DELTA DENTAL OF IOWA: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL OF IOWA (EIN 42-0959302)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-09
IRS object ID
201603149349300135
Schema version
2015v2.1
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)
Return2016-11-09T09:07:07-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

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 Begin2015-01-01TaxPeriodBeginDt

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
Signature2016-11-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRENT L ALEXANDERPreparerPersonNm
PTINP00075113PTIN
Phone5152237300PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
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$156,397,627GrossReceiptsAmt
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 Employee122TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$109,278TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$1,092NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$121,886,777PYProgramServiceRevenueAmt
CY Program Service Revenue$148,034,215CYProgramServiceRevenueAmt
PY Investment Income$5,233,718PYInvestmentIncomeAmt
CY Investment Income$2,144,063CYInvestmentIncomeAmt
PY Other Revenue$79,165PYOtherRevenueAmt
CY Other Revenue$109,879CYOtherRevenueAmt
PY Total Revenue$127,199,660PYTotalRevenueAmt
CY Total Revenue$150,288,157CYTotalRevenueAmt
PY Grants And Similar Paid$2,874,454PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$3,900,772CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$90,536,418PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$112,195,291CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$10,153,775PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$11,754,717CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$15,935,369PYOtherExpensesAmt
CY Other Expenses$19,086,217CYOtherExpensesAmt
PY Total Expenses$119,500,016PYTotalExpensesAmt
CY Total Expenses$146,936,997CYTotalExpensesAmt
PY Revenues Less Expenses$7,699,644PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,351,160CYRevenuesLessExpensesAmt
Total Assets BOY$90,683,380TotalAssetsBOYAmt
Total Assets EOY$96,862,865TotalAssetsEOYAmt
Total Liabilities BOY$25,243,781TotalLiabilitiesBOYAmt
Total Liabilities EOY$29,699,926TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$65,439,599NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$67,162,939NetAssetsOrFundBalancesEOYAmt
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$138,938,465ExpenseAmt
Grant$3,900,772GrantAmt
Revenue$148,034,816RevenueAmt
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$138,938,465TotalProgramServiceExpensesAmt
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 Document17844IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee122EmployeeCnt
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 (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
TOM ALLER
DIRECTOR2.50Yes (X)$21,700$0$0
WILLIAM WEVER DDS
DIRECTOR1.60Yes (X)$13,500$0$0
ANNE HENNESSEY DDS
DIRECTOR2.20Yes (X)$15,100$0$0
JOHN KEARNS DDS
DIRECTOR2.20Yes (X)$3,000$0$15,500
RENIE NEUBERGER
DIRECTOR2.20Yes (X)$13,100$0$00.50
JEFF PLAGGE
DIRECTOR1.60Yes (X)$139,336$0$139,336
CHARLES EDWARD BROWN
DIRECTOR1.60Yes (X)$12,200$0$0
ED HANSELL
DIRECTOR2.20Yes (X)$13,100$0$0
ROWENA CROSBIE
DIRECTOR1.60Yes (X)$13,900$0$00.50
JOHN MALETTA DDS
DIRECTOR1.60Yes (X)$500$0$7,000
TOM MAHONEY
DIRECTOR1.60Yes (X)$500$0$3,000
KRISTA TANNER
DIRECTOR1.60Yes (X)$3,400$0$0
JEFFREY S RUSSELL
PRESIDENT AND CEO40.00Yes (X)$650,050$0$154,1721.00Yes (X)
CHERYL HARDING
VICE PRESIDENT AND COO40.00$385,156$0$21,084Yes (X)
GREGORY SHIREMAN
VP SALES AND CUSTOMER RELATIONS40.00$342,235$0$13,167Yes (X)
SHERRY PERKINS
VICE PRESIDENT FINANCE & CONTROLLER40.00$225,412$0$64,8371.00Yes (X)
SUZANNE HECKENLAIBLE
VICE PRESIDENT PUBLIC AFFAIRS30.00$219,992$0$61,58110.00Yes (X)
GREGG ROUNDS
VP TECHNOLOGY40.00$33,770$0$2,285Yes (X)
JEFF CHAFFIN
DENTAL DIRECTOR40.00$227,530$0$83,9211.00Yes (X)
DONN HUTCHINS
FORMER OFFICER & DIRECTOR0.00$815,438$0$00.00Yes (X)
APRIL SCHMALTZ
VP MARKETING AND BUSINESS DEVELOPMENT40.00$151,644$0$60,854Yes (X)
TODD HERREN
VP TECHNOLOGY40.00$139,674$0$53,551Yes (X)
ELIZABETH MYERS
DIRECTOR, OPERATIONS40.00$212,221$0$28,221Yes (X)
BRENDA JENSEN
ACCOUNT EXECUTIVE40.00$242,703$0$20,511Yes (X)
RICHARD RUSSELL
DIRECTOR, STRATEGIC BUSINESS OPERATIONS40.00$240,026$0$34,391Yes (X)
RANAE CALVERT
DIRECTOR, RISK MANAGEMENT40.00$164,521$0$30,912Yes (X)
GRETCHEN HAGEMAN
DENTAL WELLNESS PLANNING DIRECTOR40.00$146,455$0$29,075Yes (X)
CAROL RAMSEY-SMITH
DIRECTOR COMPLIANCE & QUALITY ASSURANCE40.00$144,532$0$29,065Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,590,695TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$852,463TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K16IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
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$4,280,455
APPLEWHITE DENTAL IOWA PC
1340 DELHI STDUBUQUEIA52001DENTAL SERVICES$3,654,424
ORAL SURGEONS PC
7400 FLEUR DRIVE SUITE 200DES MOINESIA50321DENTAL SERVICES$1,638,641
IOWA ORAL & MAXILL SURGEONS PC
1469 29TH STWEST DES MOINESIA50266DENTAL SERVICES$1,636,209
CONSAMUS AND HAMPTON DENTAL CLINIC PLC
3324 ORION DRAMESIA50010DENTAL SERVICES$1,632,760
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K556CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PREMIUMS EARNED524114$135,928,457$135,928,457
ADMINISTRATIVE SERVICE REVENUE524292$12,105,758$12,105,758
FieldValueIRS element (for citing)
Total Program Service Revenue$148,034,215TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,820,269TotalRevenueColumnAmt
Exclusion$1,820,269ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$6,433,264SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$6,109,470SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$323,794SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$323,794TotalRevenueColumnAmt
Exclusion$323,794ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MANAGEMENT FEES541610$109,278$109,278
OTHER INCOME900099$601$601
FieldValueIRS element (for citing)
Other Revenue Total$109,879OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$150,288,157TotalRevenueColumnAmt
Related Or Exempt Func Income$148,034,816RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$109,278UnrelatedBusinessRevenueAmt
Exclusion$2,144,063ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$3,900,772TotalAmt
Program Services$3,900,772ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$112,195,291TotalAmt
Program Services$112,195,291ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$3,545,529TotalAmt
Program Services$1,513,909ProgramServicesAmt
Management And General$2,031,620ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,379,617TotalAmt
Program Services$4,874,086ProgramServicesAmt
Management And General$1,505,531ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$203,097TotalAmt
Program Services$136,439ProgramServicesAmt
Management And General$66,658ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$873,758TotalAmt
Program Services$822,134ProgramServicesAmt
Management And General$51,624ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$752,716TotalAmt
Program Services$501,293ProgramServicesAmt
Management And General$251,423ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$99,358TotalAmt
Program Services$35,617ProgramServicesAmt
Management And General$63,741ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$120,700TotalAmt
Management And General$120,700ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$50,629TotalAmt
Management And General$50,629ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$175,936TotalAmt
Management And General$175,936ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,816,239TotalAmt
Program Services$3,177,185ProgramServicesAmt
Management And General$639,054ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$642,455TotalAmt
Program Services$585,676ProgramServicesAmt
Management And General$56,779ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,725,128TotalAmt
Program Services$3,007,603ProgramServicesAmt
Management And General$717,525ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,155,494TotalAmt
Program Services$1,155,494ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$541,580TotalAmt
Management And General$541,580ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$279,568TotalAmt
Program Services$185,905ProgramServicesAmt
Management And General$93,663ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$164,831TotalAmt
Program Services$75,595ProgramServicesAmt
Management And General$89,236ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,877,228TotalAmt
Program Services$1,293,900ProgramServicesAmt
Management And General$583,328ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$232,073TotalAmt
Management And General$232,073ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BROKER COMMISSIONS$4,062,434$4,062,434
PREMIUM TAXES$699,903$699,903
ACA HEALTH INSURERS$584,394$584,394
DDPA DUES$323,224$323,224

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$535,043TotalAmt
Program Services$130,835ProgramServicesAmt
Management And General$404,208ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$146,936,997TotalAmt
Program Services$138,938,465ProgramServicesAmt
Management And General$7,998,532ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$13,245,867BOYAmt
EOY$7,266,147EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,338,022BOYAmt
EOY$427,651EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,388,789BOYAmt
EOY$14,275,228EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$395,174EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$28,371,795LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,105,004LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$20,931,221BOYAmt
EOY$23,266,791EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$49,569,921BOYAmt
EOY$49,580,244EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$471,258BOYAmt
EOY$576,506EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$738,302BOYAmt
EOY$1,075,124EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$90,683,380BOYAmt
EOY$96,862,865EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$14,946,967BOYAmt
EOY$9,542,613EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,296,814BOYAmt
EOY$20,157,313EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$25,243,781BOYAmt
EOY$29,699,926EOYAmt
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$64,963,780BOYAmt
EOY$66,687,120EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$65,439,599BOYAmt
EOY$67,162,939EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$90,683,380BOYAmt
EOY$96,862,865EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$3,351,160ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,627,820NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
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$895,609DepreciationAmt
Book Value$10,956,223BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,518,879OtherCostOrOtherBasisAmt
Depreciation$3,938,517DepreciationAmt
Book Value$8,580,362BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,335,584OtherCostOrOtherBasisAmt
Depreciation$270,878DepreciationAmt
Book Value$1,064,706BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$23,266,791TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
UNEARNED PREMIUMS$1,798,050
CLAIMS UNPAID AND RESERVE$14,030,999
OTHER POLICY RESERVES$968,449
INCENTIVE POOL RESERVE$2,345,000
INTERCOMPANY PAYABLE$137,504
OTHER LONG TERM LIABILITIES$877,311
FieldValueIRS element (for citing)
Total Liability$20,157,313TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$323,993,322TotalRevEtcAuditedFinclStmtAmt
Other Revenue$173,990,379OtherRevenueAmt
Revenue Not Reported$173,990,379RevenueNotReportedAmt
Revenue Subtotal$150,002,943RevenueSubtotalAmt
Investment Expenses Not Incld$175,936InvestmentExpensesNotIncldAmt
Other Revenues Not Included$109,278OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$285,214RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$150,288,157TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$320,642,162TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$173,990,379OtherExpensesIncludedAmt
Expenses Not Reported$173,990,379ExpensesNotReportedAmt
Expenses Subtotal$146,651,783ExpensesSubtotalAmt
Investment Expenses Not Incld2$175,936InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$109,278OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$285,214ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$146,936,997TotalExpensesPerForm990Amt

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, 2015 AND 2014, THE COMPANY'S UNRECOGNIZED TAX BENEFITS WERE NOT SIGNIFICANT. THERE WERE NO SIGNIFICANT PENALTIES OR INTEREST RECOGNIZED OR ACCURED DURING 2015 AND 2014.
PART XI, LINE 2D - OTHER ADJUSTMENTS:ADMINISTRATIVE SERVICE CLAIMS (NETTED WITH REVENUE) 173,990,379.
PART XI, LINE 4B - OTHER ADJUSTMENTS:MANAGEMENT FEES (NETTED WITH EMPLOYEE BENEFITS) 109,278.
PART XII, LINE 2D - OTHER ADJUSTMENTS:ADMINISTRATIVE SERVICE CLAIMS (NETTED WITH REVENUE) 173,990,379.
PART XII, LINE 4B - OTHER ADJUSTMENTS:MANAGEMENT FEES - NETTED WITH EXPENSES FOR FINANCIALS 109,278.

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)$3,679,395CONTRIBUTION 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 2015, 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 (15 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$465,635$0$159,231$0$25,184$0$136,973$0$17,199$0$804,222$0$0$0
CHERYL HARDING
VICE PRESIDENT AND COO$286,760$0$92,653$0$5,743$0$8,891$0$12,193$0$406,240$0$0$0
GREGORY SHIREMAN
VP SALES AND CUSTOMER RELATIONS$263,655$0$77,163$0$1,417$0$5,861$0$7,306$0$355,402$0$0$0
SHERRY PERKINS
VICE PRESIDENT FINANCE & CONTROLLER$170,081$0$53,074$0$2,257$0$47,638$0$17,199$0$290,249$0$0$0
SUZANNE HECKENLAIBLE
VICE PRESIDENT PUBLIC AFFAIRS$165,791$0$52,012$0$2,189$0$44,352$0$17,229$0$281,573$0$0$0
JEFF CHAFFIN
DENTAL DIRECTOR$200,634$0$23,951$0$2,945$0$82,316$0$1,605$0$311,451$0$0$0
DONN HUTCHINS
FORMER OFFICER & DIRECTOR$0$0$0$0$815,438$0$0$0$0$0$815,438$0$28,527$0
APRIL SCHMALTZ
VP MARKETING AND BUSINESS DEVELOPMEN$149,480$0$0$0$2,164$0$43,329$0$17,525$0$212,498$0$0$0
TODD HERREN
VP TECHNOLOGY$137,534$0$0$0$2,140$0$46,694$0$6,857$0$193,225$0$0$0
ELIZABETH MYERS
DIRECTOR, OPERATIONS$175,669$0$33,725$0$2,827$0$21,193$0$7,028$0$240,442$0$0$0
BRENDA JENSEN
ACCOUNT EXECUTIVE$60,942$0$180,280$0$1,481$0$19,229$0$1,282$0$263,214$0$0$0
RICHARD RUSSELL
DIRECTOR, STRATEGIC BUSINESS OPERATI$199,630$0$37,908$0$2,488$0$17,192$0$17,199$0$274,417$0$0$0
RANAE CALVERT
DIRECTOR, RISK MANAGEMENT$135,190$0$27,648$0$1,683$0$13,683$0$17,229$0$195,433$0$0$0
GRETCHEN HAGEMAN
DENTAL WELLNESS PLANNING DIRECTOR$128,839$0$15,923$0$1,693$0$11,876$0$17,199$0$175,530$0$0$0
CAROL RAMSEY-SMITH
DIRECTOR COMPLIANCE & QUALITY ASSURA$119,697$0$23,352$0$1,483$0$11,836$0$17,229$0$173,597$0$0$0

Supplemental Information Detail SupplementalInformationDetail (5 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 2015 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 $ 36,314 ELIZABETH MYERS $ 4,466 OFFICERS WHO RECEIVED PAYMENTS OF VESTED AMOUNTS IN 2015 AND THE AMOUNTS ARE: CHERYL HARDING $ 41,205 GREG SHIREMAN $ 26,749
PART I, LINE 5ONE EMPLOYEE OF THE COMPANY HAS COMPENSATION CONTINGENT ON REVENUES. THE INDIVIDUAL IS AN ACCOUNT EXECUTIVE OF THE COMPANY WHO RECEIVES COMMISSIONS BASED ON SALES OF GROUP BUSINESS. THIS ACCOUNT EXECUTIVE IS RESPONSIBLE FOR SELLING NEW BUSINESS.
PART I, LINE 6CONSISTENT WITH THE COMPANY'S TOTAL COMPENSATION POLICY, THE OFFICERS AND KEY 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 J, PART II, LINE 7THE W-2 COMPENSATION REPORTED FOR DONN HUTCHINS OF $28,527 IS PART OF THE $815,438 OF DEFERRED COMPENSATION THAT WAS PREVIOUSLY REPORTED ON PRIOR YEARS FORM 990 RETURNS. WHEN REPORTED IN PRIOR YEARS, THE FULL AMOUNT WAS INCLUDED IN BOX 5 OF THE FORM W-2 AS MEDICARE WAGES. IN 2015 $28,527 WAS PAID AND INCLUDED IN BOX 1 OF THE FORM W-2.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (6 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
JOHN KEARNS DDS
DIRECTOR$235,154INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES0
ANNE HENNESSEY DDS
DIRECTOR$129,980INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES0
WILLIAM WEVER DDS
DIRECTOR$171,521INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES0
JOHN MALETTA DDS
DIRECTOR$323,636INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES0
CHARLES EDWARD BROWN
DDIA DIRECTOR & OFFICER OF EMPLOYER WHO PURCHASES DENTAL BENEFITS FROM DDIA$328,741PAYMENTS BY EMPLOYER TO DDIA FOR DENTAL BENEFITS0
TOM MAHONEY
DDIA DIRECTOR & OFFICER OF EMPLOYER WHO PURCHASES DENTAL BENEFITS FROM DDIA$257,837PAYMENTS BY EMPLOYER TO DDIA FOR DENTAL BENEFITS0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2E. BROWN AND J. MALETTA HAD A PROVIDER-RELATED BUSINESS RELATIONSHIP IN 2015.
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 11THE 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 OCTOBER OF 2016. 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 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 2015 WAS $3,679,395. 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 2015 WAS $290,505 FOR MANAGEMENT FEES AND $21,217 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 2015. DELTA DENTAL OF IOWA COLLECTS PREMIUMS FROM GROUPS FOR VISION COVERAGE AND TRANSFERS THIS PREMIUM TO VERATRUS. IN 2015, DELTA DENTAL OF IOWA TRANSFERRED $2,009,097 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 2015 WAS $109,278 FOR MANAGEMENT FEES AND $229,551 FOR OTHER EXPENSES. DELTA DENTAL OF IOWA ALSO PURCHASES VISION BENEFITS FROM VERATRUS FOR DDIA EMPLOYEES. THE AMOUNT PAID TO VERATRUS IN 2015 FOR VISION BENEFITS FOR DDIA EMPLOYEES WAS $18,692.

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 11A, 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$105,247ShareOfTotalIncomeAmt
Share Of EOY Assets$848,354ShareOfEOYAssetsAmt
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$3,679,395SEE PART VII - SUPPLEMENTAL INFO.
DELTA DENTAL OF IOWA FOUNDATION
O$290,505SEE PART VII - SUPPLEMENTAL INFO.
VERATRUS BENEFIT SOLUTIONS INC
O$109,278SEE PART VII - SUPPLEMENTAL INFO.
VERATRUS BENEFIT SOLUTIONS INC
R$2,009,097SEE PART VII - SUPPLEMENTAL INFO.
VERATRUS BENEFIT SOLUTIONS INC
Q$229,551SEE 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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