DELTA DENTAL OF KENTUCKY INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- DELTA DENTAL OF KENTUCKY INC (EIN 61-0659432)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-14
- IRS object ID
- 201613199349311241
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-14T17:49:20-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 Michigan Ave Ste 100 | AddressLine1Txt |
| City | East Lansing | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48823 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 610659432 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF KENTUCKY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DELT | BusinessNameControlTxt |
| Phone | 5027365000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10100 LINN STATION ROAD NO 700 | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 40223 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RUSSELL W SKAGGS | PersonNm |
| Person Title | VP - FINANCE | PersonTitleTxt |
| Phone | 5027365000 | PhoneNum |
| Signature | 2016-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID LOWENTHAL CPA | PreparerPersonNm |
| PTIN | P00378651 | PTIN |
| Phone | 5173326200 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CLIFFORD T MAESAKA JR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10100 LINN STATION ROAD NO 700 | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 40223 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $191,473,510 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.DELTADENTALKY.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1966 | FormationYr |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Activity Or Mission | Delta Dental of KENTUCKY's mission has always been to be the leader in our markets, to deliver unmatched quality and value in our programs and services, and to vigorously promote the importance of oral health as an essential part of overall health. Its overarching mission is to be the dental benefits company of choice in the markets we serve. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 73 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $170,824,325 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $180,710,930 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,559,656 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,449,146 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$7,649 | PYOtherRevenueAmt |
| CY Other Revenue | -$191,997 | CYOtherRevenueAmt |
| PY Total Revenue | $172,376,332 | PYTotalRevenueAmt |
| CY Total Revenue | $181,968,079 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $91,861 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,862,535 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $145,300,862 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $155,448,278 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,990,920 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,778,407 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,321,004 | PYOtherExpensesAmt |
| CY Other Expenses | $13,300,206 | CYOtherExpensesAmt |
| PY Total Expenses | $165,704,647 | PYTotalExpensesAmt |
| CY Total Expenses | $179,389,426 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,671,685 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,578,653 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $92,604,522 | TotalAssetsBOYAmt |
| Total Assets EOY | $96,947,644 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $17,450,006 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $20,712,152 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $75,154,516 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $76,235,492 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE ODelta Dental of KENTUCKY's mission has always been to be the leader in our markets, to deliver unmatched quality and value in our programs and services, and to vigorously promote the importance of oral health as an essential part of overall health. Its overarching mission is to be the dental benefits company of choice in the markets we serve. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $176,168,347 | ExpenseAmt |
| Grant | $2,862,535 | GrantAmt |
| Revenue | $180,710,930 | RevenueAmt |
| Desc | THE CORE MISSION FOR DELTA DENTAL OF KENTUCKY IS TO ENHANCE ORAL HEALTH CARE FOR KENTUCKIANS AND OUR MEMBERS AROUND THE COUNTRY. WE STRIVE TO PROVIDE SUPERIOR CUSTOMER SERVICE BY UTILIZING THE MOST CURRENT TECHNOLOGY, WHILE AT THE SAME TIME MANAGING OVERALL COSTS FOR THE BEST VALUE. THROUGH OUR DENTAL BENEFITS PROGRAMS AND COMMUNITY INVOLVEMENT WE ARE MAKING A DIFFERENCE IN THE COMMUNITIES WE SERVE. IN 2015 WE PROCESSED AND PAID OVER $145 MILLION IN CLAIMS FOR 686,000 INSURED PERSONS.SEE SCHEDULE O FOR CONTINUATIONPROVIDING VALUE TO OUR CUSTOMERSDelta Dental is dedicated to members receiving quality dentistry, while also saving groups and members money. Our dentist credentialing, cost management policies and fee reduction agreements with dentists help our members receive the best dental outcomes. For five decades, Delta Dental has helped promote oral health by designing and administering innovative, cost-effective dental benefit programs. Experts at plan design, Delta Dental has created dental benefit programs that meet customer cost-objectives while helping to improve and maintain oral health.The programs feature large panels of participating dentists. In fact, 3 out of 4 dentists nationwide participate with Delta Dental. This kind of reach has enabled millions of people to receive cost-effective dental care.Delta Dental's members are afforded added protection because they guarantee that participating dentists will accept their payment for covered services and that no charges, other than co-payments and deductibles will be billed. This lowers claim costs for customers and reduces out-of-pocket costs for members.With two networks of participating dentists in one integrated claims system, Delta Dental can deliver to customers and group members, the greatest access at the best cost.COMMUNITY INVOLVEMENTDelta Dental of Kentucky is deeply committed - in principle and practice- to advancing oral health and overall health for individuals, children, and families in the communities we serve. In 2015, Delta Dental of Kentucky established a new charitable initiative, Making Smiles Happen, to further our commitment to this mission. Along with financial gifts, Delta Dental employees and colleagues also have opportunities to volunteer with various charitable and community events. Though oral health is our primary focus, we strive to be a good corporate citizen by Making Smiles Happen throughout Kentucky! Making Smiles Happen and Delta Dental of Kentucky awarded grants totaling more than $2.8 million to over 80 charitable organizations, many of which received grants through the Community Foundation of Louisville, Delta Dental donor advised fund. Some highlighted sponsorships include partnerships with the Kentucky Youth Advocates to create the Statewide Surveillance Project and Fund for the Arts 5x5 Arts Education Program. The Statewide Surveillance Project is the first children's oral health survey to be conducted in Kentucky since 2001. With KYA and the University Of Louisville School Of Dentistry, more than 6,000 students in over 60 elementary and middle schools across Kentucky participated in an oral health screening and assessment. The findings will provide a benchmark and create oral health policy and programs for children in the state for years to come. The 5x5 Arts in Education in partnership with the Fund for the Arts, will allow curriculum-based art education programs to reach 17,559 students in 74 schools in 23 Kentucky counties. Other funding initiatives include the University Of Kentucky College Of Dentistry Mobile Dental Clinic, the Western Kentucky University Mobile Health Van, and "Teeth on the Go", our oral health education program for students K through 6th grade. Hundreds of teachers have used these kits to educate over 100,000 students around the state. | Desc |
| Total Program Service Expenses | $176,168,347 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 19321 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 73 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RUSSELL W SKAGGS VP - FINANCE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5027365000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10100 LINN STATION ROAD STE 700 | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 40223 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| CLIFFORD T MAESAKA JR | ||||||||
| PRESIDENT, CEO | 35.00 | 5.00 | Yes (X) | Yes (X) | $483,097 | $0 | $62,481 | |
| J JUDE THOMPSON | ||||||||
| CHAIR | 8.00 | 0.00 | Yes (X) | Yes (X) | $32,100 | $700 | $0 | |
| MICHAEL CHILDERS DMD | ||||||||
| DIRECTOR | 2.00 | 5.00 | Yes (X) | $20,800 | $12,600 | $0 | ||
| CARRIE B BROWN DMD | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $15,100 | ||
| MARY M CORBETT | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $19,300 | $0 | $0 | ||
| OLIVIA F KIRTLEY | ||||||||
| DIRECTOR | 4.00 | 5.00 | Yes (X) | $6,950 | $9,100 | $18,000 | ||
| MICHAEL B MOUNTJOY | ||||||||
| DIRECTOR | 4.00 | 6.00 | Yes (X) | $6,250 | $12,576 | $18,000 | ||
| RODNEY A JACKSON DMD | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $20,300 | $0 | $0 | ||
| C RICHARD SEITZ | ||||||||
| DIRECTOR AS OF 3/15 | 2.00 | 10.00 | Yes (X) | $29,250 | $58,350 | $0 | ||
| BRUCE R SMITH | ||||||||
| DIRECTOR | 4.00 | 17.00 | Yes (X) | $26,100 | $80,032 | $0 | ||
| DIANE CORNWELL | ||||||||
| DIRECTOR AS OF 09/15 | 2.00 | 0.00 | Yes (X) | $7,400 | $0 | $0 | ||
| JOHN N WILLIAMS JR DMD | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $15,850 | $700 | $0 | ||
| J DAVID SMITH | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $20,300 | $700 | $0 | ||
| STEVE S REED | ||||||||
| DIRECTOR AS OF 09/15 | 2.00 | 0.00 | Yes (X) | $6,400 | $0 | $0 | ||
| GORAN JURKOVIC CPA | ||||||||
| CFO | 10.00 | 50.00 | Yes (X) | $0 | $1,460,589 | $1,089,016 | ||
| JOHN L WEEKS III | ||||||||
| VP/CLO/SECRETARY | 40.00 | 0.00 | Yes (X) | $300,703 | $0 | $20,558 | ||
| ANGELA J NENNI | ||||||||
| VP - OPERATIONS | 40.00 | 0.00 | Yes (X) | $247,256 | $0 | $12,594 | ||
| TAMARA L YORK-DAY | ||||||||
| VP - COO | 40.00 | 0.00 | Yes (X) | $364,784 | $0 | $14,831 | ||
| Russell W Skaggs | ||||||||
| VP - Finance | 40.00 | 0.00 | Yes (X) | $192,258 | $0 | $20,033 | ||
| STEPHEN C DAY | ||||||||
| VP/CMO | 40.00 | 0.00 | Yes (X) | $247,559 | $0 | $20,476 | ||
| Ronald E Story | ||||||||
| Director - IS | 40.00 | 0.00 | $166,356 | $0 | $7,291 | Yes (X) | ||
| BRIAN E KRAINER | ||||||||
| DIRECTOR - SALES | 40.00 | 0.00 | $191,439 | $0 | $13,224 | Yes (X) | ||
| JEFF DUES | ||||||||
| Senior Account Executive | 40.00 | 0.00 | $164,507 | $0 | $19,103 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,568,959 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,635,347 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,330,707 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| DELTA DENTAL PLAN OF MICHIGAN | |||||
| PO BOX 30416 | LANSING | MI | 48909 | ADMINISTRATIVE SERVICES | $4,216,665 |
| BB&T INSURANCE SERVICES INC | |||||
| 414 GALLIMORE RD STE F | GREENSBORO | NC | 27404 | BENEFITS CONSULTING | $987,285 |
| RENAISSANCE LIFE & HEALTH INSURANCE COMP | |||||
| PO BOX 30416 | LANSING | MI | 48909 | ADMINISTRATIVE SERVICES | $727,629 |
| ASSURED NEACE LUKENS INSURANCE AGENCY | |||||
| 4000 SMITH RD STE 400 | CINCINNATI | OH | 45209 | BENEFITS CONSULTING | $551,691 |
| PLANCHOICE INC | |||||
| 13257 OBANNON STATION | LOUISVILLE | KY | 40223 | BENEFITS CONSULTING | $470,985 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 25 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| DENTAL CARE REVENUE | 524114 | $180,692,930 | $180,692,930 |
| other fees | 900099 | $18,000 | $18,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $180,710,930 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,618,251 | TotalRevenueColumnAmt |
| Exclusion | $1,618,251 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $613,262 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $805,259 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$191,997 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$191,997 | TotalRevenueColumnAmt |
| Exclusion | -$191,997 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,531,067 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,700,172 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$169,105 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$169,105 | TotalRevenueColumnAmt |
| Exclusion | -$169,105 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $181,968,079 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $180,710,930 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,257,149 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,862,535 | TotalAmt |
| Program Services | $2,862,535 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $155,448,278 | TotalAmt |
| Program Services | $155,448,278 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,248,730 | TotalAmt |
| Program Services | $491,198 | ProgramServicesAmt |
| Management And General | $1,757,532 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,243,993 | TotalAmt |
| Program Services | $4,243,993 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,077 | TotalAmt |
| Program Services | $105,077 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $808,999 | TotalAmt |
| Program Services | $808,999 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $371,608 | TotalAmt |
| Program Services | $286,138 | ProgramServicesAmt |
| Management And General | $85,470 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $354,822 | TotalAmt |
| Management And General | $354,822 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,965 | TotalAmt |
| Management And General | $52,965 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,723 | TotalAmt |
| Management And General | $81,723 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $457,747 | TotalAmt |
| Program Services | $411,972 | ProgramServicesAmt |
| Management And General | $45,775 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,082,141 | TotalAmt |
| Program Services | $703,392 | ProgramServicesAmt |
| Management And General | $378,749 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $585,610 | TotalAmt |
| Program Services | $585,610 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $937,956 | TotalAmt |
| Program Services | $816,022 | ProgramServicesAmt |
| Management And General | $121,934 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $519,964 | TotalAmt |
| Program Services | $259,982 | ProgramServicesAmt |
| Management And General | $259,982 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,860 | TotalAmt |
| Program Services | $25,116 | ProgramServicesAmt |
| Management And General | $16,744 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,109 | TotalAmt |
| Program Services | $73,898 | ProgramServicesAmt |
| Management And General | $8,211 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,171 | TotalAmt |
| Management And General | $54,171 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BROKER COMMISSIONS | $6,497,102 | $6,497,102 | |
| PROCESSING FEES | $1,885,454 | $1,885,454 | |
| POSTAGE & SHIPPING | $300,127 | $297,126 | $3,001 |
| DUES & ASSESSMENTS | $292,400 | $292,400 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,055 | TotalAmt |
| Program Services | $74,055 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,389,426 | TotalAmt |
| Program Services | $176,168,347 | ProgramServicesAmt |
| Management And General | $3,221,079 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,793,523 | BOYAmt |
| EOY | $18,806,974 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $341,687 | BOYAmt |
| EOY | $80,815 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,749,007 | BOYAmt |
| EOY | $14,781,222 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,132,853 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,892,780 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,537,033 | BOYAmt |
| EOY | $10,240,073 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,902,498 | BOYAmt |
| EOY | $20,755,012 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,638,167 | BOYAmt |
| EOY | $23,947,459 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,642,607 | BOYAmt |
| EOY | $8,336,089 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,604,522 | BOYAmt |
| EOY | $96,947,644 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,449,813 | BOYAmt |
| EOY | $2,915,957 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,643,609 | BOYAmt |
| EOY | $2,294,584 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,356,584 | BOYAmt |
| EOY | $15,501,611 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,450,006 | BOYAmt |
| EOY | $20,712,152 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,154,516 | BOYAmt |
| EOY | $76,235,492 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,154,516 | BOYAmt |
| EOY | $76,235,492 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,604,522 | BOYAmt |
| EOY | $96,947,644 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,578,653 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,546,067 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $48,390 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $830,000 | OtherCostOrOtherBasisAmt |
| Book Value | $830,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,727,036 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,905,397 | DepreciationAmt |
| Book Value | $8,821,639 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $543,152 | OtherCostOrOtherBasisAmt |
| Depreciation | $338,641 | DepreciationAmt |
| Book Value | $204,511 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,605,224 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,279,968 | DepreciationAmt |
| Book Value | $325,256 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,427,441 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,368,774 | DepreciationAmt |
| Book Value | $58,667 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,240,073 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $16,522,012 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENT - DENTAL CHOICE, INC. | Desc |
| Book Value | $7,425,447 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $23,947,459 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ACCRUED INVESTMENT INCOME | $318,477 |
| 457(B) PLAN | $781,595 |
| INVESTMENT - RHC | $6,516,017 |
| surplus note receivable | $720,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $8,336,089 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| CLAIMS CHECKS OUTSTANDING | $5,012,785 |
| ESTIMATED CLAIMS LIABILITY | $10,488,826 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $15,501,611 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | AS OF DECEMBER 31, 2015 AND 2014, DELTA DENTAL PLAN OF KENTUCKY'S UNRECOGNIZED TAX BENEFITS WERE NOT SIGNIFICANT. THERE WERE NO SIGNIFICANT PENALTIES OR INTEREST RECOGNIZED DURING THE YEAR OR ACCRUED AT YEAR END. DELTA DENTAL PLAN OF KENTUCKY IS SUBJECT TO ROUTINE AUDITS BY TAXING AUTHORITIES. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| FAMILY & CHILDREN'S PLACE INC | |||||||
| 525 Zane St | LOUISVILLE | KY | 40201 | 610549561 | 501(C)(3) | $5,000 | GENERAL DONATION |
| NATIONAL DENTAL ASSOCIATION | |||||||
| 6411 IVY LANE SUITE 703 | GREENBELT | MD | 20770 | 540315311 | 501(C)(3) | $10,000 | GENERAL DONATION |
| AMERICAN HEART ASSOCIATION | |||||||
| PO BOX 4002907 | DES MOINES | IA | 50340 | 135613797 | 501(C)(3) | $5,000 | GENERAL DONATION |
| LOUISVILLE DENTAL SOCIETY INC | |||||||
| 1920 NELSON MILLER PKWY | LOUISVILLE | KY | 40223 | 610726110 | 501(C)(6) | $10,000 | METRO DENTAL VAN PROJECT |
| COMMUNITY FOUNDATION OF LOUISVILLE CORPORATE DEPOSITORY | |||||||
| 325 W MAIN ST 1110 | LOUISVILLE | KY | 40202 | 611100993 | 501(C)(3) | $2,600,000 | MAKING SMILES HAPPEN DONATION |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 4 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | Grants are made under a board approved corporate policy which sets out the grant criteria and processes for approval, distribution, and monitoring. The grant review and approval committee consists of members of the board and company executives. Grants must be submitted on specified forms which require information about the grantee organization and how the grants will be used. Grantee organizations must periodically report on how the funds have been used and certify that funds are disbursed in accordance with the grant application. These reports are regularly reviewed by company staff and summarized for the grant committee. The committee reviews the reports at least quarterly and communicates questions or concerns back to the grantee organization. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CLIFFORD T MAESAKA JR | ||||||||||||||
| PRESIDENT, CEO | $286,443 | $0 | $193,300 | $0 | $3,354 | $0 | $47,418 | $0 | $15,063 | $0 | $545,578 | $0 | $0 | $0 |
| GORAN JURKOVIC CPA | ||||||||||||||
| CFO | $0 | $702,396 | $0 | $739,354 | $0 | $18,839 | $0 | $1,067,010 | $0 | $22,006 | $0 | $2,549,605 | $0 | $0 |
| JOHN L WEEKS III | ||||||||||||||
| VP/CLO/SECRETARY | $207,141 | $0 | $90,845 | $0 | $2,717 | $0 | $0 | $0 | $20,558 | $0 | $321,261 | $0 | $0 | $0 |
| ANGELA J NENNI | ||||||||||||||
| VP - OPERATIONS | $184,200 | $0 | $61,623 | $0 | $1,433 | $0 | $0 | $0 | $12,594 | $0 | $259,850 | $0 | $0 | $0 |
| TAMARA L YORK-DAY | ||||||||||||||
| VP - COO | $245,262 | $0 | $118,458 | $0 | $1,064 | $0 | $0 | $0 | $14,831 | $0 | $379,615 | $0 | $0 | $0 |
| Russell W Skaggs | ||||||||||||||
| VP - Finance | $143,805 | $0 | $47,225 | $0 | $1,228 | $0 | $0 | $0 | $20,033 | $0 | $212,291 | $0 | $0 | $0 |
| STEPHEN C DAY | ||||||||||||||
| VP/CMO | $179,889 | $0 | $63,864 | $0 | $3,806 | $0 | $0 | $0 | $20,476 | $0 | $268,035 | $0 | $0 | $0 |
| Ronald E Story | ||||||||||||||
| Director - IS | $142,444 | $0 | $22,692 | $0 | $1,220 | $0 | $0 | $0 | $7,291 | $0 | $173,647 | $0 | $0 | $0 |
| BRIAN E KRAINER | ||||||||||||||
| DIRECTOR - SALES | $102,166 | $0 | $88,848 | $0 | $425 | $0 | $0 | $0 | $13,224 | $0 | $204,663 | $0 | $0 | $0 |
| JEFF DUES | ||||||||||||||
| Senior Account Executive | $68,060 | $0 | $96,137 | $0 | $310 | $0 | $0 | $0 | $19,103 | $0 | $183,610 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | FOR THE Annual RHSC Conference THE BOARD MEMBERS ARE ALLOWED TO HAVE COMPANION TRAVEL WITH THEM. THIS IS TAXABLE TO THE BOARD MEMBER. |
| Part I, Line 4b | Delta Dental of KentucKy, has a 457(f) SERP, a supplemental executive retirement plan. Only one position, the CEO, is eligible for the SERP. In 2015, the accrual for Clifford Maesaka's SERP totalled $47,418. NO DISTRIBUTIONS WERE MADE FROM THE SERP IN 2015. |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TAMARA L YORK-DAY | PersonNm |
| Relationship With Org | VP-COO OF DDKY | RelationshipWithOrgTxt |
| Loan Purpose | LOAN FOR TUITION | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $40,000 | OriginalPrincipalAmt |
| Balance Due | $40,000 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $40,000 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEDIATRIC DENTISTRY OF HAMBURG | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | DR JACKSON, DIRECTOR OF DDKY, IS ONE OF FOUR MEMBERS OF THE DENTISTRY | RelationshipDescriptionTxt |
| Transaction | $972,589 | TransactionAmt |
| Transaction | PAYMENTS FOR DENTAL SERVICES | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | EFFECTIVE JULY 1, 2009 RENAISSANCE HEALTH SERVICE CORPORATION BECAME THE SOLE CORPORATE MEMBER OF DELTA DENTAL OF KENTUCKY. |
| Form 990, Part VI, Section A, line 7a | RHSC IS THE SOLE VOTING MEMBER OF DDKY. HOWEVER, UNDER THE TERMS OF THE AFFILIATION AGREEMENT THE PARTIES AGREED THAT THE DELTA DENTAL OF KENTUCKY (DDKY) BOARD SELECTS DIRECTOR CANDIDATES AND SUBMITS THEM TO RENAISSANCE HEALTH SERVICE CORP (RHSC). RHSC THEN APPROVES THE CANDIDATES. RHSC CAN REJECT PROPOSED CANDIDATES FOR "JUST CAUSE" AS DEFINED IN THE AGREEMENT. OTHERWISE, RHSC MUST APPROVE ALL THE CANDIDATES PROPOSED BY THE DDKY BOARD. RHSC HAS THE RIGHT TO ELECT A NUMBER OF DIRECTORS TO THE DDKY BOARD PROPORTIONAL TO THE NUMBER OF DIRECTORS THAT DDKY MAY NOMINATE TO THE RHSC BOARD. AS OF 12/31/2015, RHSC APPOINTED ONE MEMBER OF THE 13 MEMBER DDKY BOARD. |
| Form 990, Part VI, Section A, line 7b | THE RIGHTS OF THE DDKY BOARD ARE TO APPROVE THE ANNUAL BUDGETS FOR OPERATIONS, ELECT OFFICERS OF THE DDKY BOARD OF DIRECTORS, APPROVE THE TRANSFER OF ANY OF ITS ASSETS, APPROVE THE INCURRENCE OR GUARANTY OF DEBT AND APPROVE THE MANAGEMENT OF ITS INVESTMENTS. RHSC MUST APPROVE ANY TRANSFER OF ASSETS, INVESTMENTS, LOANS, GUARANTIES OR EXPENDITURES WHICH EXCEED TEN PERCENT OF DDKY'S NET ASSETS. RHSC MUST APPROVE THE FOLLOWING CHANGES TO THE DDKY BYLAWS: THE IDENTITY, QUALIFICATION OR RIGHTS OF DDKY'S VOTING MEMBER, THE QUALIFICATIONS, CLASSIFICATIONS, TERMS OF OFFICE OR PERMISSIBLE NUMBER OF DIRECTORS ON DDKY'S BOARD OR ANY LIMITATION ON THE RIGHTS OR AUTHORITY OF THE DDKY BOARD CONTAINED IN DDKY'S ORGANIZATIONAL DOCUMENTS. |
| Form 990, Part VI, Section B, line 11 | THE FORM 990 IS FIRST REVIEWED INTERNALLY BY THE VP-FINANCE, THE IN-HOUSE LEGAL COUNSEL, CEO AND THEN A DRAFT IS PRESENTED TO THE AUDIT AND FINANCE COMMITTEE FOR REVIEW. PRIOR TO FILING, A COPY OF THE FINAL FORM 990 IS DISTRIBUTED TO THE ENTIRE GOVERNING BODY. |
| Form 990, Part VI, Section B, line 12c | OFFICERS, DIRECTORS AND KEY EMPLOYEES MUST COMPLETE AND SUBMIT A CONFLICT OF INTEREST DISCLOSURE ANNUALLY. THESE FORMS ARE REVIEWED BY THE CEO, THE CORPORATE COMPLIANCE OFFICER, AND A REPORT IS MADE TO THE AUDIT AND FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. THE AUDIT COMMITTEE REVIEWS ALL POTENTIAL CONFLICTS TO DETERMINE IF THE CONFLICTS REPRESENT MATERIAL FINANCIAL RISK TO THE COMPANY AND TAKES ANY ACTION NECESSARY TO RESOLVE OR MITIGATE THE EFFECT OF THE CONFLICTS. WHEN A CONFLICT EXISTS AMONG THE VOTING BOARD MEMBERS, THAT BOARD MEMBER WILL ABSTAIN FROM VOTING ON THE CONFLICTED ISSUE. ALL EMPLOYEES AND DIRECTORS ARE ADVISED ANNUALLY OF THE REQUIREMENT TO REPORT ANY POTENTIAL CONFLICTS OF INTEREST AS THEY OCCUR. EMPLOYEES AND DIRECTORS MAY ALSO MAKE ANONYMOUS REPORTS OF ANY VIOLATIONS OF CORPORATE POLICIES THROUGH A DEDICATED WHISTLEBLOWER SYSTEM ADMINISTERED BY A THIRD PARTY. |
| Form 990, Part VI, Section B, line 15 | CEO AND OTHER OFFICERS COMPENSATION ARE REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. The process is performed, at a minimum, annually. COMPENSATION WAS LAST REVIEWED BY DELTA DENTAL OF KENTUCKYS P&C COMMITEE IN FEBRUARY 2016. The committee is MADE UP OF independent BOARD MEMBERS. THE COMMITTEE utilizeS certain compensation surveys and outside consultants are engaged as needed. COMPENSATION WAS ALSO REVIEWED UNDER DELTA DENTAL PLAN OF MICHIGANS HR EXECUTIVE COMPENSATION PROCESS DURING 2014. THE REPORT BASED ON THIS REVIEW WAS THEN ISSUED BY THE CONSULTANTS IN JUNE OF 2015. |
| Form 990, Part VI, Section C, line 19 | GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE FILED WITH THE KENTUCKY DEPARTMENT OF INSURANCE AND ARE AVAILABLE FOR INSPECTION BY THE PUBLIC THROUGH THAT AGENCY. ADDITIONALLY, THE COMPANY MAKES ORGANIZATIONAL DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS AVAILABLE AT NO COST UPON RECEIPT OF A WRITTEN REQUEST. |
| FORM 990, PART VII | Certain employees are officers of multiple companies within the larger organization. The average hours worked reflects approximate time spent in each of those individual companies. While the hours are allocated to individual companies, much of the officers' time is spent working on issues that impact the entire organization, not just one company. Compensation is reported in full to agree to the employee's W-2 as required by IRS instructions. Any allocation of compensation is included on Schedule R. |
| Form 990, Part XI, line 9: | EQUITY IN SUBSIDIARY 48,390. |
| FORM 990, PART XII, LINE 2C: | PROCESS IS THE SAME AS THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DENTAL CHOICE PROPERTIES LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10100 LINN STATION RD SUITE | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 40223 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 610659432 | EIN |
| Primary Activities | NO BUSINESS ACTIVITY | PrimaryActivitiesTxt |
| Legal Domicile State | KY | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF KENTUCKY | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| RENAISSANCE HEALTH SERVICE CORPORATION | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 381675667 | PROMOTING DENTAL CARE | MI | 501(C)(4) | N/A | N/A | 0 | |
| DELTA DENTAL PLAN OF MICHIGAN INC | |||||||||||
| 4100 OKEMOS ROAD | OKEMOS | MI | 48864 | 381791480 | PROVIDE DENTAL SERVICE PLANS | MI | 501(C)(4) | N/A | Yes (1) | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL OF TENNESSEE INC | |||||||||||
| po BOX 30416 | lanSING | MI | 489097916 | 620812197 | PROVIDE DENTAL SERVICE PLANS | TN | 501(C)(4) | N/A | Yes (1) | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL PLAN OF NEW MEXICO INC | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 850224562 | PROVIDE DENTAL SERVICE PLANS | NM | 501(C)(4) | N/A | Yes (1) | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL OF NORTH CAROLINA | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 561018068 | PROVIDE DENTAL SERVICE PLANS | NC | 501(C)(4) | N/A | Yes (1) | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL PLAN OF OHIO inc | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 310685339 | PROVIDE DENTAL SERVICE PLANS | OH | 501(C)(4) | N/A | Yes (1) | DELTA DENTAL PLAN OF MICHIGAN INC | |
| DELTA DENTAL PLAN OF INDIANA inc | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 351545647 | PROVIDE DENTAL SERVICE PLANS | IN | 501(C)(4) | N/A | Yes (1) | DELTA DENTAL PLAN OF MICHIGAN INC | |
| DELTA DENTAL FUND | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 382337000 | SUPPORT DENTAL EDUCATION AND RESEARCH PROGRAMS | MI | 501(C)(3) | 11A TYPE II | Yes (1) | DELTA DENTAL PLAN OF MICHIGAN INC | |
| DELTA DENTAL PLAN OF ARKANSAS | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 710561140 | PROVIDE DENTAL SERVICE PLANS | AR | 501(C)(4) | NA | Yes (1) | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL OF ARKANSAS FOUNDATION | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 261569324 | PROVIDE DENTAL SERVICE PLANS | AR | 501(C)(3) | PF | Yes (1) | RENAISSANCE HEALTH SERVICE CORPORATION | |
| RENAISSANCE FAMILY FOUNDATION INC | |||||||||||
| 4100 OKEMOS ROAD | OKEMOS | MI | 48864 | 461376165 | Emphasize DENTAL HEALTH IN COMMUNITIES | IN | 501(c)(3) | PF | Yes (1) | RENAISSANCE HOLDING COMPANY | |
| SMILE 180 FOUNDATION | |||||||||||
| 240 VENTURE CIRCLE | NASHVILLE | TN | 37228 | 471654054 | Emphasize DENTAL HEALTH IN COMMUNITIES | TN | 501(c)(3) | Line 11a, I | Yes (1) | DELTA DENTAL OF TENNESSEE INC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DENTAL CHOICE INC | |||||||||||||
| 10100 LINN STATION RD SUITE 700 | LOUISVILLE | KY | 40223 | 611105118 | PROVIDE DENTAL SERVICE PLANS | KY | N/A | C | $312,439 | $7,809,742 | 1.00000 | Yes (1) | |
| DENTAL CHOICE AGENCY INC | |||||||||||||
| 10100 LINN STATION RD SUITE 700 | LOUISVILLE | KY | 40223 | 611336003 | PRIMARY GENERAL AGENCY FOR DDKY & DENTAL CHOICE | KY | N/A | C | -$6,720 | 1.00000 | Yes (1) | ||
| RENAISSANCE HOLDING COMPANY | |||||||||||||
| PO BOX 30381 | LANSING | MI | 48909 | 412177193 | HOLDING COMPANY | MI | C | $82,600 | $7,119,211 | 0.05900 | Yes (1) | RENAISSANCE HEALTH SERVICE CORPORATION | |
| Renaissance Life & Health Insurance Company of America | |||||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 470397286 | INSURANCE | IN | C | Yes (1) | RENAISSANCE HOLDING COMPANY | ||||
| Renaissance Health Insurance Company of New York | |||||||||||||
| PO BOX 30416 | LANSING | MI | 48909 | 134098096 | INSURANCE | NY | C | Yes (1) | RENAISSANCE HOLDING COMPANY | ||||
| FORE HOLDING CORPORATION | |||||||||||||
| 240 VENTURE CIRCLE | NASHVILLE | TN | 37228 | 204116122 | EMPLOYEE BENEFITS | TN | C | Yes (1) | DELTA DENTAL OF TENNESSEE | ||||
| OMEGA ADMINISTRATORS INC | |||||||||||||
| 1513 COUNTRY CLUB ROAD | SHERWOOD | AR | 72120 | 043740469 | PROVIDE THIRD-PARTY ADMINISTRATIVE SERVICES | AR | C | Yes (1) | DELTA DENTAL OF ARKANSAS | ||||
| GLM HOLDING COMPANY | |||||||||||||
| 4100 OKEMOS ROAD | OKEMOS | MI | 48864 | 472557772 | INVESTMENT IN SUBSIDIARIES | MI | C | Yes (1) | DELTA DENTAL OF MICHIGAN | ||||
| DEWPOINT INC | |||||||||||||
| 300 S WASHIGNTON SQUARE | LANSING | MI | 48933 | 383300595 | COMPUTER CONSULTING | MI | C | Yes (1) | GLM HOLDING COMPANY | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| DENTAL CHOICE INC | ||
| L | $345,073 | ACTUAL COST |
| DELTA DENTAL OF NORTH CAROLINA | ||
| D | $720,000 | ACTUAL COST |
| DELTA DENTAL PLAN OF MICHIGAN | ||
| M | $2,899,602 | ACTUAL COST |
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