DELTA DENTAL OF IOWA: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL OF IOWA (EIN 42-0959302)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-13
IRS object ID
201743179349307609
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

FieldValueIRS element (for citing)
Return2017-11-13T16:04:56-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN421229486PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BROOKS LODDEN PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11441 29TH STREET STE 305AddressLine1Txt
CityWEST DES MOINESCityNm
State AbbreviationIAStateAbbreviationCd
ZIP502661357ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN420959302EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF IOWABusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlDELTBusinessNameControlTxt
Phone5152615500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line19000 NORTHPARK DRIVEAddressLine1Txt
CityJOHNSTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50131ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSHERRY PERKINSPersonNm
Person TitleVICE PRES FINANCE & CONTROLLERPersonTitleTxt
Phone5152615500PhoneNum
Signature2017-11-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRENT L ALEXANDERPreparerPersonNm
PTINP00075113PTIN
Phone5152237300PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address174.128.52.108IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-10IPDt
IP Tm09:35:35IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id380A664F5D883E29A3C6B4000ABE887F01EA73BBAtSubmissionCreationDeviceId
At Submission Filing Device IdEAD7FFB25ED7C72B7A4B552AC656CE00B93BEB83AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJEFFREY S RUSSELLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line19000 NORTHPARK DRIVEAddressLine1Txt
CityJOHNSTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50131ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$177,329,098GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressWWW.DELTADENTALIA.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1970FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionDENTAL HEALTH CARE: TO IMPROVE THE ORAL HEALTH OF THE PEOPLE WE SERVE. THIS IS ACCOMPLISHED THROUGH THE PROVISION OF DENTAL INSURANCE AND PUBLIC HEALTH CONTRIBUTIONS THAT FOCUS ON ACCESS TO ORAL HEALTH SERVICES AND EDUCATION RELATED TO GOOD ORAL HEALTH BEHAVIORS.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee142TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$192,457TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$148,034,215PYProgramServiceRevenueAmt
CY Program Service Revenue$166,048,526CYProgramServiceRevenueAmt
PY Investment Income$2,144,063PYInvestmentIncomeAmt
CY Investment Income$1,832,800CYInvestmentIncomeAmt
PY Other Revenue$109,879PYOtherRevenueAmt
CY Other Revenue$193,418CYOtherRevenueAmt
PY Total Revenue$150,288,157PYTotalRevenueAmt
CY Total Revenue$168,074,744CYTotalRevenueAmt
PY Grants And Similar Paid$3,900,772PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$7,394,196CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$112,195,291PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$124,474,650CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,754,717PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$13,117,019CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$19,086,217PYOtherExpensesAmt
CY Other Expenses$20,299,823CYOtherExpensesAmt
PY Total Expenses$146,936,997PYTotalExpensesAmt
CY Total Expenses$165,285,688CYTotalExpensesAmt
PY Revenues Less Expenses$3,351,160PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,789,056CYRevenuesLessExpensesAmt
Total Assets BOY$96,862,865TotalAssetsBOYAmt
Total Assets EOY$107,394,521TotalAssetsEOYAmt
Total Liabilities BOY$29,699,926TotalLiabilitiesBOYAmt
Total Liabilities EOY$33,934,865TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$67,162,939NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$73,459,656NetAssetsOrFundBalancesEOYAmt
MissionDENTAL HEALTH CARE: TO IMPROVE THE ORAL HEALTH OF THE PEOPLE WE SERVE. THIS IS ACCOMPLISHED THROUGH THE PROVISION OF DENTAL INSURANCE AND PUBLIC HEALTH CONTRIBUTIONS THAT FOCUS ON ACCESS TO ORAL HEALTH SERVICES AND EDUCATION RELATED TO GOOD ORAL HEALTH BEHAVIORS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$157,637,827ExpenseAmt
Grant$7,394,196GrantAmt
Revenue$166,049,487RevenueAmt
DescSINCE 1970, DELTA DENTAL OF IOWA HAS EXPANDED ACCESS TO DENTAL CARE BY PROVIDING AFFORDABLE, NETWORK BASED DENTAL BENEFITS PLANS TO IOWA EMPLOYERS AND INDIVIDUALS THAT RESULT IN LONG-TERM COST SAVINGS AND SUPPORT GOOD ORAL HEALTH. DELTA DENTAL OF IOWA'S DENTAL BENEFIT PLANS STRIVE TO INCORPORATE THE CURRENT BEST PRACTICES IN DENTAL SCIENCE. DELTA DENTAL IS COMMITTED TO ITS VISION OF IMPROVING THE ORAL HEALTH OF THE PEOPLE AND COMMUNITIES IT SERVES. DELTA DENTAL FULFILLS ITS NOT-FOR-PROFIT VISION BY ACTIVELY PARTICIPATING IN THE COMMUNITIES IT SERVES AS A CHAMPION AND MAJOR FUNDER OF ORAL HEALTH INITIATIVES IN THE STATE OF IOWA. DELTA DENTAL INVESTS IN ORAL HEALTH PROJECTS THAT MEET THE NEEDS OF UNDERSERVED POPULATIONS AND THAT FOCUS ON ACCESS TO CARE, PREVENTION, EDUCATION AND RESEARCH.Desc
Total Program Service Expenses$157,637,827TotalProgramServiceExpensesAmt
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document18483IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee142EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SHERRY PERKINSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5152615500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line19000 NORTHPARK DRIVEAddressLine1Txt
CityJOHNSTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50131ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
TOM ALLER
DIRECTOR2.50Yes (X)$24,700$0$0
ANNE HENNESSEY DDS
DIRECTOR2.20Yes (X)$17,800$0$0
JOHN KEARNS DDS
DIRECTOR2.20Yes (X)$500$0$14,900
RENIE NEUBERGER
DIRECTOR2.20Yes (X)$11,100$0$00.50
WILLIAM WEVER DDS
DIRECTOR1.60Yes (X)$15,800$0$0
CHARLES EDWARD BROWN
DIRECTOR1.60Yes (X)$14,500$0$0
ROWENA CROSBIE
DIRECTOR1.60Yes (X)$500$600$14,9000.50
JOHN MALETTA DDS
DIRECTOR1.60Yes (X)$500$0$14,900
TOM MAHONEY
DIRECTOR1.60Yes (X)$500$0$13,300
KRISTA TANNER
DIRECTOR1.60Yes (X)$13,700$0$0
JEFFREY S RUSSELL
PRESIDENT AND CEO40.00Yes (X)$724,824$0$154,1271.00Yes (X)
SHERRY PERKINS
VICE PRESIDENT FINANCE & CONTROLLER40.00$259,042$0$66,0811.00Yes (X)
SUZANNE HECKENLAIBLE
VICE PRESIDENT PUBLIC AFFAIRS30.00$244,900$0$63,03810.00Yes (X)
JEFF CHAFFIN
DENTAL DIRECTOR40.00$287,524$0$89,3411.00Yes (X)
APRIL SCHMALTZ
VP MARKETING AND BUSINESS DEVELOPMENT40.00$235,941$0$67,712Yes (X)
TODD HERREN
VP TECHNOLOGY40.00$266,754$0$78,748Yes (X)
ELIZABETH MYERS
DIRECTOR, OPERATIONS40.00$236,948$0$78,887Yes (X)
MICHAEL ELAM
VP SALES & CUSTOMER RELATIONS40.00$202,268$0$55,145Yes (X)
BRENDA JENSEN
ACCOUNT EXECUTIVE40.00$300,507$0$22,436Yes (X)
RANAE CALVERT
DIRECTOR, RISK MANAGEMENT40.00$208,655$0$34,222Yes (X)
JOHN FLEMING
DIRECTOR, PRICING & UNDERWRITING40.00$167,191$0$27,819Yes (X)
CAROL RAMSEY-SMITH
DIRECTOR COMPLIANCE & QUALITY ASSURANCE40.00$167,945$0$30,866Yes (X)
GRETCHEN HAGEMAN
DENTAL WELLNESS PLANNING DIRECTOR40.00$163,824$0$30,434Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,565,923TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$600TotReportableCompRltdOrgAmt
Total Other Compensation$856,856TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K30IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
UNIVERSITY OF IOWA
322 DENTAL SCIENCE BLDG SIOWA CITYIA52242DENTAL SERVICES$4,684,375
APPLEWHITE DENTAL IOWA PC
1340 DELHI STDUBUQUEIA52001DENTAL SERVICES$4,406,209
COLLEGE OF DENTISTRY
322 DENTAL SCIENCE BLDG SIOWA CITYIA52242DENTAL SERVICES$2,463,901
IOWA ORAL & MAXILL SURGEONS PC
1469 29TH STWEST DES MOINESIA50266DENTAL SERVICES$1,723,553
ORAL SURGEONS PC
7400 FLEUR DRIVE SUITE 200DES MOINESIA50321DENTAL SERVICES$1,718,696
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K651CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PREMIUMS EARNED524114$152,943,282$152,943,282
ADMINISTRATIVE SERVICE REVENUE524292$13,105,244$13,105,244
FieldValueIRS element (for citing)
Total Program Service Revenue$166,048,526TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,834,412TotalRevenueColumnAmt
Exclusion$1,834,412ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$9,252,742SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$9,254,354SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$1,612SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,612TotalRevenueColumnAmt
Exclusion-$1,612ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MANAGEMENT FEES541610$192,457$192,457
OTHER INCOME900099$961$961
FieldValueIRS element (for citing)
Other Revenue Total$193,418OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$168,074,744TotalRevenueColumnAmt
Related Or Exempt Func Income$166,049,487RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$192,457UnrelatedBusinessRevenueAmt
Exclusion$1,832,800ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$7,394,196TotalAmt
Program Services$7,394,196ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$124,474,650TotalAmt
Program Services$124,474,650ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$3,268,881TotalAmt
Program Services$1,283,434ProgramServicesAmt
Management And General$1,985,447ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,339,492TotalAmt
Program Services$5,794,624ProgramServicesAmt
Management And General$1,544,868ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$616,039TotalAmt
Program Services$443,051ProgramServicesAmt
Management And General$172,988ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,069,701TotalAmt
Program Services$1,017,513ProgramServicesAmt
Management And General$52,188ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$822,906TotalAmt
Program Services$573,722ProgramServicesAmt
Management And General$249,184ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$144,516TotalAmt
Program Services$33,441ProgramServicesAmt
Management And General$111,075ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$160,407TotalAmt
Program Services$45,000ProgramServicesAmt
Management And General$115,407ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$52,504TotalAmt
Management And General$52,504ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$183,680TotalAmt
Management And General$183,680ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,217,697TotalAmt
Program Services$3,796,713ProgramServicesAmt
Management And General$420,984ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$939,649TotalAmt
Program Services$880,450ProgramServicesAmt
Management And General$59,199ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,231,097TotalAmt
Program Services$2,751,858ProgramServicesAmt
Management And General$479,239ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,228,331TotalAmt
Program Services$1,228,331ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$582,255TotalAmt
Management And General$582,255ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$272,013TotalAmt
Program Services$161,860ProgramServicesAmt
Management And General$110,153ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$137,173TotalAmt
Program Services$62,600ProgramServicesAmt
Management And General$74,573ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,894,456TotalAmt
Program Services$1,358,817ProgramServicesAmt
Management And General$535,639ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$239,160TotalAmt
Management And General$239,160ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
UBIT TAX - FEDERAL AND$244$244
BROKER COMMISSIONS$4,597,073$4,597,073
PREMIUM TAXES$804,656$804,656
ACA HEALTH INSURERS$767,784$767,784

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$847,128TotalAmt
Program Services$167,810ProgramServicesAmt
Management And General$679,318ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$165,285,688TotalAmt
Program Services$157,637,827ProgramServicesAmt
Management And General$7,647,861ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$7,266,147BOYAmt
EOY$14,293,741EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$427,651BOYAmt
EOY$607,368EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$14,275,228BOYAmt
EOY$12,227,986EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$395,174BOYAmt
EOY$447,844EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$32,660,500LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$6,999,459LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$23,266,791BOYAmt
EOY$25,661,041EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$49,580,244BOYAmt
EOY$52,025,827EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$576,506BOYAmt
EOY$686,294EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,075,124BOYAmt
EOY$1,444,420EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$96,862,865BOYAmt
EOY$107,394,521EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,542,613BOYAmt
EOY$11,150,373EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$20,157,313BOYAmt
EOY$22,784,492EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$29,699,926BOYAmt
EOY$33,934,865EOYAmt
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$475,819BOYAmt
EOY$475,819EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$66,687,120BOYAmt
EOY$72,983,837EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$67,162,939BOYAmt
EOY$73,459,656EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$96,862,865BOYAmt
EOY$107,394,521EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,789,056ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$772,364NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$2,735,297OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,665,500OtherCostOrOtherBasisAmt
Book Value$2,665,500BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,851,832OtherCostOrOtherBasisAmt
Depreciation$1,212,414DepreciationAmt
Book Value$10,639,418BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$16,807,584OtherCostOrOtherBasisAmt
Depreciation$5,427,128DepreciationAmt
Book Value$11,380,456BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,335,584OtherCostOrOtherBasisAmt
Depreciation$359,917DepreciationAmt
Book Value$975,667BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$25,661,041TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDescAmtAmt
UNEARNED PREMIUMS$1,710,723
CLAIMS UNPAID AND RESERVE$15,761,771
OTHER POLICY RESERVES$618,024
INCENTIVE POOL RESERVE$2,912,367
INTERCOMPANY PAYABLE$178,026
OTHER LONG TERM LIABILITIES$1,281,046
AMOUNTS PAYABLE UNDER RISK CORRIDOR AGREEMENT$322,535
FieldValueIRS element (for citing)
Total Liability$22,784,492TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$350,842,490TotalRevEtcAuditedFinclStmtAmt
Other Revenue$183,143,883OtherRevenueAmt
Revenue Not Reported$183,143,883RevenueNotReportedAmt
Revenue Subtotal$167,698,607RevenueSubtotalAmt
Investment Expenses Not Incld$183,680InvestmentExpensesNotIncldAmt
Other Revenues Not Included$192,457OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$376,137RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$168,074,744TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$345,318,137TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$183,143,883OtherExpensesIncludedAmt
Expenses Not Reported$183,143,883ExpensesNotReportedAmt
Expenses Subtotal$162,174,254ExpensesSubtotalAmt
Investment Expenses Not Incld2$183,680InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$2,927,754OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$3,111,434ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$165,285,688TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:DELTA DENTAL OF IOWA IS EXEMPT FROM FEDERAL INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS MADE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE COMPANY ACCOUNTS FOR INCOME TAXES OF TAXABLE CONSOLIDATED ENTITIES, WHEREBY DEFERRED TAXES ARE PROVIDED ON TEMPORARY DIFFERENCES ARISING FROM ASSETS AND LIABILITIES WHOSE BASES ARE DIFFERENT FOR FINANCIAL REPORTING AND INCOME TAX PURPOSES. DEFERRED TAXES WERE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIALS STATEMENTS. AS OF DECEMBER 31, 2016 AND 2015, THE COMPANY'S UNRECOGNIZED TAX BENEFITS WERE NOT SIGNIFICANT. THERE WERE NO SIGNIFICANT PENALTIES OR INTEREST RECOGNIZED OR ACCURED DURING 2016 AND 2015.
PART XI, LINE 2D - OTHER ADJUSTMENTS:ADMINISTRATIVE SERVICE CLAIMS (NETTED WITH REVENUE) 183,143,883.
PART XI, LINE 4B - OTHER ADJUSTMENTS:MANAGEMENT FEES (NETTED WITH EMPLOYEE BENEFITS) 192,457.
PART XII, LINE 2D - OTHER ADJUSTMENTS:ADMINISTRATIVE SERVICE CLAIMS (NETTED WITH REVENUE) 183,143,883.
PART XII, LINE 4B - OTHER ADJUSTMENTS:MANAGEMENT FEES - NETTED WITH EXPENSES FOR FINANCIALS 192,457. GRANT TO DELTA DENTAL OF IOWA FOUNDATION ACCRUED ON PRIOR YEAR FINANCIALS 2,735,297.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
DELTA DENTAL OF IOWA FOUNDATION
9000 NORTHPARK DRIVEJOHNSTONIA50131260762771501(C)(3)$7,228,857CONTRIBUTION TO DELTA DENTAL OF IOWA FOUNDATION TO SUPPORT & IMPROVE THE ORAL HEALTH OF IOWANS.
COMMUNITY FOUNDATION OF GREATER DES MOINES
1915 GRAND AVEDES MOINESIA50309426139033501(C)(3)$150,000CONTRIBUTION TO CFGDM FOR THE DDIA DONOR ADVISED FUND. THE DONOR ADVISED FUND IS USED FOR THE REPAYMENT OF DENTAL EDUCATION DEBT FOR DENTISTS WHO AGREE TO ESTABLISH AN OFFICE IN A RURAL, UNDERSERVED AREA.

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART 1, QUESTION 1:FormAndLineReferenceDesc
ExplanationPART 1, QUESTION 1: IN 2016, DELTA DENTAL OF IOWA GRANTED $150,000 TO THE COMMUNITY FOUNDATION OF GREATER DES MOINES. DELTA DENTAL OF IOWA MAINTAINS A DONOR ADVISED FUND AT THE COMMUNITY FOUNDATION OF GREATER DES MOINES FOR THE PURPOSE OF AWARDING LOAN REPAYMENT AWARDS TO DENTISTS WHO AGREE TO PRACTICE IN AN UNDERSERVED AREA IN THE STATE OF IOWA AND TO DEDICATE A PORTION OF THEIR PRACTICE TO LOW INCOME PATIENTS. DELTA DENTAL OF IOWA ADVISES THE COMMUNITY FOUNDATION OF GREATER DES MOINES ON HOW TO AWARD THIS MONEY AND THE COMMUNITY FOUNDATION OF GREATER DES MOINES ONLY GRANTS THIS MONEY TO DENTISTS IN THE STATE OF IOWA. THE COMMUNITY FOUNDATION OF GREATER DES MOINES AND DELTA DENTAL OF IOWA MAINTAIN RECORDS TO SUBSTANTIATE THE AMOUNT OF GRANTS, THE GRANTEES' ELIGIBILITY AND THE SELECTION CRITERIA. DELTA DENTAL OF IOWA ALSO MAKES GRANTS TO THE DELTA DENTAL OF IOWA FOUNDATION. THE DELTA DENTAL OF IOWA FOUNDATION MAINTAINS RECORDS TO SUBSTANTIATE THE AMOUNT OF GRANTS, THE GRANTEES' ELIGIBILITY AND THE SELECTION CRITERIA.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgYes (1)CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

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 OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JEFFREY S RUSSELL
PRESIDENT AND CEO$477,324$0$225,441$0$22,059$0$136,973$0$17,154$0$878,951$0$0$0
SHERRY PERKINS
VICE PRESIDENT FINANCE & CONTROLLER$183,523$0$71,779$0$3,740$0$48,897$0$17,184$0$325,123$0$0$0
SUZANNE HECKENLAIBLE
VICE PRESIDENT PUBLIC AFFAIRS$174,595$0$68,309$0$1,996$0$45,854$0$17,184$0$307,938$0$0$0
JEFF CHAFFIN
DENTAL DIRECTOR$199,981$0$83,121$0$4,422$0$87,756$0$1,585$0$376,865$0$0$0
APRIL SCHMALTZ
VP MARKETING AND BUSINESS DEVELOPMEN$168,052$0$65,889$0$2,000$0$50,558$0$17,154$0$303,653$0$0$0
TODD HERREN
VP TECHNOLOGY$204,940$0$57,892$0$3,922$0$69,619$0$9,129$0$345,502$0$0$0
ELIZABETH MYERS
DIRECTOR, OPERATIONS$185,925$0$47,114$0$3,909$0$72,203$0$6,684$0$315,835$0$0$0
MICHAEL ELAM
VP SALES & CUSTOMER RELATIONS$151,839$0$47,494$0$2,935$0$53,560$0$1,585$0$257,413$0$0$0
BRENDA JENSEN
ACCOUNT EXECUTIVE$61,684$0$237,105$0$1,718$0$21,200$0$1,236$0$322,943$0$0$0
RANAE CALVERT
DIRECTOR, RISK MANAGEMENT$137,714$0$69,423$0$1,518$0$16,990$0$17,232$0$242,877$0$0$0
JOHN FLEMING
DIRECTOR, PRICING & UNDERWRITING$137,206$0$28,467$0$1,518$0$13,877$0$13,942$0$195,010$0$0$0
CAROL RAMSEY-SMITH
DIRECTOR COMPLIANCE & QUALITY ASSURA$135,203$0$31,024$0$1,718$0$13,682$0$17,184$0$198,811$0$0$0
GRETCHEN HAGEMAN
DENTAL WELLNESS PLANNING DIRECTOR$129,306$0$33,000$0$1,518$0$13,280$0$17,154$0$194,258$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ATRAVEL FOR THE SPOUSE OF THE PRESIDENT AND CEO IS PAID BY THE COMPANY. THE TOTAL AMOUNT OF THE TRAVEL IS INCLUDED IN TAXABLE WAGES FOR THE PRESIDENT AND CEO. TAX GROSS UP PAYMENTS ARE RELATED TO TAXABLE FRINGE BENEFITS INCLUDED AS COMPENSATION FOR ALL COMPANY EMPLOYEES INCLUDING THE PERSONS LISTED IN PART VII, SECTION A, LINE 1. THE PAYMENTS REPRESENT 1% OR LESS OF COMPENSATION FOR THE INDIVIDUALS. SOCIAL CLUB DUES FOR THE PRESIDENT & CEO ARE PAID BY THE COMPANY. THE AMOUNT OF PERSONAL USAGE OF THE CLUB IS INCLUDED IN TAXABLE WAGES FOR THE PRESIDENT & CEO.
PART I, LINE 4BOFFICERS OF THE COMPANY PARTICIPATE IN A SEC. 457(F) PLAN. THE COMPANY MAKES A CONTRIBUTION TO THE PLAN ANNUALLY ON BEHALF OF THE OFFICERS. THIS CONTRIBUTION IS A PERCENTAGE OF SALARY AND IS SET AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. AFTER FIVE YEARS OF PARTICIPATION IN THE PLAN, AN OFFICER BECOMES VESTED IN 20% OF THE BALANCE OF THE ACCOUNT AND THAT AMOUNT IS PAID TO THE OFFICER. OTHER THAN THE VESTING CRITERIA, THE OFFICERS CANNOT ACCESS THE FUNDS UNTIL RETIREMENT, LEAVING THE COMPANY, OR DEATH. OFFICERS WHO RECEIVED DEPOSITS IN 2016 AND AMOUNTS ARE: JEFFREY S. RUSSELL $ 115,773 SHERRY PERKINS $ 31,678 SUZANNE HECKENLAIBLE $ 26,776 JEFF CHAFFIN $ 64,377 APRIL SCHMALTZ $ 31,071 TODD HERREN $ 48,419 ELIZABETH MYERS $ 53,594 MICHAEL ELAM $ 37,995 OFFICERS WHO RECEIVED PAYMENTS OF VESTED AMOUNTS IN 2016 AND THE AMOUNTS ARE: SHERRY PERKINS $ 6,996 SUZANNE HECKENLAIBLE $ 6,188
PART I, LINE 5TWO EMPLOYEES OF THE COMPANY HAVE COMPENSATION CONTINGENT ON REVENUES. THE INDIVIDUALS WORK IN THE SALES DEPARTMENT AND RECEIVE COMMISSIONS BASED ON SALES OF GROUP BUSINESS. THESE INDIVIDUALS ARE RESPONSIBLE FOR SELLING NEW BUSINESS.
PART I, LINE 6CONSISTENT WITH THE COMPANY'S TOTAL COMPENSATION POLICY, THE OFFICERS AND HIGHER COMPENSATED EMPLOYEES, ALONG WITH ALL EMPLOYEES OF THE COMPANY, PARTICIPATE IN A COMPANY INCENTIVE COMPENSATION PLAN. THIS PLAN CONTAINS EIGHT METRICS WHICH REPRESENT KEY GOALS FOR THE PLAN YEAR. AN OVERALL WEIGHTED SCORE IS CALCULATED. A BONUS WILL BE PAID IF THE COMPANY MEETS A RANGE OF GOAL ACCOMPLISHMENTS FOR THE YEAR. THE AMOUNT OF THE BONUS IS BASED ON THE TOTAL SCORE. ONE OF THESE METRICS IS PROFITABILITY, WHICH IS DEFINED AS "TOTAL NET GAIN IN DOLLARS PRIOR TO ORAL HEALTH CONTRIBUTIONS FOR THE FISCAL YEAR PER AUDITED FINANCIAL RESULTS."

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (6 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
JOHN KEARNS DDS
DIRECTOR$252,550INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES0
ANNE HENNESSEY DDS
DIRECTOR$164,513INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES0
WILLIAM WEVER DDS
DIRECTOR$202,461INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES0
JOHN MALETTA DDS
DIRECTOR$303,213INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES0
CHARLES EDWARD BROWN
DDIA DIRECTOR & OFFICER OF EMPLOYER WHO PURCHASES DENTAL BENEFITS FROM DDIA$353,295PAYMENTS BY EMPLOYER TO DDIA FOR DENTAL BENEFITS0
TOM MAHONEY
DDIA DIRECTOR & OFFICER OF EMPLOYER WHO PURCHASES DENTAL BENEFITS FROM DDIA$291,036PAYMENTS BY EMPLOYER TO DDIA FOR DENTAL BENEFITS0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2E. BROWN AND J. MALETTA HAD A PROVIDER-RELATED BUSINESS RELATIONSHIP IN 2016.
FORM 990, PART VI, SECTION A, LINE 6THE MEMBERS OF THE CORPORATION CONSIST OF THE PROVIDERS (PARTICIPATING DENTISTS), AND SUBSCRIBERS WHO ARE ELECTED BY THE BOARD.
FORM 990, PART VI, SECTION A, LINE 7ADECISIONS OF THE GOVERNING BODY ARE NOT SUBJECT TO APPROVAL BY THE MEMBERSHIP WITH THE EXCEPTION OF CHANGES TO THE ARTICLES OF INCORPORATION. THOSE CHANGES MUST BE APPROVED BY THE MEMBERSHIP.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 AND ALL RELATED SCHEDULES WERE REVIEWED BY BOTH THE MANAGEMENT OF THE COMPANY AND THE BOARD OF DIRECTORS PRIOR TO FILING. THE FORM 990 WAS REVIEWED BY MANAGEMENT OF THE COMPANY PRIOR TO PRESENTATION TO THE BOARD. THE MEMBERS OF THE MANAGEMENT TEAM WHO REVIEWED THE FORM 990 WERE THE CEO, COO, COMPLIANCE DIRECTOR, AND VICE PRESIDENT FINANCE. AN ELECTRONIC COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS IN NOVEMBER OF 2017. ALL MEMBERS OF THE BOARD REVIEWED THE FORM 990 AND RELATED SCHEDULES PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE COMPLIANCE DIRECTOR, ON BEHALF OF THE GOVERNANCE COMMITTEE, CONDUCTS AN ANNUAL CONFLICT OF INTEREST REVIEW FOR COMPLIANCE WITH FEDERAL AND STATE LAW AND THE GOVERNANCE POLICY. THE REVIEW INCLUDES ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES. COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES AND DISCLOSURES ARE COMPARED TO THE GROUP FOR POTENTIALLY CONFLICTING TRANSACTIONS, BUSINESS AND FAMILY RELATIONSHIPS, AND AFFILIATIONS. ANNUAL COMPENSATION, REIMBURSEMENTS, BENEFIT PAYMENTS, AND OTHER TRANSACTIONS ARE ALSO REVIEWED FOR APPROPRIATENESS. A WRITTEN REPORT OF THE FINDINGS IS PRESENTED TO THE GOVERNANACE COMMITTEE, BOARD OF DIRECTORS AND SENIOR MANAGEMENT. SOLUTIONS TO POTENTIAL CONFLICTS ARE DISCUSSED AND DOCUMENTED IN THE BOARD OF DIRECTOR'S MEETING MINUTES.
FORM 990, PART VI, SECTION B, LINE 15ON A BI-ANNUAL BASIS, DELTA DENTAL OF IOWA DOES A MARKET PRICE AND BENCHMARKING COMPARISON OF THE COMPENSATION OF THE LEADERSHIP TEAM AND THE STAFF. THIS ANALYSIS IS PERFORMED BY AN INDEPENDENT THIRD PARTY. THIS ANALYSIS INCLUDES THE USE OF DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THE DOCUMENTED RESULTS AND RECOMMENDATIONS OF THIS ANALYSIS ARE PRESENTED TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS REVIEWS THE DOCUMENTATION AND APPROVES THE COMPENSATION. THESE DECISIONS ARE DOCUMENTED IN THE MINUTES OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19DELTA DENTAL OF IOWA'S GOVERNING DOCUMENTS BECOME A MATTER OF PUBLIC RECORD WHEN THEY ARE FILED WITH THE IOWA SECRETARY OF STATE. THE FINANCIAL STATEMENTS BECOME A MATTER OF PUBLIC RECORD WHEN THEY ARE FILED WITH THE IOWA INSURANCE DIVISION. BOTH AGENCIES HAVE ONLINE PUBLIC VIEWING ACCESS. THE CONFLICT OF INTEREST POLICY IS NOT FILED WITH THE STATE AGENCIES; HOWEVER, IT WOULD BE MADE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:GRANT TO DELTA DENTAL OF IOWA FOUNDATION ACCRUED ON PRIOR YEAR FINANCIALS 2,735,297.
FORM 990, PART XI, LINE 2C:THE ORGANIZATION HAS A FINANCE AND AUDIT COMMITTEE THAT HAS RESPONSIBILITY FOR SELECTION OF THE INDEPENDENT ACCOUNTANT AND OVERSIGHT OF THE AUDIT. THE BOARD OF DIRECTORS APPROVES THE ANNUAL APPOINTMENT OF THE INDEPENDENT ACCOUNTANT.
SCHEDULE R, PART II, COLUMN B:DELTA DENTAL OF IOWA'S VISION IS TO IMPROVE THE ORAL HEALTH OF THOSE WE SERVE. AN AMOUNT IS SET ASIDE EACH YEAR TO FUND THIS MISSION. THE AMOUNT IS DETERMINED BY THE PERFORMANCE AND FINANCIAL STRENGTH OF THE COMPANY. AFTER THE AUDITED FINANCIALS ARE COMPLETE, AN AMOUNT IS PAID TO THE DELTA DENTAL OF IOWA FOUNDATION. THE DELTA DENTAL OF IOWA FOUNDATION IS A SEC. 501(C)(3) ORGANIZATION AND IS A TYPE 1 SUPPORTING ORGANIZATION UNDER SEC. 509(A)(3). IT IS THE RESPONSIBILITY OF THE FOUNDATION TO DISTRIBUTE THE MONIES CONSISTENT WITH IT'S MISSION AND FOUNDING DOCUMENTS. THE MISSION OF THE DELTA DENTAL OF IOWA FOUNDATION IS TO SUPPORT AND IMPROVE THE ORAL HEALTH OF IOWANS. THE FOUNDATION WILL PROVIDE FUNDS TO OTHER SEC. 501(C)(3) ORGANIZATIONS, GOVERNMENTS, OR ACADEMIC INSTITUTIONS THAT ARE UNDERTAKING PROJECTS THAT SUPPORT AND IMPROVE THE ORAL HEALTH OF IOWANS. THE FOUNDATION WILL PROVIDE FUNDS TO OTHER TAX-EXEMPT ORGANIZATIONS THROUGH THEIR GRANTS PROGRAM THAT ALIGN WITH THE PROJECTS OF ACCESS TO CARE, RESEARCH, EDUCATION AND PREVENTION. THE AMOUNT CONTRIBUTED TO THE FOUNDATION IN 2016 WAS $7,228,857. ADDITIONALLY, DELTA DENTAL OF IOWA PROVIDES MANAGEMENT SERVICES FOR THE FOUNDATION. THIS INCLUDES DUTIES PERFORMED BY THE CHIEF EXECUTIVE OFFICER AND THE VICE PRESIDENT, FINANCE. THE EXECUTIVE DIRECTOR OF THE FOUNDATION IS THE DIRECTOR OF GOVERNMENT AND COMMUNITY RELATIONS FOR DELTA DENTAL OF IOWA. ALSO, DELTA DENTAL OF IOWA PROVIDES SOME ACOUNTING FUNCTIONS. THE FOUNDATION REIMBURSES DELTA DENTAL OF IOWA FOR ALL STAFF CHARGES RELATED TO THE FOUNDATION. THE AMOUNT REIMBURSED TO DELTA DENTAL OF IOWA IN 2016 WAS $290,332 FOR MANAGEMENT FEES AND $20,456 FOR OTHER EXPENSES.
SCHEDULE R, PART IV, COLUMN B:VERATRUS BENEFIT SOLUTIONS, INC. (VERATRUS) IS A FOR-PROFIT CORPORATION AND A WHOLLY-OWNED SUBSIDIARY OF DELTA DENTAL OF IOWA. VERATRUS WAS ORGANIZED TO DISTRIBUTE THE DELTA VISION PRODUCT. DELTA DENTAL OF IOWA MADE NO ADDITIONAL INVESTMENTS IN PAID-IN CAPITAL IN VERATRUS IN 2016. DELTA DENTAL OF IOWA COLLECTS PREMIUMS FROM GROUPS FOR VISION COVERAGE AND TRANSFERS THIS PREMIUM TO VERATRUS. IN 2016, DELTA DENTAL OF IOWA TRANSFERRED $2,302,973 TO VERATRUS FOR PREMIUMS COLLECTED ON THEIR BEHALF. IN ADDITION, DELTA DENTAL OF IOWA PROVIDES MANAGEMENT SERVICES TO VERATRUS. VERATRUS REIMBURSES DELTA DENTAL OF IOWA FOR ALL STAFF CHARGES RELATED TO VERATRUS. THE AMOUNT REIMBURSED TO DELTA DENTAL OF IOWA IN 2016 WAS $192,457 FOR MANAGEMENT FEES AND $228,046 FOR OTHER EXPENSES. DELTA DENTAL OF IOWA ALSO PURCHASES VISION BENEFITS FROM VERATRUS FOR DDIA EMPLOYEES. THE AMOUNT PAID TO VERATRUS IN 2016 FOR VISION BENEFITS FOR DDIA EMPLOYEES WAS $19,750.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF IOWA FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line19000 NORTHPARK DRIVEAddressLine1Txt
CityJOHNSTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50131ZIPCd
FieldValueIRS element (for citing)
EIN260762771EIN
Primary ActivitiesCHARITABLE ORGANIZATION TO SUPPORT AND IMPROVE THE ORAL HEALTH OF IOWANS.PrimaryActivitiesTxt
Legal Domicile StateIALegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 12A, IPublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL OF IOWABusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1VERATRUS BENEFIT SOLUTIONS INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line19000 NORTHPARK DRIVEAddressLine1Txt
CityJOHNSTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50131ZIPCd
FieldValueIRS element (for citing)
EIN271584394EIN
Primary ActivitiesFOR-PROFIT CORPORATION ORGANIZED TO DISTRIBUTE THE DELTA VISION PRODUCT.PrimaryActivitiesTxt
Legal Domicile StateIALegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1DENTAL DENTAL OF IOWABusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income$109,787ShareOfTotalIncomeAmt
Share Of EOY Assets$1,012,549ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
DELTA DENTAL OF IOWA FOUNDATION
B$7,228,857SEE PART VII - SUPPLEMENTAL INFO.
DELTA DENTAL OF IOWA FOUNDATION
O$290,331SEE PART VII - SUPPLEMENTAL INFO.
VERATRUS BENEFIT SOLUTIONS INC
O$192,457SEE PART VII - SUPPLEMENTAL INFO.
VERATRUS BENEFIT SOLUTIONS INC
R$2,302,973SEE PART VII - SUPPLEMENTAL INFO.
VERATRUS BENEFIT SOLUTIONS INC
Q$228,046SEE PART VII - SUPPLEMENTAL INFO.

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, SCHEDULE R, PART V, LINE 2(1), COLUMN D:PERCENTAGE OF REVENUE BASED ON BOARD APPROVED POLICY
FORM 990, SCHEDULE R, PART V, LINE 2(2), COLUMN D:FEES CHARGED TO DELTA DENTAL OF IOWA FOUNDATION BASED ON HOURS WORKED
FORM 990, SCHEDULE R, PART V, LINE 2(3), COLUMN D:MANAGEMENT FEES CHARGED TO VERATRUS BENEFIT SOLUTIONS, INC. BASED ON HOURS WORKED
FORM 990, SCHEDULE R, PART V, LINE 2(4), COLUMN D:VISION PREMIUMS BILLED AND COLLECTED BY DDIA ON BEHALF OF VERATRUS BENEFIT SOLUTIONS, INC. CASH WAS TRANSFERRED FROM DDIA TO VERATRUS FOR THESE PREMIUMS.
FORM 990, SCHEDULE R, PART V, LINE 2(5), COLUMN D:ACTUAL COST OF INVOICES PAID BY DDIA ON BEHALF OF VERATRUS BENEFIT SOLUTIONS, INC.
FORM 990, SCHEDULE R, PART V, LINE 2(6), COLUMN D:ACTUAL COST OF INVOICES PAID BY DDIA ON BEHALF OF DELTA DENTAL OF IOWA FOUNDATION.

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