UNCERTAIN TAX POSITIONS ARE RECOGNIZED IF IT IS MORE LIKELY THAN NOT, BASED ON THE TECHNICAL MERITS, THAT THE TAX POSITION WILL BE REALIZED OR SUSTAINED UPON EXAMINIATION. THE TERM MORE LIKELY THAN NOT MEANS A LIKELIHOOD OF MORE THAN 50 PERCENT; THE TERMS EXAMINED AND UPON EXAMINATION ALSO INCLUDE RESOLUTION OF THE RELATED APPEALS OR LITIGATION PROCESSES, IF ANY. A TAX POSITION THAT MEETS THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD IS INITIALLY AND SUBSEQUENTLY MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT HAS A GREATER THAN 50 PERCENT LIKELIHOOD OF BEING REALIZED UPON SETTLEMENT WITH A TAXING AUTHORITY THAT HAS FULL KNOWLEDGE OF ALL RELEVANT INFORMATION. THE DETERMINATION OF WHETHER OR NOT A TAX POSITION HAS MET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD CONSIDERS THE FACTS, CIRCUMSTANCES AND INFORMATION AVAILABLE AT THE REPORTING DATE AND IS SUBJECT TO THE MANAGEMENT'S JUDGMENT. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES ON INCOME TAXES AS A COMPONENT OF INCOME TAX EXPENSE. ON A CONSOLIDATED BASIS, ADVANTICA HOLDING COMPANY AND ITS SUBSIDIARIES HAD OPERATING GAINS TOTALING $1,340,008 AND $1,014,292 AS OF DECEMBER 31, 2016 AND 2015, RESPECTIVELY. AT DECEMBER 31, 2016 AND 2015, ADVANTICA HOLDING COMPANY HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $27,691,000 AND $27,044,000, RESPECTIVELY, WHICH EXPIRE IN YEARS THROUGH 2035. ADVANTICA HOLDING AND ITS SUBSIDIARIES HAD DEFERRED TAX ASSETS OF APPROXIMATELY $8,362,000 AND $8,837,000 AT DECEMBER 31, 2016 AND 2015, RESPECTIVELY, NEARLY ALL OF WHICH ARISE FROM THESE NET OPERATING LOSS CARRYFORWARDS. DUE TO THE REMAINING UNCERTAINTY REGARDING WHETHER THESE WILL BE REALIZED, A FULL VALUATION ALLOWANCE HAS BEEN RECORDED AGAINST THESE DEFERRED TAX ASSETS AT DECEMBER 31, 2016 AND 2015. THE ORGANIZATION AND ITS SUBSIDIARIES ARE CURRENTLY OPEN TO EXAMINIATION UNDER THE STATUE OF LIMITATIONS BY THE INTERNAL REVENUE SERVICE AND STATES IN WHICH IT FILES FOR THE YEARS ENDED DECEMBER 31, 2013 THROUGH 2016.ExplanationTxt

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDesc
MISSOURI DEPT OF HEALTH & SENIOR SERVICE
PO BOX 570JEFFERSON CITYMO65102446000987STATE OF MO$250,000GENERAL SUPPORT
DENTAL LIFELINE NETWORK
PO BOX 105919JEFFERSON CITYMO65110900293508501(C)(3)$62,000GENERAL SUPPORT
GIVE KIDS A SMILE
10 WORTHINGTON DRMD HEIGHTSMO63043201287939501(C)(3)$50,000GENERAL SUPPORT$37,439BOOKSUPPLIES / SERVICES
SOUTH CAROLINA DENTAL CARE FOUNDATION
120 STONEMARK LANECOLUMBIASC29210562032690501(C)(3)$50,000GENERAL SUPPORT
MYRTLE HILLIARD DAVIS - COMP HEALTH CENTER
5471 DR MLK DRST LOUISMO63112430917230501(C)(3)$36,075GENERAL SUPPORT
TRUMAN MEDICAL CNTR CHARITABLE FOUNDATION
2310 HOLMESKANSAS CITYMO64108431194064501(C)(3)$20,000GENERAL SUPPORT
RONALD MCDONALD HOUSE CHARITIES
949 E PRIMROSE STSPRINGFIELDMO65807431371143501(C)(3)$15,000GENERAL SUPPORT
PALMETTO HEALTH FOUNDATION
1600 MARION STPO BOXSC29202570725699501(C)(3)$15,000GENERAL SUPPORT
YWCA METRO ST LOUIS
3820 WEST PINE BLVDST LOUISMO63108430653618501(C)(3)$10,750GENERAL SUPPORT
CAREFIRST CAROLINA FOUNDATION
201 S 5TH STHARTSVILLESC29550550839537501(C)(3)$7,000GENERAL SUPPORT
AMERICAN LUNG ASSOCATION
55 W WACKER DRCHICAGOIL60601131632524501(C)(3)$6,850GENERAL SUPPORT
AMERICAN PARKINSON DISEASE ASSOCIATION
135 PARKINSON AVESTATEN ISLANDNY10305131962771501(C)(3)$5,500GENERAL SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org12Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PART I, LINE 2FormAndLineReferenceDesc
ExplanationPROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S. DELTA DENTAL MAINTAINS RECORDS TO SUBSTANTIATE THE AMOUNT OF ASSISTANCE THAT IT PROVIDES TO THE COMMUNITY ORGANIZATIONS. DELTA DENTAL WORKS WITH THE INDIVIDUAL ORGANIZATIONS TO UNDERSTAND THEIR MISSIONS AND TO DETERMINE THE BENEFITS OF DELTA DENTAL'S PARTICIPATION.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
DAVID W HAYNES
PRESIDENT & CEO (FORMER)$57,300$0$221,007$0$61,539$0$39,750$0$0$0$379,596$0
E B ROB GOREN
PRESIDENT & CEO$401,124$0$125,713$0$25,848$0$98,118$0$28,994$0$679,797$0
BARBARA C BENTRUP
CFO & CORPORATE COUNSEL$338,894$0$117,695$0$32,484$0$153,731$0$20,309$0$663,113$0
RONALD E INGE
CHIEF DENTAL OFFICER$206,072$0$0$0$30,092$0$6,397$0$13,206$0$255,767$0
JONATHAN R JENNINGS
CHIEF ACTUARY/VP UNDERWRITING$165,231$0$0$0$38,606$0$5,038$0$23,651$0$232,526$0
PAMELA A MARTIN
VP & COO$218,647$0$76,430$0$19,109$0$82,028$0$19,718$0$415,932$0
KARL A MUDRA
CHIEF INFORMATION OFFICER$238,375$0$86,947$0$21,899$0$67,320$0$26,636$0$441,177$0
EDWARD A PATTAROZZI
CHIEF SALES/MARKETING OFFICER$320,777$0$114,948$0$40,225$0$127,729$0$21,179$0$624,858$0
JANICE M LEES
VP BOARD RELATIONS$68,820$0$101,193$0$26,110$0$53,203$0$19,778$0$269,104$0
HENRY S LAFFITTE
VP, SALES & ACCOUNT MANAGEMENT$210,563$0$181,351$0$4,173$0$39,750$0$14,756$0$450,593$0
VICKI L KATZFEY
NATIONAL ACCOUNT EXECUTIVE$87,673$0$114,588$0$7,678$0$30,854$0$26,219$0$267,012$0
ROBERT WOZNIAK
ACCOUNT EXECUTIVE$79,036$0$121,139$0$6,969$0$30,589$0$21,688$0$259,421$0
ELLEN R SAMUELS
MANAGER, CORPORATE COMPLIANCE$165,133$0$47,271$0$1,021$0$30,726$0$27,929$0$272,080$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1AINFORMATION REGARDING BENEFITS PROVIDED A HOUSING ALLOWANCE WAS PROVIDED TO THE FOLLOWING EMPLOYEES: JONATHAN JENNINGS AND RONALD INGE. THESE AMOUNTS ARE TREATED AS TAXABLE COMPENSATION. HEALTH CLUB DUES WERE PAID FOR THE FOLLOWING EMPLOYEES: DAVID HAYNES AND EDWARD PATTAROZZI. THESE AMOUNTS ARE TREATED AS TAXABLE COMPENSATION.
SCHEDULE J, PART I, LINE 4BNAMES, AMOUNTS, AND DETAILS OF ARRANGEMENTS THE ORGANIZATION HAS A NONQUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR THE BENEFIT OF CERTAIN EMPLOYEES TO RECEIVE CONTRIBUTIONS IN EXCESS OF THE LIMITATIONS IMPOSED BY THE INTERNAL REVENUE CODE ON STANDARD EMPLOYEE PENSION PLANS. AMOUNTS PAID DURING 2016 FOR THE FOLLOWING INDIVIDUALS WERE: - BARBARA BENTRUP $ 19,067 - E. B. ROB GOREN $ 15,781 - KARL MUDRA $ 6,317 - PAMELA MARTIN $ 1,233 - EDWARD PATTAROZZI $ 12,720 THE ORGANIZATION HAS AN UNFUNDED NONQUALIFIED, DEFINED BENEFIT DEFERRED COMPENSATION PLAN (DBDCP) FOR ITS SENIOR LEVEL EXECUTIVES, WITH VESTING OVER 10 TO 15 YEARS OF SERVICE TO THE ORGANIZATION. THE ACTUARIALLY DETERMINED LIABILITY IS BASED UPON ASSUMPTIONS FOR REMAINING YEARS OF SERVICE UNTIL RETIREMENT, PROJECTED SALARIES FOR THE FINAL THREE YEARS OF SERVICE, AND A PREDETERMINED BENEFIT PERCENTAGE BASED UPON THE PARTICIPANTS POSITION. INDIVIDUALS WHO PARTICIPATED IN THIS PLAN DURING 2016 WERE THE FOLLOWING: DAVID HAYNES, BARBARA BENTRUP, E. B. ROB GOREN, JANICE LEES, PAMELA MARTIN, EDWARD PATTAROZZI, AND KARL MUDRA. ALL INCREASES IN THE PROJECTED BENEFIT ACCRUALS FOR THIS DBDCP ARE REPORTED ANNUALLY IN THE FORM 990 FOR EACH PARTICIPANT. IT IS IMPORTANT TO NOTE THAT SEVERAL PARTICIPANTS IN THIS PROGRAM ARE NOT YET VESTED, YET THE INCREASE IN THE VALUE OF THE COMPANYS ACCRUAL HAS TO BE REPORTED ANNUALLY AS COMPENSATION IN THE FORM 990 FOR EACH OF THE PARTICIPANTS WHEN THERE WAS NO BENEFIT VALUE TO THEM PERSONALLY IF PARTICIPANTS LEAVE THE COMPANY PRIOR TO MEETING THE AGE AND SERVICE REQUIREMENTS, THERE IS NO BENEFIT PAYABLE. SCHEDULE J, PART II, COLUMN C INCLUDES THESES AMOUNTS FOR THE INCREASES IN THE COMPANYS ACCRUAL. THE AMOUNTS PER PARTICIPANT ARE: - BARBARA BENTRUP $ 113,961 - E. B. ROB GOREN $ 58,368 - PAMELA MARTIN $ 42,278 - KARL MUDRA $ 27,570 - JANICE LEES $ 37,331 - EDWARD PATTAROZZI $ 87,979 AMOUNTS PAID UNDER THE PLAN IN 2016 PER PARTICIPANT WERE: - DAVID HAYNES $ 57,751 - JANICE LEES $ 18,601

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
JAMES W RHEA DDS PC
BOARD MEMBER AS OWNER$220,418DENTAL SERVICES PROVIDEDfalse
FINNANE-ROBISON DENTAL LLC
BOARD MEMBER AS OWNER$184,941DENTAL SERVICES PROVIDEDfalse
CURRY TAYLOR DDS LLC
BOARD MEMBER AS OWNER$187,508DENTAL SERVICES PROVIDEDfalse
MARK R ZUST DDS LTD
BOARD MEMBER AS OWNER$200,180DENTAL SERVICES PROVIDEDfalse

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART IV, LINE 1FormAndLineReferenceDesc
ExplanationBUSINESS TRANSACTIONS BOARD MEMBER JAMES RHEA HAS A REPORTABLE INTEREST IN JAMES W RHEA DDS PC WHICH PROVIDES DENTAL SERVICES TO SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION. BOARD MEMBER EDWARD ROBISON AND ELIZABETH FINNANE, DAUGHTER OF BOARD MEMBER EDWARD ROBISON, HAVE A REPORTABLE INTEREST IN FINNANE-ROBISON DENTAL LLC WHICH PROVIDES DENTAL SERVICES TO SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION. BOARD MEMBER TIMOTHY TAYLOR HAS A REPORTABLE INTEREST IN CURRY TAYLOR DDS LLC WHICH PROVIDES DENTAL SERVICES TO SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION. BOARD MEMBER MARK ZUST AND DANIELLE RIORDAN, DAUGHTER OF BOARD MEMBER MARK ZUST, HAVE A REPORTABLE INTEREST IN MARK R ZUST DDS LTD WHICH PROVIDES DENTAL SERVICES TO SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 4BDESCRIPTION OF OTHER PROGRAM SERVICES DENTAL HEALTH THEATRE HEALTHWORKS! KIDS MUSEUM ST. LOUIS CO-SPONSORS/COALITIONS INVOLVED: ST. LOUIS OFFICE FOR DEVELOPMENTAL DISABILITY RESOURCES AND VARIOUS CHARITABLE DONORS (E.G., JEFFERSON FOUNDATION, THE SMILE GENERATION, LITTLE MEDICAL SCHOOL, TRIO FOUNDATION, MID-AMERICA TRANSPLANT AND OTHERS). PROGRAM DESCRIPTION: IN SPRING 2016, AFTER MORE THAN 38 YEARS OF PROVIDING ORAL HEALTH AND OVERALL HEALTH EDUCATION TO HUNDREDS OF THOUSANDS OF CHILDREN IN THE ST. LOUIS METRO, THE DENTAL HEALTH THEATRE RELOCATED AND EXPANDED TO BECOME PART OF THE HEALTHWORKS! KIDS MUSEUM ST. LOUIS. THE MUSEUMS MISSION IS TO EDUCATE AND INSPIRE CHILDREN AND THE COMMUNITY TO MAKE POSITIVE ORAL HEALTH AND OVERALL HEALTH CHOICES TO ACHIEVE OPTIMUM HEALTH. IT IS THE ONLY FREESTANDING CHILDRENS MUSEUM IN ST. LOUIS DEDICATED SOLELY TO HEALTH EDUCATION, WHICH IS COMBINED WITH PLAY TO HELP KIDS LEARN HEALTHY HABITS FOR HEALTHIER LIVES. AT ITS LEASED FACILITY OWNED BY THE ST. LOUIS SCIENCE CENTER FOUNDATION, THE MUSEUM HOSTS ONSITE HEALTH EDUCATION PROGRAMS AND HANDS-ON EXHIBITS ACCESSIBLE TO INDIVIDUALS OF ALL AGES. WITHIN THE MUSEUM, THE DELTA DENTAL HEALTH THEATRE SERVES AS AN INTERACTIVE LEARNING CENTER WITH HIGH-ENERGY, EDUCATOR-LED PROGRAMMING THAT ENCOURAGES POSITIVE HEALTH PRACTICES AND INCREASES INDIVIDUAL KNOWLEDGE ABOUT THE MOUTH-BODY CONNECTION TO OVERALL HEALTH AND THE IMPACT OF PERSONAL CHOICES ON HEALTH. THE MUSEUM ALSO CONDUCTS COMMUNITY OUTREACH PROGRAMS AND SERVES AS A HEALTH RESOURCE FOR TEACHERS, CAREGIVERS AND FAMILIES. APPROXIMATELY 37,000 CHILDREN, TEACHERS AND PARENTS VISITED THE MUSEUM AFTER ITS OPENING IN SPRING 2016. IT HAS THE CAPACITY TO SERVE 90,000 VISITORS ANNUALLY. LONGEVITY: DELTA DENTAL HEALTH THEATRE OPERATED FROM 1977 TO SPRING 2016, WHEN IT BECAME PART OF HEALTHWORKS! KIDS MUSEUM ST. LOUIS. DELTA DENTAL OF MISSOURI SPONSORED DELTA DENTAL HEALTH THEATRE FROM 2002 THROUGH 2015, AND HAS SPONSORED HEALTHWORKS! KIDS MUSEUM ST. LOUIS SINCE 2016. BECAUSE OF THE SUPPORT OF DELTA DENTAL OF MISSOURI, MORE THAN 135,000 CHILDREN AND CAREGIVERS HAVE RECEIVED HEALTH EDUCATION IN THE ST.LOUIS COMMUNITY. COMMUNITY.
FORM 990, PART III, LINE 4CDESCRIPTION OF OTHER PROGRAM SERVICES LAND OF SMILES TOURING THEATRICAL EDUCATION PROGRAM DESCRIPTION: LAND OF SMILES IS A TOURING, THEATRICAL PROGRAM THAT FEATURES TOOTH WIZARD, LITTLE SISTER TOOTH FAIRY AND THEIR ARCH ENEMY PLAQUEMAN. THE SHOW TRAVELED TO 400 SCHOOLS (K-3RD GRADE CLASSROOMS) THROUGHOUT THE STATES OF MISSOURI AND SOUTH CAROLINA IN 2016, TEACHING CHILDREN THE IMPORTANCE OF ORAL HEALTH. AN ASSEMBLY-STYLE LIVE PERFORMANCE WITH AUDIENCE PARTICIPATION, THE PROGRAM CAPTURES EACH STUDENT'S ATTENTION THROUGH FUN, KID-FOCUSED ENTERTAINMENT. THE THREE CHARACTERS EXPLAIN PROPER BRUSHING TECHNIQUES, HOW TO FLOSS, GOOD AND BAD FOODS FOR THE TEETH AND WHY IT IS IMPORTANT TO VISIT THE DENTIST TWICE A YEAR. EACH CHILD IS GIVEN A TAKE-HOME "SMILE BAG" FILLED WITH A TOOTHBRUSH, TOOTHPASTE, FLOSS, A COLORING SHEET, AND A REMINDER DECAL. STUDENTS WHO COMPLETE THE PROGRAM ALSO EARN HEALTHY SMILE "CERTOOTHICATES." TO REINFORCE THE MESSAGES OF THE PROGRAM AFTER THE PERFORMANCE, DDMO DISTRIBUTES A CURRICULUM KIT THAT INCLUDES A DVD, A LARGE MODEL OF A MOUTH, A LARGE TOOTHBRUSH, AND AUDIO VISUAL EDUCATIONAL TOOLS FOR USE IN THE CLASSROOM, AS WELL AS BOOKS FOR THE LIBRARY. A KIDS' WEBSITE, WWW.LANDOFSMILESVIDEO.COM, PROVIDES ANOTHER SOURCE TO VIEW THE DVD ONLINE. THIS PROGRAM REACHES OVER 90,000 CHILDREN EACH YEAR. TEACHERS AND SCHOOL NURSES CONSISTENTLY RATE THE PROGRAM AS EXCELLENT, AND TYPICALLY FOLLOW UP EACH SHOW WITH A REQUEST TO BE ADDED TO THE LIST IN THE TWO-YEAR CYCLE. IN ADDITION TO THE SCHOOL TOUR, THE LAND OF SMILES PROGRAM IS PERFORMED AT THE GIVE KIDS A SMILE CLINICS IN ST. LOUIS AND AT MORE THAN 20 AREA HEALTH FAIRS, WITH NEARLY 50,000 KIDS AND FAMILIES ATTENDING THROUGH THE YEAR. LONGEVITY: THIS PROGRAM HAS BEEN IN PLACE SINCE 2002.
FORM 990, PART III, LINE 4DDESCRIPTION OF OTHER PROGRAM SERVICES GIVE KIDS A SMILE ("GKAS") IN ST. LOUIS CO-SPONSORS/COALITIONS INVOLVED: GREATER ST. LOUIS DENTAL SOCIETY (GSLDS) AND GREATER KANSAS CITY DENTAL SOCIETY. PROGRAM DESCRIPTION: ONE OF OUR MOST SUCCESSFUL OUTREACH INITIATIVES, GKAS WAS LAUNCHED IN ST. LOUIS, MISSOURI, IN FEBRUARY OF 2002 IN PARTNERSHIP WITH GSLDS. IN 2016, GKAS IN ST. LOUIS PROVIDED 4,000 CHILDREN WITH MORE THAN $1 MILLION WORTH OF FREE DENTAL CARE AND ORAL HEALTH EDUCATION AT ITS TWO CLINICS AND OTHER COMMUNITY PROGRAMS. AT THE TWO-DAY CLINICS, SEVERAL HUNDRED LOCAL DENTISTS, HYGIENISTS AND ASSISTANTS, SUPPORTED BY LAY VOLUNTEERS AND SPONSORS, SUCH AS DELTA DENTAL, PROVIDE CHILDREN WITH FREE, COMPREHENSIVE DENTAL CARE, INCLUDING EXAMS, SEALANTS, X-RAYS, PROFESSIONAL CLEANINGS, FLUORIDE TREATMENTS, RESTORATIONS AND MORE. ON-SITE ENTERTAINMENT SUCH AS FACE PAINTING, STORYTELLING, BALLOONISTS, DELTA DENTAL'S TOOTH WIZARD, P.A.N.D.A. AND TOOTH FAIRY CHARACTERS, EDUCATIONAL VIDEOS, DENTAL CARE KITS, FREE TOYS AND BOOKS AND SACK LUNCHES ENSURE THAT THE CHILDREN'S VISIT TO THE DENTIST IS ASSOCIATED WITH A FUN AND EDUCATIONAL EXPERIENCE. FOR EACH CLINIC, DELTA DENTAL OF MISSOURI PROVIDES BUS TRANSPORTATION FOR GROUPS OF CHILDREN AND FUNDS ALL PUBLIC RELATIONS AND MARKETING ACTIVITIES, FACILITY LIABILITY COVERAGE, VOLUNTEER T-SHIRTS, EVENT SIGNAGE, DECORATIONS, GIVEAWAYS, AND ENTERTAINERS. IN 2003, GKAS WAS ADOPTED BY THE AMERICAN DENTAL ASSOCIATION AS A NATIONAL CAMPAIGN. IN 2006, GKAS WAS RECOGNIZED BY CONGRESS AS AN EXEMPLARY GRASSROOTS EFFORT. THE GKAS PROGRAM WAS EXPANDED TO THE GREATER KANSAS CITY AREA IN 2013. LONGEVITY: THIS PROGRAM HAS BEEN IN PLACE SINCE 2002.
FORM 990, PART VI, SECTION A, LINE 4CHANGES TO BY-LAWS ART. II, SEC. 1.B. CLARIFIES THAT TERMINATION OF A MEMBERS PARTICIPATING DENTIST AGREEMENT WILL RESULT IN TERMINATION OF MEMBERSHIP IN THE CORPORATION; REMOVES FAILURE TO FILE AN UPDATED FEE LISTING FROM THE POTENTIAL GROUNDS FOR TERMINATION; PROVIDES TWO ADDITIONAL GROUNDS FOR TERMINATION OF MEMBERSHIP IN THE CORPORATION: RETIREMENT FROM THE PRACTICE OF DENTISTRY AND NO LONGER BEING DULY LICENSED OR PRACTICING DENTISTRY WITHIN THE STATES OF MISSOURI OR SOUTH CAROLINA, WHICHEVER WAS APPLICABLE TO THE MEMBER. ART. III, SEC. 1 INCREASES THE NUMBER OF VOTING DIRECTORS BY TWO ONE DENTIST AND ONE REPRESENTATIVE OF THE PUBLIC WHO EITHER RESIDE IN OR HAVE THEIR PRIMARY PLACE OF EMPLOYMENT IN THE STATE OF SOUTH CAROLINA; PROVIDES FOR THE ADDITION OF ONE ADDITIONAL REPRESENTATIVE OF THE PUBLIC FROM THE STATE OF MISSOURI. ART. VI, SEC. 2 ALLOWS THE BOARD OR THE SPECIAL COMMITTEE TO DELEGATE CERTAIN POWERS OR FUNCTIONS OF A SPECIAL COMMITTEE TO OTHER DESIGNEES. ART. VI, SEC. 2.A. CHANGES THE DELIVERY METHOD OF SUSPENSION OR TERMINATION NOTICES FROM REGISTERED TO FIRST CLASS MAIL; SPECIFIES THAT SUSPENSION OR TERMINATION NOTICES WILL BE SENT TO THE LAST ADDRESS OF THE MEMBER SHOWN ON THE CORPORATIONS RECORDS.
FORM 990, PART VI, SECTION A, LINE 6CLASSES OF MEMBERS OR STOCKHOLDERS THE MEMBERS OF THE ORGANIZATION ARE COMPRISED OF LICENSED DENTISTS IN THE STATES OF MISSOURI AND SOUTH CAROLINA WHO HAVE SIGNED A PARTICIPATING DENTIST AGREEMENT WITH THE ORGANIZATION. THE MEMBERS MEET ANNUALLY.
FORM 990, PART VI, SECTION A, LINE 7AMEMBERS OR STOCKHOLDERS WHO CAN ELECT MEMBERS OF THE GOVERNING BODY THE ORGANIZATION HAS MEMBERS WHO ELECT THE INDIVIDUALS TO SERVE ON THE ORGANIZATION'S BOARD OF DIRECTORS. THE MEMBERS OF THE ORGANIZATION ARE COMPRISED OF LICENSED DENTISTS IN THE STATES OF MISSOURI AND SOUTH CAROLINA WHO HAVE SIGNED A PARTICIPATING DENTIST AGREEMENT WITH THE ORGANIZATION. THE MEMBERS MEET ANNUALLY.
FORM 990, PART VI, SECTION A, LINE 7BGOVERNANCE DECISIONS CHANGES TO THE CORPORATE BYLAWS BY THE BOARD ARE SUBJECT TO APPROVAL BY THE MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11BPROCESS TO REVIEW THE FORM 990 THE FORM 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. THE FORM 990 IS THEN REVIEWED IN DETAIL BY THE ORGANIZATION'S CFO AND PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE ELECTRONIC FILING OF THE FROM 990 WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12CPROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY DELTA DENTAL OF MISSOURI REGULARLY REQUIRES ITS OFFICERS, DIRECTORS, AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST STATEMENT. THE REVIEW OF THE STATEMENTS IS PART OF THE FINANCE AND AUDIT COMMITTEE'S RESPONSIBILITIES.
FORM 990, PART VI, SECTION B, LINE 15A & 15BCOMPENSATION APPROVAL PROCESS DELTA DENTAL OF MISSOURI HAS ESTABLISHED A COMPENSATION COMMITTEE (A SUBSET OF THE BOARD OF DIRECTORS) COMPOSED ENTIRELY OF PERSONS WITH NO CONFLICT OF INTEREST THAT REVIEWS AND SETS OFFICER COMPENSATION IN ACCORDANCE WITH THE PROCESS OUTLINED IN TREASURY REGULATION SECTION 53.4958-6 FOR ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS OF THE COMPENSATION OF THE CEO AND ALL OTHER OFFICERS. THIS PROCESS INCLUDES EMPLOYING INDEPENDENT COMPENSATION CONSULTANTS, UTILIZING RELEVANT COMPENSATION SURVEYS AND STUDIES, CONTEMPORANEOUSLY DOCUMENTING AND RECORDING THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT, AND SEEKING APPROVAL ON FINALIZED COMPENSATION PROPOSALS BY THE COMMITTEE AND BOARD OF DIRECTORS. REVIEWS ARE CONDUCTED AND APPROVED BY THE COMPENSATION COMMITTEE ON AN ANNUAL BASIS.
FORM 990, PART VI, LINE 19DISCLOSURE THE ORGANIZATION'S CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ADVANTICA HOLDING COMPANYBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line112399 GRAVOIS ROADAddressLine1Txt
CityST LOUISCityNm
State AbbreviationMOStateAbbreviationCd
ZIP63127ZIPCd
FieldValueIRS element (for citing)
EIN261323283EIN
Primary ActivitiesHOLDING COMPANYPrimaryActivitiesTxt
Legal Domicile StateMOLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeC-CORPEntityTypeTxt
Share Of Total Income$61,029,847ShareOfTotalIncomeAmt
Share Of EOY Assets$30,728,979ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (true)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
ADVANTICA HOLDING COMPANY
L$736,958ALLOCATIONS
ADVANTICA HOLDING COMPANY
M$8,573,923EXPENSE BASED

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