DELTA DENTAL PLAN OF KANSAS INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- DELTA DENTAL PLAN OF KANSAS INC (EIN 48-0793267)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-07
- IRS object ID
- 201243129349300109
- Schema version
- 2011v1.3
- 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) |
|---|---|---|
| Timestamp | 2012-11-07T09:45:48-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1551 N WATERFRONT PKWY STE 300 | AddressLine1 |
| City | WICHITA | City |
| State | KS | State |
| ZIP Code | 672066601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 480793267 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF KANSAS INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % MICHAEL HERBERT | InCareOfName |
| Name Control | DELT | NameControl |
| Phone | 3162641099 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1619 N WATERFRONT PARKWAY | AddressLine1 |
| City | WICHITA | City |
| State | KS | State |
| ZIP Code | 67206 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHAEL HERBERT | Name |
| Title | CFO | Title |
| Date Signed | 2012-11-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ELIZABETH S HOGAN | Name |
| Phone | 3162652811 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MICHAEL HERBERT | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1619 N WATERFRONT PARKWAY | AddressLine1 |
| City | WICHITA | City |
| State | KS | State |
| ZIP Code | 67206 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 244914812 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.DELTADENTALKS.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1972 | YearFormation |
| State Legal Domicile | KS | StateLegalDomicile |
| Activity Or Mission Description | TO MAKE POSSIBLE AND FACILITATE A WIDER AND MORE TIMELY AVAILABILITY OF DENTAL CARE, THEREBY ADVANCING PUBLIC HEALTH AND DENTISTRY IN KANSAS, BY OPERATING A NON-PROFIT PREPAYMENT DENTAL SERVICE PLAN. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 115 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 344035 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 18474 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 236665873 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 242993827 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1793145 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1560517 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 372528 | OtherRevenuePriorYear |
| Other Revenue Current Year | 352321 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 238831546 | TotalRevenuePriorYear |
| Total Revenue Current Year | 244906665 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1581632 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 1488375 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 8808013 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 9326127 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 226036187 | OtherExpensePriorYear |
| Other Expenses Current Year | 230228062 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 236425832 | TotalExpensesPriorYear |
| Total Expenses Current Year | 241042564 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2405714 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3864101 | RevenuesLessExpensesCY |
| Total Assets BOY | 52845160 | TotalAssetsBOY |
| Total Assets EOY | 56785026 | TotalAssetsEOY |
| Total Liabilities BOY | 13706788 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 13605627 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 39138372 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 43179399 | NetAssetsOrFundBalancesEOY |
| Mission Description | SEE SCHEDULE O | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 220477263 | Expense |
| Revenue | 235704012 | Revenue |
| Description | DENTAL BENEFITS (COVERED CHARGES) PROVIDED TO SUBSCRIBERS. DELTA DENTAL SERVED APPROXIMATELY 906,843 PEOPLE THIS YEAR. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 6905017 | Expense |
| Revenue | 7289815 | Revenue |
| Description | THE PROCESSING OF DENTAL BENEFIT CLAIMS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1488375 | Expense |
| Grants | 1488375 | Grants |
| Description | CONTRIBUTION TO DELTA DENTAL OF KS FOUNDATION | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 228870655 | TotalProgramServiceExpense |
| Described In501 C3 | false | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | true | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | true | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | true | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 29174 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 115 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MICHAEL HERBERT | NamePerson |
| Telephone Number | 3162641099 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1619 N WATERFRONT PARKWAY | AddressLine1 |
| City | WICHITA | City |
| State | KS | State |
| ZIP Code | 67206 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| HUGH HERSCHEL BRUNER JR | ||||||||
| DIRECTOR | 1.3 | X | 17526 | 0 | 96 | |||
| BRADLEY JAY CLOTHIER | ||||||||
| DIRECTOR | 0.83 | X | 12911 | 0 | 110 | |||
| RONALD ROSS DAVIS | ||||||||
| DIRECTOR/VICE CHAIRPERSON | 1.04 | X | 16611 | 0 | 110 | |||
| GEROLD LYNNE GOFORTH | ||||||||
| DIRECTOR/CHAIRPERSON | 0.87 | X | 16341 | 0 | 639 | X | ||
| MARY ELIZABETH KINCH | ||||||||
| DIRECTOR | 0.86 | X | 14722 | 0 | 626 | |||
| WILBERT JOHN LEIKER | ||||||||
| DIRECTOR | 0.86 | X | 14411 | 0 | 44 | |||
| PATRICK MORIARTY | ||||||||
| DIRECTOR | 0.96 | X | 4069 | 0 | 0 | |||
| LUCYNDA JANE RABEN | ||||||||
| DIRECTOR | 0.9 | X | 14611 | 0 | 269 | |||
| MICHAEL J SANDERS | ||||||||
| DIRECTOR | 0.87 | X | 12115 | 0 | 1573 | |||
| BRICK RANDALL SCHEER | ||||||||
| DIRECTOR | 1.03 | X | 14527 | 0 | 0 | |||
| NANCY GWEN ZOGLEMAN | ||||||||
| DIRECTOR | 0.76 | X | 12215 | 0 | 235 | |||
| LINDA BRANTNER | ||||||||
| PRESIDENT & CEO | 39.4 | 410141 | 0 | 48529 | X | |||
| MICHAEL HERBERT | ||||||||
| TREASURER & CFO | 37.1 | 257764 | 0 | 44279 | X | |||
| NANCY UMHOLTZ | ||||||||
| SECRETARY | 39.7 | 86735 | 0 | 16076 | X | |||
| DEAN NEWTON | ||||||||
| CHIEF MARKETING/SALES OFFICER | 37.2 | 263195 | 0 | 50121 | X | |||
| FRANK CLEPPER | ||||||||
| CHIEF OPERATING OFFICER | 38.9 | 206292 | 0 | 37311 | X | |||
| ROBERT EBENKAMP | ||||||||
| VP INFORMATION TECHNOLOGY | 39.3 | 178167 | 0 | 29868 | X | |||
| JUNETTA EVERETT | ||||||||
| VP PROFESSIONAL RELATIONS | 37.4 | 176442 | 0 | 32601 | X | |||
| AMELIA ELLISON | ||||||||
| VP HUMAN RESOURCES | 39.6 | 168679 | 0 | 28245 | X | |||
| DR JON TILTON | ||||||||
| VP PROF REVIEW & DENTAL DIR | 40.0 | 193209 | 0 | 33283 | X | |||
| MARY MCPHEETERS | ||||||||
| IN-HOUSE LEGAL COUNSEL | 34.9 | 148863 | 0 | 2029 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2239546 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 326044 | TotalOtherCompensation |
| Number Individuals GT100 K | 16 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|
| GAGE CENTER DENTAL GROUP PA | |
| DENTAL SERVICES | 1888086 |
| JENKINS LEBLANC PA | |
| DENTAL SERVICES | 1019176 |
| DENTAL ASSOC OF WEST WICHITA PA | |
| DENTAL SERVICES | 991465 |
| CAMBRIDGE FAMILY DENTISTRY PA | |
| DENTAL SERVICES | 966808 |
| MARTIN AND FRANKENBERY DDS PA | |
| DENTAL SERVICES | 942503 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 450 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DENTAL SERVICES | Description |
| Business Code | 524298 | BusinessCode |
| Total Revenue Column | 242993827 | TotalRevenueColumn |
| Related Or Exempt Function Income | 242993827 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 242993827 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1217092 | TotalRevenueColumn |
| Exclusion | $1,217,092 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 351572 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 8147 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 351572 | Securities |
| Other | -8147 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 343425 | TotalRevenueColumn |
| Exclusion | $343,425 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| OTHER INCOME | 900099 | 8286 | $8,286 | |
| MANAGEMENT FEE | 561000 | 344035 | 344035 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 352321 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 244906665 | TotalRevenueColumn |
| Related Or Exempt Function Income | 242993827 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 344035 | UnrelatedBusinessRevenue |
| Exclusion | $1,568,803 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1488375 | Total |
| Program Services | 1488375 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2565590 | Total |
| Program Services | 510078 | ProgramServices |
| Management And General | 2055512 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5111012 | Total |
| Program Services | 2371439 | ProgramServices |
| Management And General | 2739573 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 536890 | Total |
| Program Services | 280468 | ProgramServices |
| Management And General | 256422 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 609699 | Total |
| Program Services | 316272 | ProgramServices |
| Management And General | 293427 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 502936 | Total |
| Program Services | 225391 | ProgramServices |
| Management And General | 277545 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 110351 | Total |
| Management And General | 110351 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 120000 | Total |
| Management And General | 120000 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30395 | Total |
| Management And General | 30395 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 158541 | Total |
| Management And General | 158541 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3282454 | Total |
| Program Services | 132334 | ProgramServices |
| Management And General | 3150120 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 673992 | Total |
| Program Services | 553 | ProgramServices |
| Management And General | 673439 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1499120 | Total |
| Program Services | 1401737 | ProgramServices |
| Management And General | 97383 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24215 | Total |
| Program Services | 11403 | ProgramServices |
| Management And General | 12812 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 156984 | Total |
| Management And General | 156984 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 431364 | Total |
| Program Services | 12452 | ProgramServices |
| Management And General | 418912 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 419873 | Total |
| Program Services | 214135 | ProgramServices |
| Management And General | 205738 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 552880 | Total |
| Program Services | 281948 | ProgramServices |
| Management And General | 270932 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 102622 | Total |
| Management And General | 102622 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| BANK SERVICES | 144119 | 144119 | |
| CLAIMS | 220477263 | 220477263 | |
| STATE PREMIUM TAXES | 670317 | 670317 | |
| BOARDS, BUREAUS, AND ASSOCS. | 234629 | 234629 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1138943 | Total |
| Program Services | 476490 | ProgramServices |
| Management And General | 662453 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 241042564 | Total |
| Program Services | 228870655 | ProgramServices |
| Management And General | 12171909 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 226903 | BOY |
| EOY | 256032 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3074167 | BOY |
| EOY | 3960953 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3992714 | BOY |
| EOY | 4225184 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 290937 | BOY |
| EOY | 411854 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 11351302 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2877717 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8959898 | BOY |
| EOY | 8473585 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31527375 | BOY |
| EOY | 32620141 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4452173 | BOY |
| EOY | 6511387 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 320993 | BOY |
| EOY | 325890 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52845160 | BOY |
| EOY | 56785026 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6649661 | BOY |
| EOY | 7055786 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7057127 | BOY |
| EOY | 6549841 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13706788 | BOY |
| EOY | 13605627 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39138372 | BOY |
| EOY | 43179399 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39138372 | BOY |
| EOY | 43179399 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52845160 | BOY |
| EOY | 56785026 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 3864101 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 176926 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1401415 | OtherCostOrOtherBasis |
| Book Value | 1401415 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7332320 | OtherCostOrOtherBasis |
| Depreciation | 978891 | Depreciation |
| Book Value | 6353429 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2617567 | OtherCostOrOtherBasis |
| Depreciation | 1898826 | Depreciation |
| Book Value | 718741 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildings | |
| Total Of Book Value Land Buildings | 8473585 | TotalOfBookValueLandBuildings |
| Financial Derivatives | FinancialDerivatives | |
| Closely Held Equity Interests | CloselyHeldEquityInterests |
Other Securities OtherSecurities (2 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| INV IN DELTA DENTAL OF KS FDN | 1911304 | F |
| INV IN SURENCY LIFE & HEALTH | 4600083 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 6511387 | TotalOfBookValueSecurities |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| UNEARNED PREMIUMS | $75,196 |
| UNEARNED RENT | $86,562 |
| CITY OF WICHITA - IRB(TAXABLE) | $6,388,083 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 6549841 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FIN 48 FOOTNOTE | Identifier |
| Return Reference | SCHEDULE D, PART X, LINE 2 | ReturnReference |
| Explanation | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF KS FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1619 N WATERFRONT PARKWAY | AddressLine1 |
| City | WICHITA | City |
| State | KS | State |
| ZIP Code | 67206 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 680554527 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 1463699 | AmountOfCashGrant |
| Amount Of Non Cash Assistance | 24676 | AmountOfNonCashAssistance |
| Method Of Valuation | COST | MethodOfValuation |
| Description Of Non Cash Assistance | UTILITIES, OFFICE | DescriptionOfNonCashAssistance |
| Purpose Of Grant | ASSISTANCE TO FOUNDATION | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S. | Identifier |
| Return Reference | SCHEDULE I, PART I, QUESTION 2 | ReturnReference |
| Explanation | DELTA DENTAL OF KANSAS PROVIDED CONTRIBUTIONS TO THEIR PRIVATE FOUNDATION, DELTA DENTAL OF KANSAS FOUNDATION. THE FOUNDATION'S EXECUTIVE DIRECTOR DOCUMENTS AND REPORTS ON THE FOUNDATION'S ACTIVITIES. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | X | TravelForCompanions |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|
| LINDA BRANTNER | |||||||||
| 292510 | 0 | 85037 | 32594 | 39728 | 0 | 8801 | 0 | 458670 | 0 |
| MICHAEL HERBERT | |||||||||
| 183620 | 0 | 49308 | 24836 | 33690 | 0 | 10589 | 0 | 302043 | 0 |
| DEAN NEWTON | |||||||||
| 162768 | 0 | 74569 | 25858 | 39792 | 0 | 10329 | 0 | 313316 | 0 |
| FRANK CLEPPER | |||||||||
| 143309 | 0 | 40127 | 22856 | 26866 | 0 | 10445 | 0 | 243603 | 0 |
| ROBERT EBENKAMP | |||||||||
| 139344 | 0 | 29128 | 9695 | 22064 | 0 | 7804 | 0 | 208035 | 0 |
| JUNETTA EVERETT | |||||||||
| 123462 | 0 | 29605 | 23375 | 22391 | 0 | 10210 | 0 | 209043 | 0 |
| AMELIA ELLISON | |||||||||
| 118627 | 0 | 26927 | 23125 | 20981 | 0 | 7264 | 0 | 196924 | 0 |
| DR JON TILTON | |||||||||
| 144701 | 0 | 31555 | 16953 | 24451 | 0 | 8832 | 0 | 226492 | 0 |
| MARY MCPHEETERS | |||||||||
| 139359 | 0 | 9155 | 349 | 0 | 0 | 2029 | 0 | 150892 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| TRAVEL FOR COMPANIONS | SCHEDULE J, PART 1, LINE 1A | DELTA DENTAL OF KANSAS DID PAY FOR THE COMPANION TRAVEL FOR BOARD OF DIRECTORS AND LEADERSHIP TEAM MEMBERS WHEN THEY ATTENDED OUT OF TOWN BUSINESS MEETINGS. THE COMPANION TRAVEL AMOUNT WAS TREATED AS TAXABLE COMPENSATION AND IS INCLUDED IN THE BOARD OF DIRECTORS' 1099-MISC AND THE LEADERSHIP TEAM MEMBERS' W-2. |
| HEALTH OR SOCIAL CLUB DUES | SCHEDULE J, PART 1, LINE 1A | THE CHIEF EXECUTIVE OFFICER IS PAID A MONTHLY ALLOWANCE FOR MEMBERSHIP TO A COUNTRY CLUB. THE MONTHLY ALLOWANCE FOR MEMBERSHIP TO THE COUNTRY CLUB IS TREATED AS TAXABLE COMPENSATION AND IS INCLUDED IN THE CHIEF EXECUTIVE OFFICER'S FORM W-2. |
Schedule L IRS990ScheduleL
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 0 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV (6 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| DR RONALD DAVIS | |||
| DIRECTOR | 51867 | PAYMENT OF DENTAL SERVICES | false |
| DR LUCYNDA RABEN | |||
| DIRECTOR | 168494 | PAYMENT OF DENTAL SERVICES | false |
| DR HUGH BRUNER JR | |||
| DIRECTOR | 7888 | PAYMENT OF DENTAL SERVICES | false |
| DR BRICK SCHEER | |||
| DIRECTOR | 145616 | PAYMENT OF DENTAL SERVICES | false |
| SURENCY LIFE HEALTH COMPANY | |||
| SHARED OFFICERS | 344035 | PAYMENT OF MANAGEMENT FEES | false |
| DR PATRICK MORIARTY | |||
| DIRECTOR | 197007 | PAYMENT OF DENTAL SERVICES | false |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS | Identifier |
| Return Reference | SCHEDULE L, PART IV | ReturnReference |
| Explanation | THE DIRECTORS LISTED IN PART IV ARE ALSO PARTICIPATING DENTISTS WITH DELTA DENTAL OF KANSAS. AS A PARTICIPATING DENTIST, DELTA DENTAL OF KANSAS PAYS THE DIRECTORS LISTED IN PART IV FOR THE DENTAL SERVICES THEY PROVIDE TO OUR SUBSCRIBERS IN THE NORMAL COURSE OF THEIR BUSINESS. DELTA DENTAL OF KANSAS HAS A MANAGEMENT CONTRACT WITH SURENCY LIFE & HEALTH. IN ACCORDANCE WITH THE MANAGEMENT CONTRACT, SURENCY PAYS DELTA DENTAL OF KANSAS MANAGEMENT FEES FOR SERVICES PROVIDED. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (26 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990, PART III, LINE 1 | TO MAKE POSSIBLE AND FACILITATE A WIDER AND MORE TIMELY AVAILABILITY OF DENTAL CARE, THEREBY ADVANCING THE PUBLIC HEALTH AND THE SCIENCE AND ART OF DENTISTRY IN THE STATE OF KANSAS, BY ESTABLISHING, MAINTAINING, AND OPERATING A NON-PROFIT PREPAYMENT DENTAL SERVICE PLAN OR PLANS IN THE STATE OF KANSAS. |
| INDEPENDENT VOTING MEMBERS | FORM 990, PART VI, SECTION A, LINE 1B | BRICK SCHEER, LUCYNDA RABEN, PATRICK MORIARTY, AND RONALD DAVIS WERE ALL VOTING MEMBERS OF THE BOARD AS OF THE END OF THE ORGANIZATION'S TAX YEAR. THESE INDIVIDUALS WERE ALL INVOLVED IN TRANSACTIONS WITH THE ORGANIZATION THAT ARE REQUIRED TO BE REPORTED ON SCHEDULE L. CONSEQUENTLY, THESE MEMBERS HAVE NOT BEEN REPORTED AS INDEPENDENT. |
| BUSINESS RELATIONSHIPS | FORM 990, PART VI, SECTION A, LINE 2 | LINDA BRANTNER, MICHAEL HERBERT, DEAN NEWTON, NANCY UMHOLTZ, AND FRANK CLEPPER HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. LINDA BRANTNER, MICHAEL HERBERT, DEAN NEWTON, NANCY UMHOLTZ, AND FRANK CLEPPER SERVE AS EITHER OFFICERS OR DIRECTORS OF SURENCY LIFE & HEALTH INSURANCE COMPANY, WHICH IS A RELATED FOR-PROFIT COMPANY. THE OFFICERS AND DIRECTORS DO NOT HAVE STOCK OWNERSHIP INTEREST IN THE RELATED FOR-PROFIT COMPANY. |
| MEMBERS | FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS MEMBERS. THE MEMBERSHIP OF DELTA DENTAL OF KANSAS IS COMPRISED OF THE DENTISTS WHO HAVE CURRENT PARTICIPATING AGREEMENTS WITH DELTA DENTAL OF KANSAS. EACH MEMBER IS ENTITLED, AT EVERY MEETING OF THE MEMBERS, TO ONE VOTE PER PERSON, BUT NO MEMBER SHALL BE ENTITLED TO VOTE BY PROXY. |
| MEMBERS WHO MAY ELECT THE GOVERNING BODY | FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS ARE COMPRISED OF TEN (10) MEMBERS, FOUR (4) OF WHOM ARE ELECTED BY THE MEMBERSHIP AND ARE AMONG THE CORPORATION'S PARTICIPATING DENTISTS, TWO (2) ARE APPOINTED BY THE GOVERNOR OF THE STATE OF KANSAS, AND FOUR (4) ARE APPOINTED BY THE COMMISSIONER OF INSURANCE OF THE STATE OF KANSAS. |
| DECISIONS SUBJECT TO APPROVAL BY MEMBERS | FORM 990, PART VI, SECTION A, LINE 7B | ANY PROPOSED CHANGES TO THE BY-LAWS ARE SUBJECT TO MEMBER APPROVAL. THE BOARD OF DIRECTORS ARE COMPRISED OF TEN (10) MEMBERS, FOUR (4) OF WHOM ARE ELECTED BY THE MEMBERSHIP AND ARE AMONG THE CORPORATION'S PARTICIPATING DENTISTS, TWO (2) ARE APPOINTED BY THE GOVERNOR OF THE STATE OF KANSAS, AND FOUR (4) ARE APPOINTED BY THE COMMISSIONER OF INSURANCE OF THE STATE OF KANSAS. |
| FORM 990 REVIEW PROCESS | FORM 990, PART VI, SECTION B, LINE 11B | AN INDEPENDENT ACCOUTING FIRM PREPARES THE FORM 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S CFO AND ACCOUNTING PERSONNEL. ANY QUESTIONS OR COMMENTS ARE ADDRESSED AND ANY NECESSARY CHANGES ARE MADE. THE FORM 990 WITH ALL RELATED SCHEDULES IS THEN PROVIDED TO THE ENTIRE GOVERNING BODY FOR REVIEW PRIOR TO FILING. |
| CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | THE CHAIRPERSON OF THE BOARD AND THE GOVERNANCE COMMITTEE MONITOR AND ENFORCE OUR CONFLICT OF INTEREST POLICY. EACH DIRECTOR, OFFICER, AND KEY EMPLOYEE OF DELTA DENTAL OF KANSAS ANNUALLY FILES A STATEMENT REGARDING CONFLICTS OF INTEREST WHICH EXIST, OR WHICH MIGHT BE EXPECTED TO EXIST, WITHIN THE UPCOMING YEAR. THE STATEMENT DISCLOSES AS FULLY AS POSSIBLE THE NATURE OF POTENTIAL CONFLICTS AND THE NATURE OF THE DIRECTOR'S, OFFICER'S, OR KEY EMPLOYEE'S INTEREST IN THE POTENTIAL TRANSACTION. ALL STATEMENTS ARE REVIEWED BY THE PRESIDENT AND CHAIRPERSON AND MAY BE CIRCULATED TO MEMBERS OF THE BOARD OF DIRECTORS. EACH DIRECTOR, OFFICER, AND KEY EMPLOYEE AGREE TO ANSWER ANY QUESTIONS ABOUT POTENTIAL CONFLICTS THEY MAY HAVE. IF A CONFLICT IS IDENTIFIED, VOTING MAY BE RESTRICTED. |
| COMPENSATION REVIEW | FORM 990, PART VI, SECTION B, LINES 15A AND 15B | THE DELTA DENTAL OF KANSAS PROCESS FOR DETERMINING COMPENSATION FOR THE CEO, OFFICERS, AND KEY EMPLOYEES DOES INCLUDE A REVIEW BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. DELTA DENTAL OF KANSAS HAS CONTRACTED WITH INSIGHT MANAGEMENT CONSULTING GROUP TO PROVIDE COMPENSATION STUDIES FOR OUR POSITIONS. INSIGHT USES PUBLISHED MARKET DATA SOURCES TO IDENTIFY THE RELEVANT MARKET FOR POSITIONS, WHICH ARE MATCHED BASED UPON THE DESCRIPTION OF DUTIES AND RESPONSIBILITIES PROVIDED. MARKET DATA IS USED AS APPROPRIATE FOR EACH POSITION, FROM LOCAL, REGIONAL AND NATIONAL MARKETS. INSIGHT PROVIDES A COMPLETE REPORT THAT DOCUMENTS THE FINDINGS OF THE MARKET REVIEW PROCESS FOR OUR POSITIONS AND THEIR RECOMMENDATION REGARDING THE GRADE LEVEL OF PLACEMENT OF THE POSITION. DELTA DENTAL OF KANSAS ALSO HAS A COMPENSATION COMMITTEE, COMPRISED OF SELECTED BOARD MEMBERS. ONE OF THE PURPOSES OF THE COMMITTEE IS TO REVIEW, REPORT, AND MAKE RECOMMENDATIONS TO THE BOARD REGARDING COMPENSATION OF ALL OFFICERS AND EXECUTIVE TEAM EMPLOYEES. THE COMMITTEE IS RESPONSIBLE TO MEET WITH THE PRESIDENT/CHIEF EXECUTIVE OFFICER ANNUALLY TO REVIEW HIS/HER PERFORMANCE AND EMPLOYMENT CONTRACT, MAKE RECOMMENDATIONS TO THE BOARD REGARDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER'S ANNUAL COMPENSATION AND BENEFITS PACKAGE AND TO REVIEW THE PRESIDENT/CHIEF EXECUTIVE OFFICER'S RECOMMENDATIONS AS TO SALARY ADJUSTMENTS AND INCENTIVE PAYMENTS FOR OFFICERS, EXECUTIVES, AND SENIOR MANAGEMENT. |
| AVAILABILITY OF DOCUMENTS | FORM 990, PART VI, SECTION C, LINE 19 | DELTA DENTAL OF KANSAS ANNUAL REPORT IS AVAILABLE TO THE PUBLIC THROUGH OUR WEBSITE, WWW.DELTADENTALKS.COM; OUR GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| COMPENSATION OF OFFICERS | FORM 990, PART VII, SECTION A | ALL OF THE ORGANIZATION'S BOARD MEMBERS RECEIVE COMPENSATION FROM THE ORGANIZATION FOR THEIR SERVICES AS DIRECTORS. THEY ARE NOT COMPENSATED AS INDEPENDENT CONTRACTORS. |
| RECONCILIATION OF NET ASSETS | FORM 990, PART XI, LINE 5 | (261,580.00) UNREALIZED LOSS ON INVESTMENTS NOT INCLUDED ON RETURN (120,708.00) MARK-TO-MARKET ADJUSTMENT NOT INCLUDED ON RETURN 947,945.00 EARNINGS FROM SUBSIDIARY NOT ON RETURN - FOUNDATION (388,731.00) EARNINGS FROM SUBSIDIARY NOT ON RETURN - SURENCY ------------ 176,926.00 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:HUGH HERSCHEL BRUNER JR TITLE:DIRECTOR HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:BRADLEY JAY CLOTHIER TITLE:DIRECTOR HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:RONALD ROSS DAVIS TITLE:DIRECTOR/VICE CHAIRPERSON HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MARY ELIZABETH KINCH TITLE:DIRECTOR HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:BRICK RANDALL SCHEER TITLE:DIRECTOR HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:LINDA BRANTNER TITLE:PRESIDENT & CEO HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MICHAEL HERBERT TITLE:TREASURER & CFO HOURS:3 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:NANCY UMHOLTZ TITLE:SECRETARY HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DEAN NEWTON TITLE:CHIEF MARKETING/SALES OFFICER HOURS:3 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:FRANK CLEPPER TITLE:CHIEF OPERATING OFFICER HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ROBERT EBENKAMP TITLE:VP INFORMATION TECHNOLOGY HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JUNETTA EVERETT TITLE:VP PROFESSIONAL RELATIONS HOURS:3 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:AMELIA ELLISON TITLE:VP HUMAN RESOURCES HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MARY MCPHEETERS TITLE:IN-HOUSE LEGAL COUNSEL HOURS:5 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KSDD PROPERTIES LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1619 N WATERFRONT PARKWAY | AddressLine1 |
| City | WICHITA | City |
| State | KS | State |
| ZIP Code | 67206 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 480793267 | EIN |
| Primary Activities | REAL ESTATE | PrimaryActivities |
| Legal Domicile State | KS | LegalDomicileState |
| Total Income | 890191 | TotalIncome |
| EOY Assets | 8347156 | EOYAssets |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF KANSAS FOUNDATION INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1619 N WATERFRONT PARKWAY | AddressLine1 |
| City | WICHITA | City |
| State | KS | State |
| ZIP Code | 67206 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 680554527 | EIN |
| Primary Activities | ORAL HEALTH | PrimaryActivities |
| Legal Domicile State | KS | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | PF | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | false | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SURENCY LIFE & HEALTH COMPANY | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1619 N WATERFRONT PARKWAY | AddressLine1 |
| City | WICHITA | City |
| State | KS | State |
| ZIP Code | 67206 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 261969006 | EIN |
| Primary Activity | INSURANCE | PrimaryActivity |
| Legal Domicile State | KS | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C CORPORATION | TypeOfEntity |
| Share Of Total Income | -388731 | ShareOfTotalIncome |
| Share Of EOY Assets | 5010589 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| SURENCY LIFE & HEALTH INSURANCE COMPANY | ||
| B | 1200000 | COST |
| SURENCY LIFE & HEALTH INSURANCE COMPANY | ||
| N | 344035 | COST |
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