DELTA DENTAL OF KENTUCKY INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- DELTA DENTAL OF KENTUCKY INC (EIN 61-0659432)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-17
- IRS object ID
- 201443219349306694
- Schema version
- 2013v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-17T13:43:54-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | 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 | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 MICHIGAN AVE | AddressLine1 |
| City | EAST LANSING | City |
| State | MI | State |
| ZIP Code | 48823 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | 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 | BusinessNameLine1 |
| 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 | AddressLine1 |
| City | LOUISVILLE | City |
| State | KY | State |
| ZIP Code | 40223 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RUSSELL W SKAGGS | PersonNm |
| Person Title | VP - FINANCE | PersonTitleTxt |
| Phone | 5027365000 | PhoneNum |
| Signature | 2014-11-17 | 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 | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | 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 | AddressLine1 |
| City | LOUISVILLE | City |
| State | KY | State |
| ZIP Code | 40223 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $174,418,020 | 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 | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 92 | 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 | $159,274,037 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $166,279,098 | CYProgramServiceRevenueAmt |
| PY Investment Income | $308,551 | PYInvestmentIncomeAmt |
| CY Investment Income | $992,631 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$247,256 | PYOtherRevenueAmt |
| CY Other Revenue | -$256,707 | CYOtherRevenueAmt |
| PY Total Revenue | $159,335,332 | PYTotalRevenueAmt |
| CY Total Revenue | $167,015,022 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,062,204 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $33,557 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $136,870,410 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $141,704,577 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,322,060 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,909,898 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,727,598 | PYOtherExpensesAmt |
| CY Other Expenses | $10,812,676 | CYOtherExpensesAmt |
| PY Total Expenses | $155,982,272 | PYTotalExpensesAmt |
| CY Total Expenses | $161,460,708 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,353,060 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,554,314 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $76,806,803 | TotalAssetsBOYAmt |
| Total Assets EOY | $87,057,493 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $17,758,849 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $19,014,341 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $59,047,954 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $68,043,152 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| 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. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $158,804,821 | ExpenseAmt |
| Grant | $33,557 | GrantAmt |
| Revenue | $166,279,098 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES ACCESS TO ORAL HEALTH CARE PROVIDERS THROUGH DENTAL BENEFIT PROGRAMS AS A MEMBER OF THE DELTA DENTAL PLANS ASSOCIATION. SERVICES BENEFITED APPROXIMATELY 647,000 INDIVIDUALS. | Desc |
| Total Program Service Expenses | $158,804,821 | 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 | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | 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 | 0 | 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 | 18639 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 92 | 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 |
| Other Website | Yes (X) | OtherWebsiteInd |
| 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 | BusinessNameLine1 |
| 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 | AddressLine1 |
| City | LOUISVILLE | City |
| State | KY | State |
| ZIP Code | 40223 | ZIPCode |
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 |
|---|---|---|---|---|---|---|---|---|
| MICHAEL CHILDERS DMD | ||||||||
| CHAIR | 2.00 | 0.00 | Yes (X) | Yes (X) | $21,600 | $0 | $0 | |
| CLIFFORD T MAESAKA JR | ||||||||
| PRESIDENT, CEO | 35.00 | 5.00 | Yes (X) | Yes (X) | $535,908 | $0 | $57,441 | |
| CARRIE B BROWN DMD | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $16,150 | ||
| MARY M CORBETT | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $13,500 | $0 | $0 | ||
| OLIVIA F KIRTLEY | ||||||||
| DIRECTOR | 2.00 | 5.00 | Yes (X) | $0 | $17,900 | $15,650 | ||
| MICHAEL B MOUNTJOY | ||||||||
| DIRECTOR | 2.00 | 5.50 | Yes (X) | $0 | $26,950 | $15,500 | ||
| JOHN L G RICHARDS | ||||||||
| DIRECTOR- THRU MARCH 2013 | 2.00 | 0.00 | Yes (X) | $3,250 | $0 | $0 | ||
| C RICHARD SEITZ | ||||||||
| DIRECTOR | 2.00 | 11.00 | Yes (X) | $14,000 | $23,000 | $0 | ||
| BRUCE R SMITH | ||||||||
| DIRECTOR | 2.00 | 15.00 | Yes (X) | $14,000 | $43,640 | $0 | ||
| JEFFREY C SMITH | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $31,750 | $0 | $0 | ||
| J JUDE THOMPSON | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $19,100 | $0 | $0 | ||
| JOHN N WILLIAMS JR DMD | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $14,750 | $0 | $0 | ||
| J DAVID SMITH | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $16,650 | $0 | $0 | ||
| STEPHEN C DAY | ||||||||
| VP/CMO | 40.00 | 0.00 | Yes (X) | $238,478 | $0 | $21,725 | ||
| JOHN L WEEKS III | ||||||||
| VP/CLO/SECRETARY | 40.00 | 0.00 | Yes (X) | $267,566 | $0 | $20,314 | ||
| ANGELA J NENNI | ||||||||
| VP | 40.00 | 0.00 | Yes (X) | $257,443 | $0 | $11,354 | ||
| TAMARA L YORK-DAY | ||||||||
| VP - OPERATIONS | 40.00 | 0.00 | Yes (X) | $289,215 | $0 | $12,495 | ||
| RUSSELL W SKAGGS | ||||||||
| VP - FINANCE | 40.00 | 0.00 | Yes (X) | $176,912 | $0 | $18,421 | ||
| GORAN JURKOVIC CPA | ||||||||
| CFO | 20.00 | 30.00 | Yes (X) | $0 | $717,169 | $345,991 | ||
| RONALD E STORY | ||||||||
| DIRECTOR - IS | 40.00 | 0.00 | $149,428 | $0 | $6,315 | Yes (X) | ||
| LINA K STIRSMAN | ||||||||
| DIRECTOR - HR | 40.00 | 0.00 | $129,119 | $0 | $6,519 | Yes (X) | ||
| BRIAN E KRAINER | ||||||||
| DIRECTOR - SALES | 40.00 | 0.00 | $202,127 | $0 | $6,105 | Yes (X) | ||
| JEFF DUES | ||||||||
| SENIOR ACCOUNT EXECUTIVE | 40.00 | 0.00 | $131,372 | $0 | $17,571 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,526,168 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $828,659 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $571,551 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | 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/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| DELTA DENTAL PLAN OF MICHIGAN | |||||
| PO BOX 30416 | LANSING | MI | 48909 | ADMINISTRATIVE SERVICES | $1,086,083 |
| BB&T INSURANCE SERVICES INC | |||||
| 414 GALLIMORE RD STE F | GREENSBORO | NC | 27404 | BENEFITS CONSULTING | $900,789 |
| REISERT & ASSOCIATES INC | |||||
| 700 UPS DRIVE STE 105 | LOUISVILLE | KY | 40223 | BENEFITS CONSULTING | $482,013 |
| ASSURED NEACE LUKENS INSURANCE AGENCY | |||||
| 4000 SMITH RD STE 400 | CINCINNATI | OH | 45209 | BENEFITS CONSULTING | $451,193 |
| MERCER HEALTH & BENEFITS LLC | |||||
| 4565 PAYSPHERE CIRCLE | CHICAGO | IL | 60674 | BENEFITS CONSULTING | $322,933 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 20 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| SUBSCRIBER REVENUE | 524114 | $166,261,098 | $166,261,098 |
| SUBSIDIARY MANAGEMENT | 900099 | $18,000 | $18,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $166,279,098 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $811,115 | TotalRevenueColumnAmt |
| Exclusion | $811,115 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $535,684 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $792,391 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$256,707 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$256,707 | TotalRevenueColumnAmt |
| Exclusion | -$256,707 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,792,123 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,608,886 | SecuritiesAmt |
| Other | $1,721 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $183,237 | SecuritiesAmt |
| Other | -$1,721 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $181,516 | TotalRevenueColumnAmt |
| Exclusion | $181,516 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $167,015,022 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $166,279,098 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $735,924 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,557 | TotalAmt |
| Program Services | $33,557 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,704,577 | TotalAmt |
| Program Services | $141,704,577 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,103,172 | TotalAmt |
| Program Services | $459,389 | ProgramServicesAmt |
| Management And General | $1,643,783 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,616,032 | TotalAmt |
| Program Services | $5,616,032 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,267 | TotalAmt |
| Program Services | $41,267 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $782,208 | TotalAmt |
| Program Services | $782,208 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $367,219 | TotalAmt |
| Program Services | $282,759 | ProgramServicesAmt |
| Management And General | $84,460 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $269,468 | TotalAmt |
| Management And General | $269,468 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,651 | TotalAmt |
| Management And General | $27,651 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,243 | TotalAmt |
| Management And General | $78,243 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $381,276 | TotalAmt |
| Program Services | $343,148 | ProgramServicesAmt |
| Management And General | $38,128 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $247,272 | TotalAmt |
| Program Services | $160,717 | ProgramServicesAmt |
| Management And General | $86,555 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $561,470 | TotalAmt |
| Program Services | $561,470 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $877,698 | TotalAmt |
| Program Services | $763,597 | ProgramServicesAmt |
| Management And General | $114,101 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $474,047 | TotalAmt |
| Program Services | $237,024 | ProgramServicesAmt |
| Management And General | $237,023 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,212 | TotalAmt |
| Program Services | $26,527 | ProgramServicesAmt |
| Management And General | $17,685 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,427 | TotalAmt |
| Program Services | $66,984 | ProgramServicesAmt |
| Management And General | $7,443 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,840 | TotalAmt |
| Management And General | $47,840 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BROKER COMMISSIONS | $6,026,463 | $6,026,463 | |
| PROCESSING FEES | $1,006,254 | $1,006,254 | |
| POSTAGE & SHIPPING | $350,719 | $347,212 | $3,507 |
| DUES & ASSESSMENTS | $197,143 | $197,143 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,493 | TotalAmt |
| Program Services | $148,493 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,460,708 | TotalAmt |
| Program Services | $158,804,821 | ProgramServicesAmt |
| Management And General | $2,655,887 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,549,197 | BOYAmt |
| EOY | $13,524,609 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $366,804 | BOYAmt |
| EOY | $79,352 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,868,422 | BOYAmt |
| EOY | $11,351,645 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $257,611 | BOYAmt |
| EOY | $187 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,769,956 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,016,924 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,223,217 | BOYAmt |
| EOY | $10,753,032 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,708,957 | BOYAmt |
| EOY | $19,562,161 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,493,874 | BOYAmt |
| EOY | $23,144,768 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,338,721 | BOYAmt |
| EOY | $8,641,739 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,806,803 | BOYAmt |
| EOY | $87,057,493 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,850,201 | BOYAmt |
| EOY | $3,977,176 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,565,753 | BOYAmt |
| EOY | $2,391,807 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,342,895 | BOYAmt |
| EOY | $12,645,358 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,758,849 | BOYAmt |
| EOY | $19,014,341 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,047,954 | BOYAmt |
| EOY | $68,043,152 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,047,954 | BOYAmt |
| EOY | $68,043,152 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,806,803 | BOYAmt |
| EOY | $87,057,493 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $5,554,314 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $3,113,263 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $327,621 | 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 | $11,312,800 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,183,942 | DepreciationAmt |
| Book Value | $9,128,858 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $543,152 | OtherCostOrOtherBasisAmt |
| Depreciation | $156,853 | DepreciationAmt |
| Book Value | $386,299 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,728,647 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,320,772 | DepreciationAmt |
| Book Value | $407,875 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,355,357 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,355,357 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,753,032 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $15,664,402 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENT - DENTAL CHOICE, INC. | Desc |
| Book Value | $7,480,366 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $23,144,768 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ACCRUED INVESTMENT INCOME | $314,081 |
| 457(B) PLAN | $623,947 |
| INVESTMENT - RHC | $6,653,711 |
| SURPLUS NOTE RECEIVABLE | $1,050,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $8,641,739 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| CLAIMS CHECKS OUTSTANDING | $5,544,888 |
| ESTIMATED CLAIMS LIABILITY | $7,100,470 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $12,645,358 | 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, 2013 AND 2012, THE ENTERPRISE'S UNRECOGNIZED TAX BENEFITS WERE NOT SIGNIFICANT. THERE WERE NO SIGNIFICANT PENALTIES OR INTEREST RECOGNIZED DURING THE YEAR OR ACCRUED DURING 2013 AND 2012. THE ENTERPRISE IS NO LONGER SUBJECT TO TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE DECEMBER 31, 2010. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAMILY & CHILDREN'S PLACE INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3784 | AddressLine1 |
| City | LOUISVILLE | City |
| State | KY | State |
| ZIP Code | 40201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 610549561 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $5,000 | CashGrantAmt |
| Valuation Method Used | CASH | ValuationMethodUsedDesc |
| Non Cash Assistance | N/A | NonCashAssistanceDesc |
| Purpose Of Grant | GENERAL DONATION TO FAMILY & CHILDREN'S PLACE INITIATIVES | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | DELTA DENTAL OF KENTUCKY HAS FORMED A SUBCOMMITTE WHICH IS MADE UP OF VARIOUS BOARD OF DIRECTORES. THIS GROUP MEETS ANNUALLY TO REVIEW AND APPROVE GRANTS FOR THE FOLLOWING YEAR. | 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 |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 (9 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 | $267,257 | $0 | $166,713 | $0 | $101,938 | $0 | $43,872 | $0 | $13,569 | $0 | $593,349 | $0 | $0 | $0 |
| STEPHEN C DAY | ||||||||||||||
| VP/CMO | $157,064 | $0 | $77,379 | $0 | $4,035 | $0 | $0 | $0 | $21,725 | $0 | $260,203 | $0 | $0 | $0 |
| JOHN L WEEKS III | ||||||||||||||
| VP/CLO/SECRETARY | $178,795 | $0 | $83,602 | $0 | $5,169 | $0 | $0 | $0 | $20,314 | $0 | $287,880 | $0 | $0 | $0 |
| ANGELA J NENNI | ||||||||||||||
| VP | $157,134 | $0 | $99,385 | $0 | $924 | $0 | $0 | $0 | $11,354 | $0 | $268,797 | $0 | $0 | $0 |
| TAMARA L YORK-DAY | ||||||||||||||
| VP - OPERATIONS | $177,577 | $0 | $110,732 | $0 | $906 | $0 | $0 | $0 | $12,495 | $0 | $301,710 | $0 | $0 | $0 |
| RUSSELL W SKAGGS | ||||||||||||||
| VP - FINANCE | $129,884 | $0 | $46,367 | $0 | $661 | $0 | $0 | $0 | $18,421 | $0 | $195,333 | $0 | $0 | $0 |
| GORAN JURKOVIC CPA | ||||||||||||||
| CFO | $0 | $344,396 | $0 | $358,443 | $0 | $14,330 | $0 | $323,985 | $0 | $22,006 | $0 | $1,063,160 | $0 | $0 |
| RONALD E STORY | ||||||||||||||
| DIRECTOR - IS | $117,370 | $0 | $31,391 | $0 | $667 | $0 | $0 | $0 | $6,315 | $0 | $155,743 | $0 | $0 | $0 |
| BRIAN E KRAINER | ||||||||||||||
| DIRECTOR - SALES | $93,218 | $0 | $108,465 | $0 | $444 | $0 | $0 | $0 | $6,105 | $0 | $208,232 | $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 2013, THE ACCRUAL FOR CLIFFORD MAESKA'S SERP TOTALLED $48,320. |
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. CURRENTLY, RHSC APPOINTS TWO MEMBERS OF THE 12 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 2014. 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 2012. THE REPORT BASED ON THIS REVIEW WAS THEN ISSUED BY THE CONSULTANTS IN APRIL OF 2013. |
| 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 XI, LINE 9: | EQUITY IN SUBSIDIARY 327,621. |
| FORM 990, PART XII, LINE 2C: | PROCESS IS THE SAME AS THE PRIOR YEAR. |
| FORM 990, PART IV, LINE 12A: | THE ORGANIZATION ISSUES INDEPENDENT AUDITED FINANCIAL STATEMENTS ON THE STATUTORY BASIS OF ACCOUNTING. THE ORGANIZATION IS ALSO PART OF A CONSOLIDATED GAAP BASIS FINANCIAL STATEMENT. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DENTAL CHOICE PROPERTIES LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10100 LINN STATION RD SUITE | AddressLine1 |
| City | LOUISVILLE | City |
| State | KY | State |
| ZIP Code | 40223 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 610659432 | EIN |
| Primary Activities | REAL ESTATE HOLDING COMPANY | PrimaryActivitiesTxt |
| Legal Domicile State | KY | LegalDomicileStateCd |
| Total Income | $0 | TotalIncomeAmt |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF KENTUCKY | BusinessNameLine1 |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | 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/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DENTAL CHOICE INC | |||||||||||||
| 10100 LINN STATION RD SUITE 700 | LOUISVILLE | KY | 40223 | 611105118 | REAL ESTATE HOLDING COMPANY | KY | N/A | C | $226,752 | $7,477,544 | 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 | $2,450 | 1.00000 | Yes (1) | ||
| RENAISSANCE HOLDING COMPANY | |||||||||||||
| PO BOX 30381 | LANSING | MI | 48909 | 412177193 | HOLDING COMPANY | MI | C | $6,877,881 | 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 | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | 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 (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| DENTAL CHOICE INC | ||
| L | $396,284 | ACTUAL COST |
| DELTA DENTAL OF NORTH CAROLINA | ||
| D | $1,050,000 | ACTUAL COST |
| DELTA DENTAL PLAN OF MICHIGAN | ||
| M | $1,603,823 | ACTUAL COST |
| RENAISSANCE HEALTH SERVICES CORPORATION | ||
| B | $3,000,000 | ACTUAL COST |
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