FURP.ORG / PUBLIC DATA EXPLORER

DELTA DENTAL PLAN OF MICHIGAN: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL PLAN OF MICHIGAN (EIN 38-1791480)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-15
IRS object ID
201143199349304669
Schema version
2010v3.4
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

FieldValueIRS element (for citing)
Timestamp2011-11-15T11:53:52-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORANPLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11111 MICHIGAN AVE PO BOX 2500AddressLine1
CityEAST LANSINGCity
StateMIState
ZIP Code488262500ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN381791480EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL PLAN OF MICHIGAN INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlDELTNameControl
Phone5173496000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line14100 OKEMOS ROADAddressLine1
CityOKEMOSCity
StateMIState
ZIP Code48864ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGORAN JURKOVICName
TitleCHIEF FINANCIAL OFFICERTitle
Phone5173496000Phone
Date Signed2011-11-11DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKEVIN E KRAUSE CPAName
Phone5173326200Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTHOMAS J FLESZAR DDS MNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line14100 OKEMOS ROADAddressLine1
CityOKEMOSCity
StateMIState
ZIP Code48864ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1373897296GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.DDPMI.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1957YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionTO BE THE LEADER IN OUR MARKETS, TO DELIVER UNMATCHED QUALITY AND VALUE IN OUR PROGRAMS AND SERVICES, AND TO VIGOROUSLY PROMOTE THE IMPORTANCE OF ORAL HEALTH AS AN ESSENTIAL PART OF OVERALL HEALTH.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees666TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI8046777TotalGrossUBI
Net Unrelated Business Txbl Income-2304170NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year1315435653ProgramServiceRevenuePriorYear
Program Service Revenue CY1296150820ProgramServiceRevenueCY
Investment Income Prior Year2315371InvestmentIncomePriorYear
Investment Income Current Year5334961InvestmentIncomeCurrentYear
Other Revenue Prior Year47701097OtherRevenuePriorYear
Other Revenue Current Year46491584OtherRevenueCurrentYear
Total Revenue Prior Year1365452121TotalRevenuePriorYear
Total Revenue Current Year1347977365TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY637000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year1234102205BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY1174358975BenefitsPaidToMembersCY
Salaries Etc Prior Year82253217SalariesEtcPriorYear
Salaries Etc Current Year63909575SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year70643513OtherExpensePriorYear
Other Expenses Current Year74088171OtherExpensesCurrentYear
Total Expenses Prior Year1386998935TotalExpensesPriorYear
Total Expenses Current Year1312993721TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-21546814RevenuesLessExpensesPriorYear
Revenues Less Expenses CY34983644RevenuesLessExpensesCY
Total Assets BOY352014045TotalAssetsBOY
Total Assets EOY383149845TotalAssetsEOY
Total Liabilities BOY128963341TotalLiabilitiesBOY
Total Liabilities EOY121838194TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY223050704NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY261311651NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO BE THE LEADER IN OUR MARKETS, TO DELIVER UNMATCHED QUALITY AND VALUE IN OUR PROGRAMS AND SERVICES, AND TO VIGOROUSLY PROMOTE THE IMPORTANCE OF ORAL HEALTH AS AN ESSENTIAL PART OF OVERALL HEALTH.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense1256800520Expense
Grants592000Grants
Revenue1288103558Revenue
DescriptionPROMOTING DENTAL CAREDELTA DENTAL PLAN OF MICHIGAN, INC. IS A LEADING GROUP DENTAL BENEFITS PROVIDER IN THE MIDWEST. THE PURPOSE OF THE ORGANIZATION IS TO ADVANCE AND PROMOTE THE IMPROVEMENT OF ORAL HEALTH. THIS IS DONE BY OFFERING INNOVATIVE, COST-EFFECTIVE PRODUCTS THAT MEET THE NEEDS OF CUSTOMERS. THIS WAS DEMONSTRATED IN 2010 BY PAYING OUT OVER $1.1 BILLION AND BY PROVIDING DENTAL BENEFITS FOR THE PUBLIC AND ADVANCING THE SCIENCE OF DENTISTRY. IN ADDITION, OVER 6.8 MILLION CLAIMS WERE PROCESSED FOR OVER 1.7 MILLION SUBSCRIBERS.COST SAVING STRATEGIESDELTA DENTAL BENEFIT PLANS ARE COMMITTED TO SAVING GROUPS AND SUBSCRIBERS MONEY. THE DELTA DIFFERENCE IS AN INTEGRATION OF ACTIVITIES; SUCH AS COST MANAGEMENT POLICIES, FEE REDUCTION AGREEMENTS WITH DENTISTS, AND AN ANTI-FRAUD HOTLINE, PUT TO WORK ENSURING QUALITY, COST-EFFECTIVE DENTAL BENEFIT DELIVERY. IN 2010, THE DELTA DIFFERENCE SAVED GROUPS AND SUBSCRIBERS NEARLY $435 MILLION. IN ADDITION, THE DELTA DIFFERENCE HELPS KEEP OUR TREND BELOW THE NATIONAL INFLATIONARY TREND IN DENTAL BENEFITS.ANOTHER COST SAVING STRATEGY WAS THE ADVENT OF A SECURE WEB SITE ALLOWING DENTAL OFFICES TO SUBMIT AND REVIEW CLAIMS, CHECK ELIGIBILITY AND GET REIMBURSED VIA ELECTRONIC DIRECT DEPOSIT. MANY DENTISTS MAIL CLAIMS INCURRING POSTAGE COSTS UP TO 70 CENTS PER CLAIM. BY USING THE DENTAL OFFICE TOOLKIT, THESE COSTS ARE REDUCED TO ZERO. IN 2010, 72% OF CLAIMS WERE SUBMITTED ELECTRONICALLY. THE ONLINE TOOL REDUCES STAFF TIME FOR CLAIMS PROCESSING AND WILL ULTIMATELY LOWER THE COST OF DOING BUSINESS FOR EVERYONE, INCLUDING CUSTOMERS AND SUBSCRIBERS.QUALITY INITIATIVES AND RESULTSBRINGING QUALITY TO ALL WE DO IS THE QUALITY POLICY FOR DELTA DENTAL PLAN OF MICHIGAN, INC. THE AFFILIATED DELTA DENTAL PLANS OF MICHIGAN, OHIO AND INDIANA HOLD THE PRESTIGIOUS ISO 9001 CERTIFICATION, UNDERSCORING OUR COMMITMENT TO PROVIDING QUALITY PRODUCTS AND SERVICES THAT SURPASS CUSTOMER'S EXPECTATIONS. QUALITY STANDARDS ARE EXTREMELY RIGOROUS AND GUARANTEE THAT DELTA DENTAL HAS DOCUMENTED ITS QUALITY PROCEDURES AND SYSTEMS THROUGHOUT THE COMPANY. THE LONGSTANDING COMMITMENT TO PROVIDING QUALITY TO CUSTOMERS, DENTISTS, SUBSCRIBERS AND OTHER BUSINESS PARTNERS HAS NOW BEEN INTERNATIONALLY RECOGNIZED.IN JULY 2003, OUR CUSTOMER SERVICE CALL CENTER WAS CERTIFIED BY BENCHMARKPORTAL AS A "CERTIFIED CENTER OF EXCELLENCE" OFFERING "WORLD-CLASS" CUSTOMER SERVICE. THIS CERTIFICATION WAS AWARDED FOLLOWING A LENGTHY AND RIGOROUS AUDIT THAT DOCUMENTED THE PERFORMANCE OF OUR CALL CENTER AGAINST THE BEST PRACTICES OF A PEER GROUP OF COMPARABLE CUSTOMER SERVICE CALL CENTERS. THESE CALL CENTERS INCLUDED THOSE OF ALL OUR MAJOR COMMERCIAL COMPETITORS.IN JANUARY 2007, BENCHMARKPORTAL AGAIN RECOGNIZED DELTA DENTAL WITH A CERTIFICATE OF EXCELLENCE. CURRENT RESULTS REVEALED THAT DELTA DENTAL'S PERFORMANCE OUTRANKED ALL OTHER CORPORATIONS IN THE DENTAL INDUSTRY AND RANKED SECOND COMPARED TO THE BENCHMARKED HEALTH CARE INDUSTRY.QUALITY SERVICE IS ALSO MEASURED THROUGH INTERNAL AUDITS. RESULTS INDICATE OVER 91 PERCENT OF CLAIMS ARE PROCESSED WITHIN 10 WORKING DAYS, 99 PERCENT OF INQUIRIES ARE RESOLVED ON FIRST CONTACT AND CALLS WERE ANSWERED IN 16 SECONDS. COMMITMENT TO THE COMMUNITYDELTA DENTAL PLAN OF MICHIGAN, INC. BELIEVES ADVANCES IN DENTAL RESEARCH AND ENHANCED EDUCATIONAL OPPORTUNITIES FOR DENTISTS GO A LONG WAY TOWARD IMPROVING ORAL HEALTH. THE COMPANY IS A KEY PLAYER IN GROUNDBREAKING RESEARCH ON TRENDS IN ORAL HEALTH IN THE INSURED POPULATION. THE DELTA DENTAL FUND, THE COMPANY'S PHILANTHROPIC AFFILIATE, ENCOURAGES ADVANCES IN DENTISTRY AND SUPPORTS DENTAL EDUCATION AND RESEARCH. ONLY AN ORGANIZATION OF DELTA DENTAL'S SIZE AND EXPERIENCE IN THE BENEFITS FIELD WOULD HAVE OVER 25 YEARS WORTH OF EXTENSIVE DATA REGARDING DENTAL TREATMENT PATTERNS OVER EXTENDED PERIODS OF TIME. BECAUSE OF ITS COMMITMENT TO ADVANCING THE SCIENCE OF DENTISTRY, EACH YEAR THE COMPANY GRANTS RESEARCHERS AT FIVE DENTAL SCHOOLS IN MICHIGAN, OHIO AND INDIANA ACCESS TO THIS IMPORTANT INFORMATION TO STUDY ORAL HEALTH TRENDS. THE RESULTS OF THEIR STUDIES WILL ADD SIGNIFICANT DATA TO THE BODY OF KNOWLEDGE IN THE FIELD OF DENTISTRY.SINCE IT WAS FORMED IN 1980, THE DELTA DENTAL FUND HAS GRANTED OVER $13 MILLION TOWARD THE ADVANCEMENT OF DENTAL SCIENCE AND IMPROVEMENT OF THE ORAL HEALTH OF THE PUBLIC. DELTA DENTAL FUND REGULARLY PROVIDES FUNDING FOR PROGRAMS THAT HELP AT-RISK POPULATIONS AND INDIVIDUALS WITH SPECIAL NEEDS OBTAIN DENTAL TREATMENT, FOR SCHOLARSHIP AND LEADERSHIP AWARDS TO DENTAL STUDENTS, FOR GRANTS TO PURCHASE LEARNING TOOLS AND OTHER PROGRAMS TO DENTAL SCHOOLS, FOR CONTINUING EDUCATION PROGRAMS FOR THE DENTAL PROFESSION, AND FOR EDUCATIONAL MATERIALS ON THE IMPORTANCE OF ORAL HEALTH AND HAZARDS TO ORAL HEALTH.IN 2010, DELTA DENTAL FUND PROVIDED GRANTS TOTALING NEARLY $1 MILLION FOR DENTAL AND COMMUNITY RELATIONS PROJECTS. AMONG THEM WAS A GRANT TO THE OHIO STATE UNIVERSITY COLLEGE OF DENTISTRY TO SUPPORT THE MOBILE DENTAL CLINIC IT OPERATES TO PROVIDE DENTAL TREATMENT TO THOUSANDS OF CHILDREN IN COLUMBUS, OHIO, WHO LACK ACCESS TO DENTAL CARE.DELTA DENTAL PLAN OF MICHIGAN IS ALSO COMMITTED TO THE COMMUNITY. DELTA DENTAL HAS ALWAYS BEEN KEENLY AWARE OF ITS CIVIC AND SOCIAL RESPONSIBILITY. DELTA DENTAL PLANS ARE PROUD TO SHARE, THROUGH DIRECT FINANCIAL CONTRIBUTIONS, WITH HUNDREDS OF COMMUNITY AGENCIES AND GROUPS. IN ADDITION, EMPLOYEES LOG COUNTLESS HOURS OF THEIR OWN TIME AS VOLUNTEERS. COMMUNITY SUPPORT GENERALLY FALLS UNDER THE BROAD CATEGORIES THAT PROVIDE SUPPORT TO AGENCIES AND INSTITUTIONS SERVING CHILDREN, SENIORS, LOW-INCOME INDIVIDUALS, MINORITIES, AND THE DISABLED AND AT-RISK INDIVIDUALS, TO ORGANIZATIONS THAT PROMOTE EDUCATION, ARTS AND RECREATION AND COMMUNITY DEVELOPMENT, AND TO CHARITABLE PROJECTS OR PROGRAMS RECOMMENDED BY EMPLOYEES, CUSTOMERS, PARTICIPATING DENTISTS AND OTHER KEY GROUPS. THROUGH A PUBLIC-PRIVATE PARTNERSHIP WITH THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH, DELTA DENTAL ADMINISTERS THE HEALTHY KIDS DENTAL AND MICHILD PROGRAMS. HEALTHY KIDS DENTAL IS A DENTAL BENEFITS PROGRAM FOR MEDICAID BENEFICIARIES UNDER AGE 21. IT IS AVAILABLE IN 61 COUNTIES AND COVERS BASIC DENTAL HEALTH BENEFITS SUCH AS X-RAYS, CLEANINGS, CAVITY FILLINGS, ROOT CANALS, TOOTH EXTRACTIONS AND DENTURES. MORE THAN 300,000 MICHIGAN CHILDREN ARE SERVED BY THIS PROGRAM.MICHILD IS AN INSURANCE PROGRAM THAT IS STATE AND FEDERALLY FUNDED WHICH MAKES COMPREHENSIVE HEALTH AND DENTAL COVERAGE AVAILABLE TO UNINSURED LOW AND MIDDLE INCOME CHILDREN UNDER 19 YEARS OF AGE. DELTA DENTAL PLAN OF MICHIGAN HAS APPLIED ITS ADMINISTRATIVE EXPERTISE AND DENTIST NETWORKS TO IMPROVING ORAL HEALTH CARE FOR THIS SEGMENT OF THE POPULATION ALSO.UNEQUALED ACCESS TO DENTISTSTHE BENEFITS OF DELTA DENTAL ARE NOW AVAILABLE BEYOND THIS NATION'S BORDERS. THROUGH A PARTNERSHIP WITH INTERNATIONAL SOS ASSISTANCE, INC., DELTA DENTAL ENROLLEES CAN NOW RECEIVE EXPERT TREATMENT FOR NON-EMERGENCY AND EMERGENCY DENTAL CARE WHEN THEY ARE OUTSIDE OF THE UNITED STATES.FOR FIVE DECADES, DELTA DENTAL HAS HELPED PROMOTE ORAL HEALTH BY DESIGNING AND ADMINISTERING INNOVATIVE, COST-EFFECTIVE DENTAL BENEFIT PROGRAMS. EXPERTS AT PLAN DESIGN, DELTA DENTAL HAS CREATED DENTAL BENEFIT PROGRAMS THAT MEET CUSTOMER COST-OBJECTIVES WHILE HELPING TO IMPROVE AND MAINTAIN ORAL HEALTH.THE PROGRAMS FEATURE LARGE PANELS OF FULL-TIME PARTICIPATING DENTISTS. IN FACT, 3 OUT OF 4 DENTISTS NATIONWIDE PARTICIPATE WITH DELTA DENTAL. THIS KIND OF REACH HAS ENABLED MILLIONS OF PEOPLE TO RECEIVE COST-EFFECTIVE DENTAL CARE.DELTA DENTAL'S GROUP MEMBERS ARE AFFORDED ADDED PROTECTION BECAUSE THEY GUARANTEE THAT PARTICIPATING DENTISTS WILL ACCEPT THEIR PAYMENT FOR COVERED SERVICES AND THAT NO CHARGES, OTHER THAN CO-PAYMENTS AND DEDUCTIBLES WILL BE BILLED. THIS LOWERS CLAIM COSTS FOR CUSTOMERS AND REDUCES OUT-OF-POCKET COSTS FOR SUBSCRIBERS.WITH TWO NETWORKS OF FULL-TIME PARTICIPATING DENTISTS IN ONE INTEGRATED CLAIMS SYSTEM, DELTA DENTAL CAN DELIVER TO CUSTOMERS AND GROUP MEMBERS, THE GREATEST ACCESS AT THE BEST COST.Description
Total Program Service Expense1256800520TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities1PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109648737NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees666NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledMIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1GORAN JURKOVIC CHIEF FINANCIAL OFFICERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5173496000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14100 OKEMOS ROADAddressLine1
CityOKEMOSCity
StateMIState
ZIP Code48864ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (39 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
COLLEEN G VIENNA DDS
DIRECTOR5.00X1685940000
LONNY E ZIETZ DDS MS
DIRECTOR5.00X70002000
BRUCE BAIRD DDS
DIRECTOR5.00X1860000
FATHER JACK H BAKER
DIRECTOR5.00X197005000
LISA DANCSOK
MEMBER AT LARGE5.00X256005000
TODD V ESTER DDS
DIRECTOR5.00X207045000
RORY GAMBLE
DIRECTOR5.00X1690000
JOSEPH C HARRIS DDS
SECRETARY5.00X239765000X
JEFFREY A KELLER
DIRECTOR5.00X140000
TERRI A MILLER CPCU
DIRECTOR5.00X225705000
TIMOTHY E MOFFIT DBA
DIRECTOR5.00X238045000
C RICHARD SEITZ
MEMBER AT LARGE5.00X2210030000
BRUCE R SMITH
TREASURER5.00X2484867500X
LU BATTAGLIERI
VICE CHAIRPERSON5.00X244005000X
TERENCE R COMAR DDS MS
CHAIRPERSON5.00X388665000X
JAMES P HALLAN
IMMEDIATE PAST CHAIRPERSON5.00X5721383500
GORAN JURKOVIC CPA
CHIEF FINANCIAL OFFICER50.003993480211052X
THOMAS FLESZAR DDS MS
CEO50.001545225025794X
JOHN A BREZA DDS
SENIOR EXECUTIVE OFFICER5.002420035000X
JAMES EPILITO
PRESIDENT50.0058383102325X
MICHAEL CLARK
MARKETING PRESIDENT50.003872630111697X
BRENDA LAIRD
V-P INFORMATION TECHNOLOGY50.0010221970430935X
KAREN GREEN
V-P INFORMATICS/QUALITY AS50.00322668041615X
RANDY TASCO
V-P SALES & ACCT MGT50.00376418056765X
EDWARD ZOBECK
EXEC. V-P, HUMAN RESOURCES50.005528210270213X
NANCY HOSTETLER
SR. V-P, CORP & PUBLIC AFF50.00374907056853X
SHERRY CRISP
SR. V-P, OPERATIONS50.00411573094615X
PATRICK CAHILL
EXEC. V-P, INT'L DEVELOPME50.00253154625021189X
JED JACOBSON DDS MS MPH
SR. V-P, PROFESSIONAL SERV50.0016596800219698X
CHARLES FLOYD
EXEC. VICE PRES, UNDERWRIT50.00955103061842X
LAURA L CZELADA
COO50.009131860832349X
RICK KARAS
SR. V-P, LABOR MKT RELATIO50.0016936109475X
TOBY HALL
VICE PRESIDENT- CHIEF ACTUARY50.00206860043263X
JON GROAT
VICE PRESIDENT- GENERAL COUNSEL50.00207522019737X
DANIEL RIENSTRA
SENIOR ACCOUNT EXECUTIVE50.00372832040701X
LORI WHEELRIGHT
SR. ACCT EXECUTIVE50.00264736056864X
MICHAEL BOBAK
SR. ACCT EXECUTIVE50.00203998034365X
TOM MCLELLAN
DIRECTOR OF PROFESSIONAL SERVICES50.00196214055444X
ANTHONY ROBINSON
DIRECTOR, COMMUN & GOVT ACCOUNTS50.00219020036236X
FieldValueIRS element (for citing)
Total Reportable Comp From Org11956157TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs32350TotalReportableCompFrmRltdOrgs
Total Other Compensation2735027TotalOtherCompensation
Number Individuals GT100 K122NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
WALBRIDGE ALDINGER
777 WOODWARD AVE SUITE 300DETROITMI48226GENERAL CONSTRUCTION CONTRACTOR3895590
MESSA
1480 KENDALE BLVDEAST LANSINGMI48826COMMISSIONS2927883
CLOVER CONSULTING
400 E DIVISION STE 6 PMB 163ROCKFORDMI49341IT SERVICES1999468
ADAGE GROUP LLC
3665 OBSERVATORY LNHOLTMI48842ADVERTISING1848810
TEK SYSTEMS
PO BOX 198568ATLANTAGA303848568CONTRACT SERVICES1410090
FieldValueIRS element (for citing)
Number Of Contractors GT100 K29NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
DENTAL CARE REVENUE62410012865700061286570006
E-COMMERCE SOLUTIONS518210843683615335526902799$485
IS EXTERNAL SERVICES52429211439781143978
FieldValueIRS element (for citing)
Total Program Service Revenue1296150820TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4959098TotalRevenueColumn
Exclusion$4,959,098ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities25787264Securities
Other508530Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities25837045Securities
Other82886Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-49781Securities
Other425644Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column375863TotalRevenueColumn
Exclusion$375,863ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
ADMINISTRATIVE REIMBUR90009946105720$46,105,720
MISCELLANEOUS INCOME900099385864$385,864
FieldValueIRS element (for citing)
Total Other Revenue46491584TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1347977365TotalRevenueColumn
Related Or Exempt Function Income1288103558RelatedOrExemptFunctionIncome
Unrelated Business Revenue8046777UnrelatedBusinessRevenue
Exclusion$51,827,030ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total637000Total
Program Services637000ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total1174358975Total
Program Services1174358975ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total10251150Total
Program Services6663247ProgramServices
Management And General3587903ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total41248465Total
Program Services23787261ProgramServices
Management And General17461204ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total322118Total
Program Services150650ProgramServices
Management And General171468ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8897756Total
Program Services5015220ProgramServices
Management And General3882536ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3190086Total
Program Services1888419ProgramServices
Management And General1301667ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2160399Total
Program Services794194ProgramServices
Management And General1366205ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total526055Total
Program Services21769ProgramServices
Management And General504286ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total439141Total
Management And General439141ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total172176Total
Management And General172176ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total13186289Total
Program Services7352809ProgramServices
Management And General5833480ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total845351Total
Program Services244181ProgramServices
Management And General601170ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total10830995Total
Program Services9324441ProgramServices
Management And General1506554ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total7738960Total
Program Services5872089ProgramServices
Management And General1866871ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2417202Total
Program Services1885ProgramServices
Management And General2415317ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total2359450Total
Program Services1645738ProgramServices
Management And General713712ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total479297Total
Program Services171507ProgramServices
Management And General307790ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total50694Total
Management And General50694ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total8640865Total
Program Services4494046ProgramServices
Management And General4146819ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total528360Total
Management And General528360ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
COMMISSIONS91179539117953
RSS EXPENSES833423208334232
PROCESSING FEES27587332758733
EXTERNAL BUSINESS EXPEN1847469176298284487
MEMBERSHIP DUES999760120462879298

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total654790Total
Program Services616959ProgramServices
Management And General37831ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1312993721Total
Program Services1256800520ProgramServices
Management And General56193201ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2047BOY
EOY2044EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY37776217BOY
EOY29801450EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY72642683BOY
EOY90473512EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY-707252BOY
EOY6999680EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis182770186LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec66096326LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY100668842BOY
EOY116673860EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY123477707BOY
EOY119676643EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY16943504BOY
EOY16937944EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1210297BOY
EOY2584712EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY352014045BOY
EOY383149845EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY51531479BOY
EOY39056676EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY77431862BOY
EOY82781518EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY128963341BOY
EOY121838194EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY15744473BOY
EOY15744473EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY5122500BOY
EOY5122500EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY202183731BOY
EOY240444678EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY223050704BOY
EOY261311651EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY352014045BOY
EOY383149845EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses34983644ReconcilationRevenueExpenses
Reconcilation Other Changes3277303ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Political Expenditures5000PoliticalExpenditures
Amt Of Internal Funds Contributed5000AmtOfInternalFundsContributed
Total Exmpt Function Expenditures5000TotalExmptFunctionExpenditures
Form1120 Pol Filed1Form1120PolFiled

Sec527 Pol Orgs Sec527PolOrgs

Name Of527 Organization NameOf527Organization

FieldValueIRS element (for citing)
Business Name Line1BILL SCHUETTE ADMINISTRATIVE ACCOUNTBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15915 EASTMAN AVE STE 100AddressLine1
CityMIDLANDCity
StateMIState
ZIP Code48640ZIPCode
FieldValueIRS element (for citing)
EIN274215506EIN
Amt Pd From Internal Funds5000AmtPdFromInternalFunds

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis5816461OtherCostOrOtherBasis
Book Value5816461BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis93149169OtherCostOrOtherBasis
Depreciation17826278Depreciation
Book Value75322891BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis28524600OtherCostOrOtherBasis
Depreciation18060884Depreciation
Book Value10463716BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis55279956OtherCostOrOtherBasis
Depreciation30209164Depreciation
Book Value25070792BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings116673860TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
IBNR - CLAIM ADJUSTMENT RESERVES$48,146,971
UNEARNED PREMIUMS$29,331,854
FAS 158 FUNDED STATUS$5,302,693
FieldValueIRS element (for citing)
Total Of Amounts82781518TotalOfAmounts
Total Revenue1347977365TotalRevenue
Total Expenses1312993721TotalExpenses
Excess Or Deficit For Year34983644ExcessOrDeficitForYear
Other$3,277,303OtherAmount
Total Adjustments3277303TotalAdjustments
Excess Or Deficit Per FS38260947ExcessOrDeficitPerFS

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE ENTERPRISE ADOPTED NEW ACCOUNTING GUIDANCE RELATED TO ACCOUNTING FOR INCOME TAXES AS OF JANUARY 1, 2009. THE NEW ACCOUNTING STANDARD CLARIFIES THE GUIDANCE FOR THE RECOGNITION AND MEASUREMENT OF INCOME TAX BENEFITS RELATED TO UNCERTAIN TAX POSITIONS. THE ADOPTION OF THE NEW GUIDANCE DID NOT HAVE A MATERIAL IMPACT ON THE CONSOLIDATED AND COMBINED FINANCIAL STATEMENTS. AS OF DECEMBER 31, 2010 AND 2009, THE ENTERPRISE'S UNRECOGNIZED TAX BENEFITS WERE NOT SIGNIFICANT. THERE WERE NO SIGNIFICANT PENALTIES OR INTEREST RECOGNIZED DURING THE YEARS OR ACCRUED AT YEAR END.
PART XI, LINE 8 - OTHER ADJUSTMENTS:LOSS ON EQUITY IN SUBSIDIARIES -351,148. UNREALIZED GAIN ON FIXED INCOME SECURITIES 121,997. UNREALIZED GAIN ON EQUITIES 7,909,692. PENSION RELATED CHANGES -4,403,238.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrant
DELTA DENTAL FUND
PO BOX 30416LANSINGMI489097916382337000501(C)(3)5920000CASHN/ASUPPORT DENTAL EDUCATION AND RESEARCH PROGRAMS
FREEDOM VOTE
PO BOX 2121COLUMBUSOH43216273004397501(C)(4)50000CASHN/ASUPPORT ADMINISTRATIVE FUNCTIONS OF LOCAL LEADERS
ON DUTY FOR MICHIGAN
120 N WASHINGTON SQ 410LANSINGMI48933274111592501(C)(4)50000CASHN/ASUPPORT ADMINISTRATIVE FUNCTIONS OF LOCAL LEADERS
CELEBRATING THE POWER OF MICHIGAN INC
PO BOX 15157LANSINGMI48910273955283501(C)(4)100000CASHN/ASUPPORT ADMINISTRATIVE FUNCTIONS OF LOCAL LEADERS
KASICHTAYLOR NEW DAY COMMITTEE
PO BOX 06590COLUMBUSOH43206273902346501(C)(4)100000CASHN/ASUPPORT ADMINISTRATIVE FUNCTIONS OF LOCAL LEADERS
MICHIGAN ECONOMIC DEVELOPMENT FOUNDATION
PO BOX 13063LANSINGMI489013063382527475501(C)(3)150000CASHN/ASUPPORT ADMINISTRATIVE FUNCTIONS OF LOCAL LEADERS
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations4TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: THE ASSISTED ORGANIZATION IS PART OF A CONTROLLED ORGANIZATION THAT SUPPORTS DELTA DENTAL PLAN OF MICHIGAN'S MISSION.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelXFirstClassOrCharterTravel
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (22 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
GORAN JURKOVIC CPA
202660014768904899901845480265040610400000
THOMAS FLESZAR DDS MS
65960807895000961170-272502851901571019000
JAMES EPILITO
32813002530000270100023250586156000
MICHAEL CLARK
20596401702440110550847090269880498960000
BRENDA LAIRD
2605380203607055805204190240119110145313205191110
KAREN GREEN
15866601264890375130157340258810364283000
RANDY TASCO
18961001535960332120302930264720433183000
EDWARD ZOBECK
266865024186904408702429590272540823034000
NANCY HOSTETLER
18110801505520432470305870262660431760000
SHERRY CRISP
19702301801200344300834580111570506188000
PATRICK CAHILL
2531546250000000211890274343625000
JED JACOBSON DDS MS MPH
246154021987401193652020100801869001879378011418620
CHARLES FLOYD
2167610607818013052404269501914701016945000
LAURA L CZELADA
4027280431763078695082015501219401745535000
RICK KARAS
169361000000094750178836000
TOBY HALL
1523970391160153470184520248110250123000
JON GROAT
15491604372408882093540103830227259000
DANIEL RIENSTRA
5886603034960104700165310241700413533000
LORI WHEELRIGHT
578710198698081670326770241870321600000
MICHAEL BOBAK
588050138157070360161970181680238363000
TOM MCLELLAN
1428850386630146660370330184110251658000
ANTHONY ROBINSON
1251160790910148130109250253110255256000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1AFIRST CLASS TRAVEL AVAILABLE TO KEY EMPLOYEES. THIS AMOUNT WAS TREATED AS NONTAXABLE TO THE KEY EMPLOYEE. TRAVEL FOR COMPANIONS RELATED TO TRAVEL FOR A SPOUSE. THIS AMOUNT WAS TREATED AS TAXABLE TO THE BOARD MEMBER OR EMPLOYEE.
PART I, LINE 4BJED JACOBSON= $1,141,862 BRENDA LAIRD= $519,111 ADDITIONALLY, DELTA DENTAL PLAN OF MICHIGAN, HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). IN ORDER TO BE ELIGIBLE FOR THE SERP, AN EMPLOYEE MUST BE A SENIOR VICE PRESIDENT OR HIGHER. AN OUTSIDE INDEPENDENT ACTUARY CALCULATES THE VALUE ON AN ANNUAL BASIS. ADDITIONALLY, ALL EXECUTIVES ARE ELIGIBLE FOR A 457(F) PLAN. THIS PLAN IS FUNDED SOLELY BY EMPLOYEE CONTRIBUTIONS. THE INDIVIDUALS ARE VESTED UPON FUNDING THE 457(F) PLAN.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
COMAR COMAR PC
TERENCE COMAR, DIRECTOR OF DDPMI, IS AN OWNER IN COMAR & COMAR, PC.164491HEALTH CARE PAYMENTS0
RENAISSANCE ENDODONTICS PLLC
TODD ESTER, DIRECTOR OF DDPMI, IS AN OWNER IN RENAISSANCE ENDODONTICS PLLC381843HEALTH CARE PAYMENTS0
JOSEPH C HARRIS DDS
JOSEPH HARRIS, DIRECTOR OF DDPMI, RECEIVES HEALTH CARE PAYMENTS FROM DDPMI113217HEALTH CARE PAYMENTS0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 6DELTA DENTAL PLAN OF MICHIGAN HAS A SOLE MEMBER, RENAISSANCE HEALTH SERVICE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE MEMBER HAS VOTING RIGHTS AND ELECTS DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BTHE FOLLOWING ITEMS ARE SUBJECT TO APPROVAL BY THE SOLE MEMBER: IF 10% OF THE ASSETS ARE TO BE SPENT/SOLD OR A NEW PRESIDENT IS TO BE APPOINTED.
FORM 990, PART VI, SECTION B, LINE 11THE INFORMATION PRESENTED ON THE FORM 990 IS GATHERED BY THE SENIOR TAX ADMINISTRATOR FOR THE ORGANIZATION. THE CFO REVIEWS THE INFORMATION. ONCE APPROVED THE INFORMATION IS GIVEN TO OUTSIDE TAX PREPARERS WHO PREPARE AND REVIEW THE FORM 990. ONCE COMPLETE AN ELECTRONIC COPY OF THE FORM 990 IS PUT ONTO A WEBSITE FOR THE BOARD TO REVIEW. THIS IS DONE BEFORE THE RETURN IS FILED WITH THE IRS.
THE COMPANY'S VICE PRESIDENT AND GENERAL COUNSEL IS CHARGED WITH REVIEWING AND MONITORING ANY POTENTIAL CONFLICT OF INTEREST TRANSACTIONS. ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO REVIEW AND EXECUTE A CONFLICT OF INTEREST POLICY. THIS POLICY REQUIRES THAT ANY CONFLICTS OF INTEREST BE DISCLOSED ON AN ANNUAL BASIS, OR AT ANY OTHER TIME THAT THE PERSON EXECUTING THE POLICY BECOMES AWARE OF A SITUATION OR TRANSACTION THAT ACTUALLY OR POTENTIALLY CREATES A CONFLICT OF INTEREST. ALL CONFLICT OF INTEREST DISCLOSURE FORMS ARE INITIALLY REVIEWED BY THE VICE PRESIDENT AND GENERAL COUNSEL. IF A PROHIBITED TRANSACTION WERE IDENTIFIED, THE MATTER WOULD BE BROUGHT TO THE CHAIRPERSON OF THE BOARD FOR FURTHER REVIEW AND APPROPRIATE ACTION. IN THE EVENT OF A CONFLICT OF INTEREST INVOLVING A MEMBER OF THE BOARD OF DIRECTORS, SUCH AS A CONFLICT IN WHICH A MEMBER HAD AN INTEREST, THE MEMBER IS REQUIRED TO DISCLOSE THE POTENTIAL CONFLICT AND ABSTAIN FROM ANY VOTE ON THE MATTER. WHETHER FURTHER PRECAUTIONS ARE REQUIRED (E.G., PROHIBITING THE INTERESTED PARTY FROM ENGAGING IN DISCUSSIONS) WOULD DEPEND UPON THE SPECIFIC NATURE AND BACKGROUND OF THE CONFLICT.FORM 990, PART VI, SECTION B, LINE 12C
OUTSIDE COMPENSATION CONSULTANTS ARE USED TO DETERMINE MARKET DATA FOR THE EXECUTIVE POSITIONS AND FOR OTHER OFFICERS AND KEY EMPLOYEES. THE POSITIONS COVERED ARE THE CEO, COO, CAO, CIO, SVP & CFO, AND THE SVP & CSO. THE ORGANIZATION CONTRACTS WITH TOWERS WATSON TO DO A COMPENSATION AND REASONABLENESS ANALYSIS EVERY TWO YEARS. THE FINAL DETERMINATION OF COMPENSATION IS DONE BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, WHICH IS MADE UP OF INDEPENDENT PERSONS, AND IS BASED ON THE COMPARABILITY DATA PROVIDED BY THE COMPENSATION CONSULTANTS. THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARE CONTEMPORANEOUSLY DOCUMENTED IN THE COMMITTEE MINUTES AND APPROVED BY THE BOARD. THE COMPENSATION WAS LAST REVIEWED UNDER THIS PROCESS DURING 2010. THE CONSULTANTS WERE USED IN JANUARY OF 2011.FORM 990, PART VI, SECTION B, LINE 15
THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:LOSS ON EQUITY IN SUBSIDIARIES -351,148. UNREALIZED GAIN ON FIXED INCOME SECURITIES 121,997. UNREALIZED GAIN ON EQUITIES 7,909,692. PENSION RELATED CHANGES -4,403,238. TOTAL TO FORM 990, PART XI, LINE 5: 3,277,303.FORM 990, PART XI, LINE 5:
DELTA DENTAL PLAN OF MICHIGAN IS AUDITED BY AN INDEPENDENT ACCOUNTANT AS PART OF A CONSOLIDATED FINANCIAL STATEMENT ISSUED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. DELTA DENTAL PLAN OF MICHIGAN ALSO RECEIVES AN AUDITED FINANCIAL STATEMENT BY AN INDEPENDENT ACCOUNTANT THAT IS PREPARED ON A STATUTORY BASIS. THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.FORM 990 PART XII LINE 2C AND 2D:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1RENAISSANCE SYSTEMS AND SERVICES LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 30416AddressLine1
CityLANSINGCity
StateMIState
ZIP Code489097916ZIPCode
FieldValueIRS element (for citing)
EIN383638865EIN
Primary ActivitiesE-COMMERCE SOLUTIONS FOR DENTISTSPrimaryActivities
Legal Domicile StateMILegalDomicileState
Total Income8436836TotalIncome
EOY Assets1681349EOYAssets
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
RENAISSANCE HEALTH SERVICE CORPORATION
PO BOX 30416LANSINGMI489097916381675667PROMOTING DENTAL CAREMI501(C)(4)N/AN/A0
DELTA DENTAL PLAN OF OHIO
PO BOX 30416LANSINGMI489097916310685339PROVIDE DENTAL SERVICE PLANSOH501(C)(4)N/AN/A1
DELTA DENTAL PLAN OF INDIANA
PO BOX 30416LANSINGMI489097916351545647PROVIDE DENTAL SERVICE PLANSIN501(C)(4)N/AN/A1
DELTA DENTAL OF TENNESSEE
PO BOX 30416LANSINGMI489097916620812197PROVIDE DENTAL SERVICE PLANSTN501(C)(4)N/A1RENAISSANCE HEALTH SERVICE CORPORATION
DELTA DENTAL FUND
PO BOX 30416LANSINGMI489097916382337000SUPPORT DENTAL EDUCATION AND RESEARCH PROGRAMSMI501(C)(3)11A TYPE IIN/A1
DELTA DENTAL OF NEW MEXICO
PO BOX 30416LANSINGMI489097916850224562PROVIDE DENTAL SERVICE PLANSNM501(C)(4)N/A1RENAISSANCE HEALTH SERVICE CORPORATION
DELTA DENTAL OF KENTUCKY
PO BOX 30416LANSINGMI489097916610659432PROVIDE DENTAL SERVICE PLANSKY501(C)(4)N/A1RENAISSANCE HEALTH SERVICE CORPORATION
DELTA DENTAL OF NORTH CAROLINA
PO BOX 30416LANSINGMI489097916561018068PROVIDE DENTAL SERVICE PLANSNC501(C)(4)N/A1RENAISSANCE HEALTH SERVICE CORPORATION

Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
SUITE 244 PARTNERS LLC
240 VENTURE CIRCLENASHVILLETN37228203643584HOLDS THE LEASE TO SUITE 244 AT LP FIELD (TITANS STADIUM)TNFORE HOLDING CORPORATIONN/A00
LIQUID CORN LLC
240 VENTURE CIRCLENASHVILLETN37228203349680OWNS SUITE 244TNFORE HOLDING CORPORATIONN/A00
PREMIER INSURANCE SERVICES LLC
240 VENTURE CIRCLENASHVILLETN37228113662057INSURANCE BROKERTNFORE HOLDING CORPORATIONN/A00
DENTAL CHOICE PROPERTIES LLC
10100 LINN STATION RD SUITE 700LOUISVILLEKY40223610659432REAL ESTATE HOLDING COMPANYKYDELTA DENTAL OF KENTUCKYN/A00

Form990 Schedule R Part IV Form990ScheduleRPartIV (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
RENAISSANCE HOLDING COMPANY
PO BOX 30381LANSINGMI48909412177193HOLDING COMPANYMIRENAISSNCE HEALTH SERVICE CORPORATIONC
RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA
PO BOX 30416LANSINGMI489097916470397286INSURANCEINRENAISSANCE HOLDING COMPANYC
RENAISSANCE HEALTH INSURANCE COMPANY OF NEW YORK
PO BOX 30416LANSINGMI489097916134098096INSURANCENYRENAISSANCE HOLDING COMPANYC
TML LLC
4100 OKEMOS ROAD PO BOX 30381LANSINGMI489097881262403888CLEARING HOUSEMIRENAISSANCE HOLDING COMPANYC
RENAISSANCE HEALTH NETWORKS
4100 OKEMOS ROAD PO BOX 30381LANSINGMI489097881113774096PPO NETWORKMIRENAISSANCE HOLDING COMPANYC
RENAISSANCE DENTAL NETWORK LLC
4100 OKEMOS ROAD PO BOX 30381LANSINGMI489097881421749772PPO NETWORKMIRENAISSANCE HEALTH NETWORKS LLCC
DENTAL WELLNESS NETWORK LLC
1540 W EDGEWOOD SUITE BINDIANAPOLISIN46217010862825PPO NETWORKMIRENAISSANCE HEALTH NETWORKS LLCC
FORE HOLDING CORPORATION
240 VENTURE CIRCLENASHVILLETN37228204116122EMPLOYEE BENEFITSTNDELTA DENTAL OF TENNESSEEC
DENTAL CHOICE INC
10100 LINN STATION RD SUITE 700LOUISVILLEKY40223611105118REAL ESTATE HOLDING COMPANYKYDELTA DENTAL OF KENTUCKYC
DENTAL CHOICE AGENCY INC
10100 LINN STATION RD SUITE 700LOUISVILLEKY40223611336003PRIMARY GENERAL AGENCY FOR DDKY & DENTAL CHOICEKYDELTA DENTAL OF KENTUCKYC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (11 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
DELTA DENTAL OF TENNESSEE
K3197004ACTUAL COST
DELTA DENTAL PLAN OF OHIO
K19223876ACTUAL COST
DELTA DENTAL PLAN OF INDIANA
K5547932ACTUAL COST
RENAISSANCE HEALTH SERVICE CORPORATION
K125000ACTUAL COST
DELTA DENTAL FUND
K169000ACTUAL COST
RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA
K6059713ACTUAL COST
DELTA DENTAL PLAN OF NEW MEXICO
K967971ACTUAL COST
DELTA DENTAL OF KENTUCKY
K150867ACTUAL COST
RENAISSANCE HEALTH INSURANCE COMPANY OF NEW YORK
K53851ACTUAL COST
DELTA DENTAL OF NORTH CAROLINA
D4050000ACTUAL COST
DELTA DENTAL FUND
B592000ACTUAL COST