DELTA DENTAL OF IOWA: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: DELTA DENTAL OF IOWA (EIN 42-0959302)
Tax period: 2011-01-01 to 2011-12-31
Filed: 2012-11-13
IRS object ID: 201243189349304304
Schema version: 2011v1.2
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
Form 990
Schedule D
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-11-13T15:57:33-06:00	Timestamp
Tax Period End Date	2011-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	421229486	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BROOKS LODDEN PC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	1441 29TH STREET STE 305	AddressLine1
City	WEST DES MOINES	City
State	IA	State
ZIP Code	502661357	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	420959302	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	DELTA DENTAL OF IOWA	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	DELT	NameControl
Phone	5152615500	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	9000 NORTHPARK DRIVE	AddressLine1
City	JOHNSTON	City
State	IA	State
ZIP Code	50131	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	CHERYL HARDING	Name
Title	VICE PRES & CHIEF OPER OFFICER	Title
Phone	5152615500	Phone
Date Signed	2012-11-13	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	BRENT L ALEXANDER	Name
PTIN	P00075113	PTIN
Phone	5152237300	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	DONN HUTCHINS	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	9000 NORTHPARK DRIVE	AddressLine1
City	JOHNSTON	City
State	IA	State
ZIP Code	50131	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	79468700	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c	X	Organization501c
Web Site	WWW.DELTADENTALIA.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1970	YearFormation
State Legal Domicile	IA	StateLegalDomicile
Activity Or Mission Description	DENTAL HEALTH CARE: TO IMPROVE THE ORAL HEALTH OF THE PEOPLE WE SERVE. THIS IS ACCOMPLISHED THROUGH THE PROVISION OF DENTAL INSURANCE AND PUBLIC HEALTH CONTRIBUTIONS THAT FOCUS ON ACCESS TO ORAL HEALTH SERVICES AND EDUCATION RELATED TO GOOD ORAL HEALTH BEHAVIORS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	9	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	3	NbrIndependentVotingMembers
Total Nbr Employees	79	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	101066	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	0	ContributionsGrantsPriorYear
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	67111304	ProgramServiceRevenuePriorYear
Program Service Revenue CY	72381744	ProgramServiceRevenueCY
Investment Income Prior Year	976111	InvestmentIncomePriorYear
Investment Income Current Year	1290713	InvestmentIncomeCurrentYear
Other Revenue Prior Year	130498	OtherRevenuePriorYear
Other Revenue Current Year	101066	OtherRevenueCurrentYear
Total Revenue Prior Year	68217913	TotalRevenuePriorYear
Total Revenue Current Year	73773523	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	1858714	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	2880371	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	46244699	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	48289991	BenefitsPaidToMembersCY
Salaries Etc Prior Year	7419331	SalariesEtcPriorYear
Salaries Etc Current Year	7595505	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	9081213	OtherExpensePriorYear
Other Expenses Current Year	9766543	OtherExpensesCurrentYear
Total Expenses Prior Year	64603957	TotalExpensesPriorYear
Total Expenses Current Year	68532410	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	3613956	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	5241113	RevenuesLessExpensesCY
Total Assets BOY	53430840	TotalAssetsBOY
Total Assets EOY	59976161	TotalAssetsEOY
Total Liabilities BOY	11407284	TotalLiabilitiesBOY
Total Liabilities EOY	12229165	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	42023556	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	47746996	NetAssetsOrFundBalancesEOY
Mission Description	DENTAL HEALTH CARE: TO IMPROVE THE ORAL HEALTH OF THE PEOPLE WE SERVE. THIS IS ACCOMPLISHED THROUGH THE PROVISION OF DENTAL INSURANCE AND PUBLIC HEALTH CONTRIBUTIONS THAT FOCUS ON ACCESS TO ORAL HEALTH SERVICES AND EDUCATION RELATED TO GOOD ORAL HEALTH BEHAVIORS.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	61890157	Expense
Grants	2880371	Grants
Revenue	72381744	Revenue
Description	SINCE 1970, DELTA DENTAL OF IOWA HAS EXPANDED ACCESS TO DENTAL CARE BY PROVIDING AFFORDABLE, NETWORK BASED DENTAL BENEFITS PLANS TO IOWA EMPLOYERS AND INDIVIDUALS THAT RESULT IN LONG-TERM COST SAVINGS AND SUPPORT GOOD ORAL HEALTH. DELTA DENTAL OF IOWA'S DENTAL BENEFIT PLANS STRIVE TO INCORPORATE THE CURRENT BEST PRACTICES IN DENTAL SCIENCE. DELTA DENTAL IS COMMITTED TO ITS VISION OF IMPROVING THE ORAL HEALTH OF THE PEOPLE AND COMMUNITIES IT SERVES. DELTA DENTAL FULFILLS ITS NOT-FOR-PROFIT VISION BY ACTIVELY PARTICIPATING IN THE COMMUNITIES IT SERVES AS A CHAMPION AND MAJOR FUNDER OF ORAL HEALTH INITIATIVES IN THE STATE OF IOWA. DELTA DENTAL INVESTS IN ORAL HEALTH PROJECTS THAT MEET THE NEEDS OF UNDERSERVED POPULATIONS AND THAT FOCUS ON ACCESS TO CARE, PREVENTION, EDUCATION AND RESEARCH.	Description
Total Program Service Expense	61890157	TotalProgramServiceExpense
Described In501 C3	0	DescribedIn501C3
Schedule B Required	0	ScheduleBRequired
Political Activities	0	PoliticalActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	0	Hospital
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	1	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	15811	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	79	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	9	NbrVotingGoverningBodyMembers
Number Independent Voting Members	3	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	CHERYL HARDING	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	5152615500	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	9000 NORTHPARK DRIVE	AddressLine1
City	JOHNSTON	City
State	IA	State
ZIP Code	50131	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee
W BRYAN CLEMONS II DDS
DIRECTOR	1.60	X	8200	0	0
CHARLES EDWARD BROWN
DIRECTOR	1.60	X	6200	0	0
ANNE HENNESSEY DDS
DIRECTOR	1.60	X	12500	0	0
JOHN KEARNS DDS
DIRECTOR	2.20	X	500	600	11500
MERRITT KRAUSE
DIRECTOR	2.20	X	13100	0	0
JEFF PLAGGE
DIRECTOR	1.60	X	8750	200	8250
RENIE NEUBERGER
DIRECTOR	1.60	X	12400	0	0
TOM ALLER
DIRECTOR	2.50	X	17100	0	0
WILLIAM WEVER DDS
DIRECTOR	1.60	X	7300	0	0
DONN HUTCHINS
PRESIDENT AND CEO	40.00	X	600748	0	153321	X
CHERYL HARDING
VICE PRESIDENT AND COO	40.00		332342	0	71341	X
GREGORY SHIREMAN
VICE PRESIDENT OF MARKETIN	40.00		343184	0	32076	X
RICHARD RUSSELL
VICE PRESIDENT, OPERATIONS	40.00		234666	0	51194	X
ED SCHOOLEY DDS
VICE PRESIDENT AND DENTAL	40.00		206179	0	20325		X
SHERRY MALY
DIRECTOR OF CLIENT SERVICE	40.00		149817	0	18227		X
SHERRY PERKINS
CONTROLLER	40.00		153158	0	31549		X
BRENDA LOWE
MARKETING ACCOUNT EXECUTIVE	40.00		148429	0	18366		X
SUZANNE HECKENLAIBLE
DIRECTOR,COMMUNITY & GOVT	40.00		126182	0	29860		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2380755	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	800	TotalReportableCompFrmRltdOrgs
Total Other Compensation	446009	TotalOtherCompensation
Number Individuals GT100 K	15	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
UNIVERSITY OF IOWA
322 DENTAL SCIENCE BLDG S	IOWA CITY	IA	52242	DENTAL SERVICES	3472931
CONSAMUS AND HAMPTON DENTAL CLINIC PLC
3324 ORION DR	AMES	IA	50010	DENTAL SERVICES	1559673
APPLEWHITE DENTAL IOWA PC
1340 DELHI ST	DUBUQUE	IA	52001	DENTAL SERVICES	1468471
DENTAL ASSOCIATES PC
3700 WESTOWN PKWY	WEST DES MOINES	IA	50266	DENTAL SERVICES	1405951
IOWA ORAL & MAXILL SURGEONS PC
1469 29TH ST	WEST DES MOINES	IA	50266	DENTAL SERVICES	1338223

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	495	NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PREMIUMS EARNED	524114	62695297	62695297
ADMINISTRATIVE SERVICE	524292	9686447	9686447

Field	Value	IRS element (for citing)
Total Program Service Revenue	72381744	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1205043	TotalRevenueColumn
Exclusion	$1,205,043	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	5780847	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	5695177	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	85670	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	85670	TotalRevenueColumn
Exclusion	$85,670	ExclusionAmount

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	MANAGEMENT FEES	Description
Business Code	541610	BusinessCode
Total Revenue Column	101066	TotalRevenueColumn
Unrelated Business Revenue	101066	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Other Revenue	101066	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	73773523	TotalRevenueColumn
Related Or Exempt Function Income	72381744	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	101066	UnrelatedBusinessRevenue
Exclusion	$1,290,713	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	2880371	Total
Program Services	2880371	ProgramServices

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	48289991	Total
Program Services	48289991	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	2380755	Total
Program Services	298246	ProgramServices
Management And General	2082509	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	3374336	Total
Program Services	2214651	ProgramServices
Management And General	1159685	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	549402	Total
Program Services	146851	ProgramServices
Management And General	402551	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	911364	Total
Program Services	616148	ProgramServices
Management And General	295216	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	379648	Total
Program Services	194027	ProgramServices
Management And General	185621	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	81968	Total
Program Services	1368	ProgramServices
Management And General	80600	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	107545	Total
Program Services	45	ProgramServices
Management And General	107500	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	57501	Total
Management And General	57501	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	163523	Total
Management And General	163523	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	1080976	Total
Program Services	595898	ProgramServices
Management And General	485078	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	475183	Total
Program Services	434273	ProgramServices
Management And General	40910	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	1639697	Total
Program Services	1286930	ProgramServices
Management And General	352767	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	1312596	Total
Program Services	1312596	ProgramServices

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	325046	Total
Management And General	325046	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	155528	Total
Program Services	85431	ProgramServices
Management And General	70097	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	72303	Total
Program Services	25902	ProgramServices
Management And General	46401	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	319716	Total
Program Services	61892	ProgramServices
Management And General	257824	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	170066	Total
Management And General	170066	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
BROKER COMMISSIONS	2880895	2880895
PREMIUM TAXES	519153	519153
DDPA DUES	209572		209572
CIVIC AND CHARITABLE CO	102720	22547	80173

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	92555	Total
Program Services	22942	ProgramServices
Management And General	69613	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	68532410	Total
Program Services	61890157	ProgramServices
Management And General	6642253	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	2458670	BOY
EOY	4861869	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	752617	BOY
EOY	604056	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	2043166	BOY
EOY	1667768	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	10237709	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	1615978	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	8701040	BOY
EOY	8621731	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	38812789	BOY
EOY	43505201	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	226126	BOY
EOY	241927	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	436432	BOY
EOY	473609	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	53430840	BOY
EOY	59976161	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	6671677	BOY
EOY	7912287	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	4735607	BOY
EOY	4316878	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	11407284	BOY
EOY	12229165	EOY

Field	Value	IRS element (for citing)
Do Not Follow SFAS117	X	DoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

Field	Value	IRS element (for citing)
BOY	475819	BOY
EOY	475819	EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

Field	Value	IRS element (for citing)
BOY	41547737	BOY
EOY	47271177	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	42023556	BOY
EOY	47746996	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	53430840	BOY
EOY	59976161	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	5241113	ReconcilationRevenueExpenses
Reconcilation Other Changes	482327	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2665500	OtherCostOrOtherBasis
Book Value	2665500	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	5099092	OtherCostOrOtherBasis
Depreciation	180593	Depreciation
Book Value	4918499	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2473117	OtherCostOrOtherBasis
Depreciation	1435385	Depreciation
Book Value	1037732	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	8621731	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescription	AmountAmount
UNEARNED PREMIUMS	$1,325,951
CLAIMS UNPAID	$2,779,831
OTHER POLICY RESERVES	$211,096

Field	Value	IRS element (for citing)
Total Of Amounts	4316878	TotalOfAmounts
Total Revenue	73773523	TotalRevenue
Total Expenses	68532410	TotalExpenses
Excess Or Deficit For Year	5241113	ExcessOrDeficitForYear
Net Unrealized GL On Investments	482327	NetUnrealizedGLOnInvestments
Total Adjustments	482327	TotalAdjustments
Excess Or Deficit Per FS	5723440	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	223683098	TotRevenueEtcAuditedFinclStmt
Other Revenues	150174165	OtherRevenues
Revenue Not Rptd F990	150174165	RevenueNotRptdF990
Revenue Subtotal	73508933	RevenueSubtotal
Investment Expenses Not Included	163524	InvestmentExpensesNotIncluded
Other Revenues Not Included	101066	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	264590	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	73773523	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	218441985	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	150174165	OtherExpensesIncluded
Expenses Not Rptd F990	150174165	ExpensesNotRptdF990
Expenses Subtotal	68267820	ExpensesSubtotal
Investment Expenses Not Included2	163524	InvestmentExpensesNotIncluded2
Other Expenses Not Included	101066	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	264590	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	68532410	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X:	DELTA DENTAL OF IOWA IS ORGANIZED AS A NONPROFIT DENTAL CARE PLAN FOR FEDERAL INCOME TAX PURPOSES UNDER SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE AND, AS SUCH, DOES NOT PAY FEDERAL INCOME TAXES. THE COMPANY IS EXEMPT FROM STATE INCOME TAXES. THE COMPANY EVALUATES TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING ITS TAX RETURNS TO DETERMINE WHETHER IT IS "MORE LIKELY THAN NOT" THAT EACH TAX POSITION WOULD BE SUSTAINED UPON EXAMINATION BY A TAXING AUTHORITY BASED ON THE TECHNICAL MERITS OF THE POSITION. TAX POSITIONS NOT DEEMED TO MEET THE MORE-LIKELY-THAN-NOT THRESHOLD WOULD BE RECORDED AS A TAX BENEFIT OR EXPENSE IN THE CURRENT YEAR. DURING THE YEARS ENDED DECEMBER 31, 2011 AND 2010, THE COMPANY DID NOT RECORD ANY SUCH TAX BENEFIT OR EXPENSE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. NO EXAMINATIONS ARE IN PROGRESS OR ANTICIPATED AT THIS TIME.
PART XII, LINE 2D - OTHER ADJUSTMENTS:		ADMINISTRATIVE SERVICE CLAIMS (NETTED WITH REVENUE) 150,174,165.
PART XII, LINE 4B - OTHER ADJUSTMENTS:		MANAGEMENT FEES (NETTED WITH EMPLOYEE BENEFITS) 101,066.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:		ADMINISTRATIVE SERVICE CLAIMS (NETTED WITH REVENUE) 150,174,165.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:		MANAGEMENT FEES - NETTED WITH EXPENSES FOR FINANCIALS 101,066.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
DELTA DENTAL OF IOWA FOUNDATION
9000 NORTHPARK DRIVE	JOHNSTON	IA	50131	260762771	501(C)(3)	1503467	CONTRIBUTION TO DELTA DENTAL OF IOWA FOUNDATION TO SUPPORT & IMPROVE THE ORAL HEALTH OF IOWANS.
COMMUNITY FOUNDATION OF GREATER DES MOINES
1915 GRAND AVE	DES MOINES	IA	50309	426139033	501(C)(3)	50000	CONTRIBUTION TO CFGDM FOR THE DDIA DONOR ADVISED FUND. THE DONOR ADVISED FUND IS USED FOR THE REPAYMENT OF DENTAL EDUCATION DEBT FOR A DENTIST WHO AGREES TO ESTABLISH AN OFFICE IN A RURAL, UNDERSERVED AREA.

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Explanation	PART I, QUESTION 1: IN 2011, DELTA DENTAL OF IOWA GRANTED $50,000 TO THE COMMUNITY FOUNDATION OF GREATER DES MOINES. DELTA DENTAL OF IOWA MAINTAINS A DONOR ADVISED FUND AT THE COMMUNITY FOUNDATION OF GREATER DES MOINES FOR THE PURPOSE OF AWARDING LOAN REPAYMENT AWARDS TO DENTISTS WHO AGREE TO PRACTICE IN AN UNDERSERVED AREA IN THE STATE OF IOWA AND TO DEDICATE A PORTION OF THEIR PRACTICE TO LOW INCOME PATIENTS. DELTA DENTAL OF IOWA ADVISES THE COMMUNITY FOUNDATION OF GREATER DES MOINES ON HOW TO AWARD THIS MONEY AND THE COMMUNITY FOUNDATION OF GREATER DES MOINES ONLY GRANTS THIS MONEY TO DENTISTS IN THE STATE OF IOWA. THE COMMUNITY FOUNDATION OF GREATER DES MOINES AND DELTA DENTAL OF IOWA MAINTAIN RECORDS TO SUBSTANTIATE THE AMOUNT OF GRANTS, THE GRANTEES' ELIGIBILITY AND THE SELECTION CRITERIA. DELTA DENTAL OF IOWA ALSO MAKES GRANTS TO THE DELTA DENTAL OF IOWA FOUNDATION. THE DELTA DENTAL OF IOWA FOUNDATION MAINTAINS RECORDS TO SUBSTANTIATE THE AMOUNT OF GRANTS, THE GRANTEES' ELIGIBILITY AND THE SELECTION CRITERIA.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Payments	X	IdemnificationGrossUpPayments
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	1	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	1	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DONN HUTCHINS
409350	0	174832	0	16566	0	140234	0	13087	0	754069	0	0	0
CHERYL HARDING
240811	0	87722	0	3809	0	52012	0	19329	0	403683	0	0	0
GREGORY SHIREMAN
231172	0	107791	0	4221	0	19600	0	12476	0	375260	0	0	0
RICHARD RUSSELL
168660	0	61969	0	4037	0	31943	0	19251	0	285860	0	0	0
ED SCHOOLEY DDS
139584	0	64973	0	1622	0	16305	0	4020	0	226504	0	0	0
SHERRY MALY
121548	0	26786	0	1483	0	11876	0	6351	0	168044	0	0	0
SHERRY PERKINS
113501	0	37961	0	1696	0	12298	0	19251	0	184707	0	0	0
BRENDA LOWE
48110	0	98665	0	1654	0	11895	0	6471	0	166795	0	0	0
SUZANNE HECKENLAIBLE
100509	0	23789	0	1884	0	10609	0	19251	0	156042	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReference	ExplanationExplanation
PART I, LINE 1A	TAX GROSS UP PAYMENTS ARE RELATED TO TAXABLE FRINGE BENEFITS INCLUDED AS COMPENSATION FOR ALL COMPANY EMPLOYEES INCLUDING THE PERSONS LISTED IN PART VII, SECTION A, LINE 1. THE PAYMENTS REPRESENT 1% OR LESS OF COMPENSATION FOR THE INDIVIDUALS.
PART I, LINE 4B	OFFICERS OF THE COMPANY PARTICIPATE IN A SEC. 457(F) PLAN. THE COMPANY MAKES A CONTRIBUTION TO THE PLAN ANNUALLY ON BEHALF OF THE OFFICERS. THIS CONTRIBUTION IS A PERCENTAGE OF SALARY AND IS SET AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE OFFICERS CANNOT ACCESS THE FUNDS UNTIL RETIREMENT, LEAVING THE COMPANY, OR DEATH. OFFICERS WHO RECEIVED DEPOSITS IN 2011 AND AMOUNTS ARE: DONN HUTCHINS $120,634 CHERYL HARDING $ 32,427 GREG SHIREMAN $ 31,815 RICHARD RUSSELL $ 15,634
PART I, LINE 5	ONE EMPLOYEE OF THE COMPANY HAS COMPENSATION CONTINGENT ON REVENUES. THE INDIVIDUAL IS AN ACCOUNT EXECUTIVE OF THE COMPANY WHO RECEIVES COMMISSIONS BASED ON SALES OF GROUP BUSINESS. THIS ACCOUNT EXECUTIVE IS RESPONSIBLE FOR SELLING NEW BUSINESS.
PART I, LINE 6	CONSISTENT WITH THE COMPANY'S TOTAL COMPENSATION POLICY, THE OFFICERS AND KEY EMPLOYEES, ALONG WITH ALL EMPLOYEES OF THE COMPANY, PARTICIPATE IN A COMPANY INCENTIVE COMPENSATION PLAN. THIS PLAN CONTAINS EIGHT METRICS WHICH REPRESENT KEY GOALS FOR THE PLAN YEAR. AN OVERALL WEIGHTED SCORE IS CALCULATED. A BONUS WILL BE PAID IF THE COMPANY MEETS A RANGE OF GOAL ACCOMPLISHMENTS FOR THE YEAR. THE AMOUNT OF THE BONUS IS BASED ON THE TOTAL SCORE. ONE OF THESE METRICS IS PROFITABILITY, WHICH IS DEFINED AS "TOTAL NET GAIN IN DOLLARS PRIOR TO ORAL HEALTH CONTRIBUTIONS FOR THE FISCAL YEAR PER AUDITED FINANCIAL RESULTS."

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
JOHN KEARNS DDS
DIRECTOR	226167	INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES	0
ANNE HENNESSEY DDS
DIRECTOR	147297	INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES	0
WILLIAM WEVER DDS
DIRECTOR	113650	INDEPENDENT CONTRACTOR - PAYMENTS FROM DDIA FOR DENTAL SERVICES	0
MERRITT KRAUSE
DDIA DIRECTOR & OFFICER OF EMPLOYER WHO PURCHASES DENTAL BENEFITS FROM DDIA	278468	PAYMENTS TO DDIA FOR ADMINISTRATIVE SERVICES	0
CHARLES EDWARD BROWN
DDIA DIRECTOR & OFFICER OF EMPLOYER WHO PURCHASES DENTAL BENEFITS FROM DDIA	199971	PAYMENTS TO DDIA FOR ADMINISTRATIVE SERVICES	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2	TWO DIRECTORS HAVE A BUSINESS RELATIONSHIP. JEFF PLAGGE IS PRESIDENT OF A COMPANY THAT PURCHASES BENEFITS FROM A BROKER COMPANY IN WHICH MERRITT KRAUSE SERVES AS PRESIDENT. MR. PLAGGE MAKES DECISIONS REGARDING BENEFIT PURCHASES.
FORM 990, PART VI, SECTION A, LINE 6	THE MEMBERS OF THE CORPORATION CONSIST OF THE PROVIDERS (PARTICIPATING DENTISTS), AND SUBSCRIBER DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7A	DECISIONS OF THE GOVERNING BODY ARE NOT SUBJECT TO APPROVAL BY THE MEMBERSHIP WITH THE EXCEPTION OF CHANGES TO THE ARTICLES OF INCORPORATION. THOSE CHANGES MUST BE APPROVED BY THE MEMBERSHIP.
FORM 990, PART VI, SECTION B, LINE 11	THE FORM 990 AND ALL RELATED SCHEDULES WERE REVIEWED BY BOTH THE MANAGEMENT OF THE COMPANY AND THE BOARD OF DIRECTORS PRIOR TO FILING. THE FORM 990 WAS REVIEWED BY MANAGEMENT OF THE COMPANY PRIOR TO PRESENTATION TO THE BOARD. THE MEMBERS OF THE MANAGEMENT TEAM WHO REVIEWED THE FORM 990 WERE THE CEO, COO, COMPLIANCE MANAGER, AND CONTROLLER. AN ELECTRONIC COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO THE BOARD MEETING HELD ON SEPTEMBER 20, 2012. ALL MEMBERS OF THE BOARD REVIEWED THE FORM 990 AND RELATED SCHEDULES PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C	THE COMPLIANCE MANAGER, ON BEHALF OF THE GOVERNANCE COMMITTEE, CONDUCTS AN ANNUAL CONFLICT OF INTEREST REVIEW FOR COMPLIANCE WITH FEDERAL AND STATE LAW. THE REVIEW INCLUDES ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES. COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES AND DISCLOSURES ARE COMPARED TO THE GROUP FOR POTENTIALLY CONFLICTING TRANSACTIONS, BUSINESS AND FAMILY RELATIONSHIPS, AND AFFILIATIONS. ANNUAL COMPENSATION, REIMBURSEMENTS, BENEFIT PAYMENTS, AND OTHER TRANSACTIONS ARE REVIEWED FOR APPROPRIATENESS. A WRITTEN REPORT OF THE FINDINGS IS PRESENTED TO THE GOVERNANACE COMMITTEE, BOARD OF DIRECTORS AND SENIOR MANAGEMENT. SOLUTIONS TO POTENTIAL CONFLICTS ARE DISCUSSED AND DOCUMENTED IN THE BOARD OF DIRECTOR'S MEETING MINUTES.
FORM 990, PART VI, SECTION B, LINE 15	ON A BI-ANNUAL BASIS, DELTA DENTAL OF IOWA DOES A MARKET PRICE AND BENCHMARKING COMPARISON OF THE COMPENSATION OF THE LEADERSHIP TEAM AND THE STAFF. THIS ANALYSIS IS PERFORMED BY AN INDEPENDENT THIRD PARTY. THIS ANALYSIS INCLUDES THE USE OF DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THE DOCUMENTED RESULTS AND RECOMMENDATIONS OF THIS ANALYSIS ARE PRESENTED TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS REVIEWS THE DOCUMENTATION AND APPROVES THE COMPENSATION. THESE DECISIONS ARE DOCUMENTED IN THE MINUTES OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19	DELTA DENTAL OF IOWA'S ARTICLES OF INCORPORATION BECOME A MATTER OF PUBLIC RECORD WHEN THEY ARE FILED WITH THE IOWA SECRETARY OF STATE. THE FINANCIAL STATEMENTS BECOME A MATTER OF PUBLIC RECORD WHEN THEY ARE FILED WITH THE IOWA INSURANCE DIVISION. BOTH AGENCIES HAVE ONLINE PUBLIC VIEWING ACCESS. THE CONFLICT OF INTEREST POLICY IS NOT FILED WITH THE STATE AGENCIES; HOWEVER, IT WOULD BE MADE AVAILABLE UPON REQUEST. ALL GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE FROM THE ORGANIZATION UPON REQUEST.
FORM 990, PART XI, LINE 5:	NET UNREALIZED GAINS ON INVESTMENTS: 482,327.	CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 2C:	THE ORGANIZATION HAS A FINANCE AND AUDIT COMMITTEE THAT HAS RESPONSIBILITY FOR SELECTION OF THE INDEPENDENT ACCOUNTANT AND OVERSIGHT OF THE AUDIT. THE BOARD OF DIRECTORS APPROVES THE ANNUAL APPOINTMENT OF THE INDEPENDENT ACCOUNTANT.
FORM 990, PART IV, LINE 35B:	THIS QUESTION IS ANSWERED AS "NO" BECAUSE THE ORGANIZATION DID NOT RECEIVE ANY OF THE "SPECIFIED PAYMENTS" AS OUTLINED IN IRC SEC 512(B)(13).
SCHEDULE R, PART II, COLUMN B:	DELTA DENTAL OF IOWA'S VISION IS TO IMPROVE THE ORAL HEALTH OF THOSE WE SERVE. AN AMOUNT IS SET ASIDE EACH YEAR TO FUND THIS MISSION. THE AMOUNT IS DETERMINED BY THE PERFORMANCE AND FINANCIAL STRENGTH OF THE COMPANY. AFTER THE AUDITED FINANCIALS ARE COMPLETE, THE AMOUNT IS PAID TO THE DELTA DENTAL OF IOWA FOUNDATION. THE DELTA DENTAL OF IOWA FOUNDATION IS A SEC. 501(C)(3) ORGANIZATION AND IS A TYPE 1 SUPPORTING ORGANIZATION UNDER SEC. 509(A)(3). IT IS THE RESPONSIBILITY OF THE FOUNDATION TO DISTRIBUTE THE MONIES CONSISTENT WITH IT'S MISSION AND FOUNDING DOCUMENTS. THE MISSION OF THE DELTA DENTAL OF IOWA FOUNDATION IS TO SUPPORT AND IMPROVE THE ORAL HEALTH OF IOWANS. THE FOUNDATION WILL PROVIDE FUNDS TO OTHER SEC. 501(C)(3) ORGANIZATIONS, GOVERNMENTS, OR ACADEMIC INSTITUTIONS THAT ARE UNDERTAKING PROJECTS THAT SUPPORT AND IMPROVE THE ORAL HEALTH OF IOWANS. THE FOUNDATION WILL PROVIDE FUNDS TO OTHER TAX-EXEMPT ORGANIZATIONS THROUGH THEIR GRANTS PROGRAM THAT ALIGN WITH THE PROJECTS OF ACCESS TO CARE, RESEARCH, EDUCATION AND PREVENTION. THE AMOUNT CONTRIBUTED TO THE FOUNDATION IN 2011 WAS $1,503,467. ADDITIONALLY, DELTA DENTAL OF IOWA PROVIDES MANAGEMENT SERVICES FOR THE FOUNDATION. THIS INCLUDES DUTIES PERFORMED BY THE CHIEF EXECUTIVE OFFICER AND CHIEF OPERATING OFFICER. THE EXECUTIVE DIRECTOR OF THE FOUNDATION IS THE DIRECTOR OF GOVERNMENT AND COMMUNITY RELATIONS FOR DELTA DENTAL OF IOWA. ALSO, DELTA DENTAL OF IOWA PROVIDES SOME ACOUNTING FUNCTIONS. THE FOUNDATION REIMBURSES DELTA DENTAL OF IOWA FOR ALL STAFF CHARGES RELATED TO THE FOUNDATION. THE AMOUNT REIMBURSED TO DELTA DENTAL OF IOWA IN 2011 WAS $87,132 FOR MANAGEMENT FEES AND $37,305 FOR OTHER EXPENSES.	PRIMARY ACTIVITY OF DELTA DENTAL PLAN OF IOWA FOUNDATION:
SCHEDULE R, PART IV, COLUMN B:	VERATRUS BENEFIT SOLUTIONS, INC. (VERATRUS) IS A FOR-PROFIT CORPORATION AND A WHOLLY-OWNED SUBSIDIARY OF DELTA DENTAL OF IOWA. VERATRUS WAS ORGANIZED TO DISTRIBUTE THE DELTA VISION PRODUCT. DELTA DENTAL OF IOWA INVESTED $125,000 IN PAID-IN CAPITAL IN VERATRUS DURING 2011. DELTA DENTAL OF IOWA COLLECTS PREMIUMS FROM GROUPS FOR VISION COVERAGE AND TRANSFERS THIS PREMIUM TO VERATRUS. IN 2011, DELTA DENTAL OF IOWA TRANSFERRED $480,986 TO VERATRUS FOR PREMIUMS COLLECTED ON THEIR BEHALF. IN ADDITION, DELTA DENTAL OF IOWA PROVIDES MANAGEMENT SERVICES TO VERATRUS. VERATRUS REIMBURSES DELTA DENTAL OF IOWA FOR ALL STAFF CHARGES RELATED TO VERATRUS. THE AMOUNT REIMBURSED TO DELTA DENTAL OF IOWA IN 2011 WAS $101,066 FOR MANAGEMENT FEES AND $48,227 FOR OTHER EXPENSES. DELTA DENTAL OF IOWA ALSO PURCHASES VISION BENEFITS FROM VERATRUS FOR DDIA EMPLOYEES. THE AMOUNT PAID TO VERATRUS IN 2011 FOR VISION BENEFITS FOR DDIA EMPLOYEES WAS $10,608.	PRIMARY ACTIVITY OF VERATRUS BENEFIT SOLUTIONS, INC.:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	DELTA DENTAL OF IOWA FOUNDATION	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	9000 NORTHPARK DRIVE	AddressLine1
City	JOHNSTON	City
State	IA	State
ZIP Code	50131	ZIPCode

Field	Value	IRS element (for citing)
EIN	260762771	EIN
Primary Activities	CHARITABLE ORGANIZATION TO SUPPORT AND IMPROVE THE ORAL HEALTH OF IOWANS.	PrimaryActivities
Legal Domicile State	IA	LegalDomicileState
Exempt Code Section	501(C)(3)	ExemptCodeSection
Public Charity Status	LINE 11A, I	PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	DELTA DENTAL OF IOWA	BusinessNameLine1

Field	Value	IRS element (for citing)
Controlled Org	1	ControlledOrg

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	VERATRUS BENEFIT SOLUTIONS INC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	9000 NORTHPARK DRIVE	AddressLine1
City	JOHNSTON	City
State	IA	State
ZIP Code	50131	ZIPCode

Field	Value	IRS element (for citing)
EIN	271584394	EIN
Primary Activity	FOR-PROFIT CORPORATION ORGANIZED TO DISTRIBUTE THE DELTA VISION PRODUCT.	PrimaryActivity
Legal Domicile State	IA	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	DENTAL DENTAL OF IOWA	BusinessNameLine1

Field	Value	IRS element (for citing)
Type Of Entity	C	TypeOfEntity
Share Of Total Income	-109200	ShareOfTotalIncome
Share Of EOY Assets	315672	ShareOfEOYAssets
Percentage Ownership	1.00000	PercentageOwnership

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	1	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	0	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	1	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
DELTA DENTAL OF IOWA FOUNDATION
B	1503467	SEE PART VII - SUPPLEMENTAL INFO.
DELTA DENTAL OF IOWA FOUNDATION
N	87132	SEE PART VII - SUPPLEMENTAL INFO.
DELTA DENTAL OF IOWA FOUNDATION
P	37305	SEE PART VII - SUPPLEMENTAL INFO.
DELTA DENTAL OF IOWA FOUNDATION
Q	300000	CASH TRANSFERRED FROM DDIA TO FDN
VERATRUS BENEFIT SOLUTIONS INC
B	125000	SEE PART VII - SUPPLEMENTAL INFO.
VERATRUS BENEFIT SOLUTIONS INC
N	101066	SEE PART VII - SUPPLEMENTAL INFO.
VERATRUS BENEFIT SOLUTIONS INC
Q	480986	SEE PART VII - SUPPLEMENTAL INFO.
VERATRUS BENEFIT SOLUTIONS INC
P	48227	SEE PART VII - SUPPLEMENTAL INFO.
VERATRUS BENEFIT SOLUTIONS INC
L	10608	SEE PART VII - SUPPLEMENTAL INFO.

Form990 Schedule R Part VII Form990ScheduleRPartVII (9 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
METHOD OF DETERMINING AMOUNT INVOLVED -	FORM 990, SCHEDULE R, PART V, LINE 2(8), COLUMN D:	ACTUAL COST OF INVOICES PAID BY DDIA ON BEHALF OF VERATRUS BENEFIT SOLUTIONS, INC.
METHOD OF DETERMINING AMOUNT INVOLVED -	FORM 990, SCHEDULE R, PART V, LINE 2(9), COLUMN D:	VISION PREMIUMS PAID TO VERATRUS BENEFIT SOLUTIONS, INC. FOR DDIA EMPLOYEES.
METHOD OF DETERMINING AMOUNT INVOLVED -	FORM 990, SCHEDULE R, PART V, LINE 2(1), COLUMN D:	PERCENTAGE OF REVENUE BASED ON BOARD APPROVED POLICY
METHOD OF DETERMINING AMOUNT INVOLVED -	FORM 990, SCHEDULE R, PART V, LINE 2(2), COLUMN D:	FEES CHARGED TO DELTA DENTAL OF IOWA FOUNDATION BASED ON HOURS WORKED
METHOD OF DETERMINING AMOUNT INVOLVED -	FORM 990, SCHEDULE R, PART V, LINE 2(3), COLUMN D:	ACTUAL COST OF INVOICES PAID BY DDIA ON BEHALF OF DELTA DENTAL OF IOWA FOUNDATION
METHOD OF DETERMINING AMOUNT INVOLVED -	FORM 990, SCHEDULE R, PART V, LINE 2(4), COLUMN D:	CASH TRANSFERRED FROM DDIA TO DELTA DENTAL OF IOWA FOUNDATION
METHOD OF DETERMINING AMOUNT INVOLVED -	FORM 990, SCHEDULE R, PART V, LINE 2(5), COLUMN D:	CAPITAL CONTRIBUTION TO SUBSIDIARY (VERATRUS BENEFIT SOLUTIONS, INC.)
METHOD OF DETERMINING AMOUNT INVOLVED -	FORM 990, SCHEDULE R, PART V, LINE 2(6), COLUMN D:	MANAGEMENT FEES CHARGED TO VERATRUS BENEFIT SOLUTIONS, INC. BASED ON HOURS WORKED
METHOD OF DETERMINING AMOUNT INVOLVED -	FORM 990, SCHEDULE R, PART V, LINE 2(7), COLUMN D:	VISION PREMIUMS BILLED AND COLLECTED BY DDIA ON BEHALF OF VERATRUS BENEFIT SOLUTIONS, INC. CASH WAS TRANSFERRED FROM DDIA TO VERATRUS FOR THESE PREMIUMS.