2016-11-14T17:49:20-06:00 2015-12-31 381357951 PLANTE & MORAN PLLC 1111 Michigan Ave Ste 100 East Lansing MI 48823 990 2015-01-01 610659432 DELTA DENTAL OF KENTUCKY INC DELT 5027365000 10100 LINN STATION ROAD NO 700 LOUISVILLE KY 40223 RUSSELL W SKAGGS VP - FINANCE 5027365000 2016-11-14 1 DAVID LOWENTHAL CPA P00378651 5173326200 2015 2017-02-10 21:41:12Z CLIFFORD T MAESAKA JR 10100 LINN STATION ROAD NO 700 LOUISVILLE KY 40223 191473510 0 X WWW.DELTADENTALKY.COM X 1966 KY 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. 13 11 73 0 0 0 0 0 170824325 180710930 1559656 1449146 -7649 -191997 172376332 181968079 91861 2862535 145300862 155448278 7990920 7778407 0 0 0 12321004 13300206 165704647 179389426 6671685 2578653 92604522 96947644 17450006 20712152 75154516 76235492 X 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. 0 0 176168347 2862535 180710930 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. 176168347 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0 1 1 1 1 0 1 19321 0 1 73 1 0 0 0 0 0 0 X 13 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X RUSSELL W SKAGGS VP - FINANCE 5027365000 10100 LINN STATION ROAD STE 700 LOUISVILLE KY 40223 X CLIFFORD T MAESAKA JR PRESIDENT, CEO 35.00 5.00 X X 483097 0 62481 J JUDE THOMPSON CHAIR 8.00 0.00 X X 32100 700 0 MICHAEL CHILDERS DMD DIRECTOR 2.00 5.00 X 20800 12600 0 CARRIE B BROWN DMD DIRECTOR 2.00 0.00 X 0 0 15100 MARY M CORBETT DIRECTOR 2.00 0.00 X 19300 0 0 OLIVIA F KIRTLEY DIRECTOR 4.00 5.00 X 6950 9100 18000 MICHAEL B MOUNTJOY DIRECTOR 4.00 6.00 X 6250 12576 18000 RODNEY A JACKSON DMD DIRECTOR 2.00 0.00 X 20300 0 0 C RICHARD SEITZ DIRECTOR AS OF 3/15 2.00 10.00 X 29250 58350 0 BRUCE R SMITH DIRECTOR 4.00 17.00 X 26100 80032 0 DIANE CORNWELL DIRECTOR AS OF 09/15 2.00 0.00 X 7400 0 0 JOHN N WILLIAMS JR DMD DIRECTOR 2.00 0.00 X 15850 700 0 J DAVID SMITH DIRECTOR 2.00 0.00 X 20300 700 0 STEVE S REED DIRECTOR AS OF 09/15 2.00 0.00 X 6400 0 0 GORAN JURKOVIC CPA CFO 10.00 50.00 X 0 1460589 1089016 JOHN L WEEKS III VP/CLO/SECRETARY 40.00 0.00 X 300703 0 20558 ANGELA J NENNI VP - OPERATIONS 40.00 0.00 X 247256 0 12594 TAMARA L YORK-DAY VP - COO 40.00 0.00 X 364784 0 14831 Russell W Skaggs VP - Finance 40.00 0.00 X 192258 0 20033 STEPHEN C DAY VP/CMO 40.00 0.00 X 247559 0 20476 Ronald E Story Director - IS 40.00 0.00 X 166356 0 7291 BRIAN E KRAINER DIRECTOR - SALES 40.00 0.00 X 191439 0 13224 JEFF DUES Senior Account Executive 40.00 0.00 X 164507 0 19103 2568959 1635347 1330707 9 0 1 0 DELTA DENTAL PLAN OF MICHIGAN PO BOX 30416 LANSING MI 48909 ADMINISTRATIVE SERVICES 4216665 BB&T INSURANCE SERVICES INC 414 GALLIMORE RD STE F GREENSBORO NC 27404 BENEFITS CONSULTING 987285 RENAISSANCE LIFE & HEALTH INSURANCE COMP PO BOX 30416 LANSING MI 48909 ADMINISTRATIVE SERVICES 727629 ASSURED NEACE LUKENS INSURANCE AGENCY 4000 SMITH RD STE 400 CINCINNATI OH 45209 BENEFITS CONSULTING 551691 PLANCHOICE INC 13257 OBANNON STATION LOUISVILLE KY 40223 BENEFITS CONSULTING 470985 25 DENTAL CARE REVENUE 524114 180692930 180692930 other fees 900099 18000 18000 180710930 1618251 1618251 613262 805259 -191997 -191997 -191997 8531067 8700172 -169105 -169105 -169105 181968079 180710930 0 1257149 2862535 2862535 155448278 155448278 2248730 491198 1757532 4243993 4243993 105077 105077 808999 808999 371608 286138 85470 354822 354822 52965 52965 81723 81723 457747 411972 45775 1082141 703392 378749 585610 585610 937956 816022 121934 519964 259982 259982 41860 25116 16744 82109 73898 8211 54171 54171 BROKER COMMISSIONS 6497102 6497102 PROCESSING FEES 1885454 1885454 POSTAGE & SHIPPING 300127 297126 3001 DUES & ASSESSMENTS 292400 292400 74055 74055 179389426 176168347 3221079 0 15793523 18806974 341687 80815 12749007 14781222 16132853 5892780 10537033 10240073 19902498 20755012 24638167 23947459 8642607 8336089 92604522 96947644 3449813 2915957 2643609 2294584 11356584 15501611 17450006 20712152 X 75154516 76235492 75154516 76235492 92604522 96947644 X 2578653 -1546067 48390 X X 0 1 X 1 0 830000 830000 11727036 2905397 8821639 543152 338641 204511 1605224 1279968 325256 1427441 1368774 58667 10240073 16522012 F INVESTMENT - DENTAL CHOICE, INC. 7425447 F 23947459 ACCRUED INVESTMENT INCOME 318477 457(B) PLAN 781595 INVESTMENT - RHC 6516017 surplus note receivable 720000 8336089 CLAIMS CHECKS OUTSTANDING 5012785 ESTIMATED CLAIMS LIABILITY 10488826 15501611 X Part X, Line 2: 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. 1 FAMILY & CHILDREN'S PLACE INC 525 Zane St LOUISVILLE KY 40201 610549561 501(C)(3) 5000 GENERAL DONATION NATIONAL DENTAL ASSOCIATION 6411 IVY LANE SUITE 703 GREENBELT MD 20770 540315311 501(C)(3) 10000 GENERAL DONATION AMERICAN HEART ASSOCIATION PO BOX 4002907 DES MOINES IA 50340 135613797 501(C)(3) 5000 GENERAL DONATION LOUISVILLE DENTAL SOCIETY INC 1920 NELSON MILLER PKWY LOUISVILLE KY 40223 610726110 501(C)(6) 10000 METRO DENTAL VAN PROJECT COMMUNITY FOUNDATION OF LOUISVILLE CORPORATE DEPOSITORY 325 W MAIN ST 1110 LOUISVILLE KY 40202 611100993 501(C)(3) 2600000 MAKING SMILES HAPPEN DONATION 4 1 Part I, Line 2: 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. X 1 1 X X X X 0 1 0 0 0 0 0 0 0 CLIFFORD T MAESAKA JR PRESIDENT, CEO 286443 0 193300 0 3354 0 47418 0 15063 0 545578 0 0 0 GORAN JURKOVIC CPA CFO 0 702396 0 739354 0 18839 0 1067010 0 22006 0 2549605 0 0 JOHN L WEEKS III VP/CLO/SECRETARY 207141 0 90845 0 2717 0 0 0 20558 0 321261 0 0 0 ANGELA J NENNI VP - OPERATIONS 184200 0 61623 0 1433 0 0 0 12594 0 259850 0 0 0 TAMARA L YORK-DAY VP - COO 245262 0 118458 0 1064 0 0 0 14831 0 379615 0 0 0 Russell W Skaggs VP - Finance 143805 0 47225 0 1228 0 0 0 20033 0 212291 0 0 0 STEPHEN C DAY VP/CMO 179889 0 63864 0 3806 0 0 0 20476 0 268035 0 0 0 Ronald E Story Director - IS 142444 0 22692 0 1220 0 0 0 7291 0 173647 0 0 0 BRIAN E KRAINER DIRECTOR - SALES 102166 0 88848 0 425 0 0 0 13224 0 204663 0 0 0 JEFF DUES Senior Account Executive 68060 0 96137 0 310 0 0 0 19103 0 183610 0 0 0 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. TAMARA L YORK-DAY VP-COO OF DDKY LOAN FOR TUITION X 40000 40000 0 1 1 40000 PEDIATRIC DENTISTRY OF HAMBURG DR JACKSON, DIRECTOR OF DDKY, IS ONE OF FOUR MEMBERS OF THE DENTISTRY 972589 PAYMENTS FOR DENTAL SERVICES 0 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. DENTAL CHOICE PROPERTIES LLC 10100 LINN STATION RD SUITE LOUISVILLE KY 40223 610659432 NO BUSINESS ACTIVITY KY DELTA DENTAL OF KENTUCKY 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 RENAISSANCE HEALTH SERVICE CORPORATION 1 DELTA DENTAL OF TENNESSEE INC po BOX 30416 lanSING MI 489097916 620812197 PROVIDE DENTAL SERVICE PLANS TN 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 1 DELTA DENTAL PLAN OF NEW MEXICO INC PO BOX 30416 LANSING MI 489097916 850224562 PROVIDE DENTAL SERVICE PLANS NM 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 1 DELTA DENTAL OF NORTH CAROLINA PO BOX 30416 LANSING MI 489097916 561018068 PROVIDE DENTAL SERVICE PLANS NC 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 1 DELTA DENTAL PLAN OF OHIO inc PO BOX 30416 LANSING MI 489097916 310685339 PROVIDE DENTAL SERVICE PLANS OH 501(C)(4) N/A DELTA DENTAL PLAN OF MICHIGAN INC 1 DELTA DENTAL PLAN OF INDIANA inc PO BOX 30416 LANSING MI 489097916 351545647 PROVIDE DENTAL SERVICE PLANS IN 501(C)(4) N/A DELTA DENTAL PLAN OF MICHIGAN INC 1 DELTA DENTAL FUND PO BOX 30416 LANSING MI 489097916 382337000 SUPPORT DENTAL EDUCATION AND RESEARCH PROGRAMS MI 501(C)(3) 11A TYPE II DELTA DENTAL PLAN OF MICHIGAN INC 1 DELTA DENTAL PLAN OF ARKANSAS PO BOX 30416 LANSING MI 489097916 710561140 PROVIDE DENTAL SERVICE PLANS AR 501(C)(4) NA RENAISSANCE HEALTH SERVICE CORPORATION 1 DELTA DENTAL OF ARKANSAS FOUNDATION PO BOX 30416 LANSING MI 489097916 261569324 PROVIDE DENTAL SERVICE PLANS AR 501(C)(3) PF RENAISSANCE HEALTH SERVICE CORPORATION 1 RENAISSANCE FAMILY FOUNDATION INC 4100 OKEMOS ROAD OKEMOS MI 48864 461376165 Emphasize DENTAL HEALTH IN COMMUNITIES IN 501(c)(3) PF RENAISSANCE HOLDING COMPANY 1 SMILE 180 FOUNDATION 240 VENTURE CIRCLE NASHVILLE TN 37228 471654054 Emphasize DENTAL HEALTH IN COMMUNITIES TN 501(c)(3) Line 11a, I DELTA DENTAL OF TENNESSEE INC 1 DENTAL CHOICE INC 10100 LINN STATION RD SUITE 700 LOUISVILLE KY 40223 611105118 PROVIDE DENTAL SERVICE PLANS KY N/A C 312439 7809742 1.00000 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 -6720 1.00000 1 RENAISSANCE HOLDING COMPANY PO BOX 30381 LANSING MI 48909 412177193 HOLDING COMPANY MI RENAISSANCE HEALTH SERVICE CORPORATION C 82600 7119211 0.05900 1 Renaissance Life & Health Insurance Company of America PO BOX 30416 LANSING MI 489097916 470397286 INSURANCE IN RENAISSANCE HOLDING COMPANY C 1 Renaissance Health Insurance Company of New York PO BOX 30416 LANSING MI 48909 134098096 INSURANCE NY RENAISSANCE HOLDING COMPANY C 1 FORE HOLDING CORPORATION 240 VENTURE CIRCLE NASHVILLE TN 37228 204116122 EMPLOYEE BENEFITS TN DELTA DENTAL OF TENNESSEE C 1 OMEGA ADMINISTRATORS INC 1513 COUNTRY CLUB ROAD SHERWOOD AR 72120 043740469 PROVIDE THIRD-PARTY ADMINISTRATIVE SERVICES AR DELTA DENTAL OF ARKANSAS C 1 GLM HOLDING COMPANY 4100 OKEMOS ROAD OKEMOS MI 48864 472557772 INVESTMENT IN SUBSIDIARIES MI DELTA DENTAL OF MICHIGAN C 1 DEWPOINT INC 300 S WASHIGNTON SQUARE LANSING MI 48933 383300595 COMPUTER CONSULTING MI GLM HOLDING COMPANY C 1 0 0 0 1 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 DENTAL CHOICE INC L 345073 ACTUAL COST DELTA DENTAL OF NORTH CAROLINA D 720000 ACTUAL COST DELTA DENTAL PLAN OF MICHIGAN M 2899602 ACTUAL COST