2024-11-14T11:06:25-06:00 2023-12-31 420714325 RSM US LLP 4622 PENNSYLVANIA AVE STE 1100 KANSAS CITY MO 64112 990 2023-01-01 237322578 DELTA DENTAL PLAN OF OKLAHOMA DELT 4056072100 PO BOX 54709 OKLAHOMA CITY OK 731541709 ASHLEY ALBRIGHT CFO 4056072100 2024-11-12 1 0 KEVIN ENSMINGER P01310558 8167533000 2024-11-12 2023 2024-10-15 13:58:12Z ASHLEY ALBRIGHT PO BOX 54709 OKLAHOMA CITY OK 731541709 288319709 0 X DELTADENTALOK.ORG X 1973 OK PROVIDE DENTAL BENEFITS 19 10 130 0 0 0 0 0 262762052 278435976 1944916 2802476 165975 141602 264872943 281380054 1007471 8300000 0 0 13532354 15195943 0 0 0 237121206 254257482 251661031 277753425 13211912 3626629 99133405 113210248 16758877 24935179 82374528 88275069 X OUR MISSION IS TO BE OKLAHOMA'S FOREMOST DEVELOPER, MARKETER, AND ADMINISTRATOR OF QUALITY DENTAL BENEFIT PROGRAMS WHICH ASSURE HIGHEST STANDARDS OF SERVICE, STABILITY, EFFICIENCY, FAIRNESS AND PROFESSIONALISM, SUPPORTING AND ENCOURAGING QUALITY DENTAL CARE FOR THE CITIZENS WE SERVE. IN FULFILLING THIS MISSION, WE WILL MAINTAIN FINANCIAL STABILITY THAT ALLOWS FOR THE GROWTH, COMPETITIVENESS AND THE FLEXIBILITY TO RESPOND TO CHANGING CONDITIONS. FINALLY, TO BE MINDFUL OF THE NEEDS OF CONSTITUENCIES WE SERVE-PATIENTS, PURCHASERS AND DENTISTS. 0 0 237737132 278432490 DENTAL BENEFIT PLAN ADMINISTRATION, PROVIDER NETWORK MAINTENANCE, AND CLAIMS PROCESSING FOR EMPLOYER GROUPS AND INDIVIDUAL MEMBERS 8300000 8300000 97270 CONTRIBUTIONS TO THE DELTA DENTAL OF OKLAHOMA FOUNDATION WHICH PROVIDES GRANTS AND SERVICES TO NUMEROUS FREE AND LOW-COST INNER-CITY AND RURAL DENTAL CLINICS TO HELP PROVIDE VITAL CARE TO THOSE LESS FORTUNATE AS WELL AS SUPPORTING ORAL HEALTH EDUCATION IN OKLAHOMA 246037132 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 737 0 1 130 1 0 0 0 0 0 0 1 0 X 19 10 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OK X ASHLEY ALBRIGHT 4056072100 16 NW 63RD ST OKLAHOMA CITY OK 73116 X MICHAEL MCCULLOUGH VICE CHAIRMAN 1.00 1.00 X X 6200 0 0 DR MICHAEL MCLEOD SECRETARY 1.00 1.00 X X 23801 0 0 JOY SWANSON LABAR TREASURER 1.00 1.00 X X 6600 0 0 DR ROSS ALLEN BOARD MEMBER 1.00 1.00 X 68500 0 0 GEAN ATKINSON BOARD MEMBER 1.00 1.00 X 5800 0 0 DR STEVE BERKLACY BOARD MEMBER 1.00 1.00 X 141563 0 0 SANDY P BJORNSON BOARD MEMBER (THRU 5/2023) 1.00 1.00 X 3617 0 0 DR LYMAN COLIN FOSTER BOARD MEMBER 1.00 1.00 X 4600 0 0 DR DEBORAH CORWIN BOARD MEMBER 1.00 1.00 X X 11221 0 0 DAVID GREENWELL BOARD MEMBER 1.00 1.00 X 5600 0 0 BRAD HOGAN BOARD MEMBER 1.00 1.00 X 6200 0 0 DR MICHAEL HOWL BOARD MEMBER 1.00 1.00 X 82232 0 0 DR JEREMY JOHNSON BOARD MEMBER 1.00 1.00 X 70789 0 0 WILLIAM CARLISLE MABREY IV BOARD MEMBER 1.00 1.00 X 7400 0 0 DR TOMMY MAYHUE BOARD MEMBER 1.00 1.00 X 6600 0 0 MIKE MEANS BOARD MEMBER 1.00 1.00 X 6200 0 0 DR ANDREW MINNIGH BOARD MEMBER 1.00 1.00 X 121727 0 0 DANNY RAMSEY BOARD MEMBER 1.00 1.00 X 10170 0 0 KATHY SNYDER BOARD MEMBER 1.00 1.00 X 6600 0 0 JOHN GLADDEN PRESIDENT AND CEO AND BOARD CHAIR 40.00 1.00 X X 1130461 0 64124 TANIA FOSS CHIEF OPERATING & PRIVACY OFFICER 40.00 1.00 X 357101 0 114667 DAVID JONES CHIEF INFORMATION & SECURITY OFFICER 40.00 1.00 X 316302 0 107987 LAN MILLER CHIEF SALES OFFICER 40.00 1.00 X 264983 0 95808 ASHLEY ALBRIGHT CHIEF FINANCIAL OFFICER 40.00 1.00 X 340825 0 111281 SAMUEL DECH VICE PRESIDENT OF IT 40.00 0.00 X 177105 0 68834 MARTHA TUMELSON DIRECTOR OF HUMAN RESOURCES 40.00 0.00 X 172570 0 38210 JOE RODANO VP OF FINANCE 40.00 0.00 X 179879 0 51918 PAUL BRAY DIRECTOR, CLAIMS SYSTEM ARCHITECTURE & DEVELOPMENT 40.00 0.00 X 157687 0 52818 JAMES WILLIAMS DIRECTOR OF APPLICATIONS DEVELOPMENT 40.00 0.00 X 153848 0 42932 AMANDA BRAY DIRECTOR OF CORPORATE COMMUNICATIONS 40.00 0.00 X 130911 0 46754 CRYS VAN DUSEN MANAGER, SOFTWARE ENGINEERING 40.00 0.00 X 133996 0 31689 CASSANDRA DAVIS DIRECTOR OF FINANCE 40.00 1.00 X 130205 0 28040 4241293 0 855062 22 0 1 0 M INFORMATION TECHNOLOGY GROUP LLC 3232 W BRITTON RD STE 170 OKLAHOMA CITY OK 73120 SOFTWARE MAINTENANCE SERVICES 1503013 WINSTON & STRAWN LLP 35 W WACKER DR CHICAGO IL 60601 LEGAL SERVICES 1043697 PEAK MEDIA LLC 6016 NW 154TH ST EDMOND OK 73013 ADVERTISING SERVICES 785745 RED CARD SYSTEMS LLC PO BOX 874488 KANSAS CITY MO 64187 PRINTING AND MAILING SERVICES 676410 USA TODAY PO BOX 120687 DALLAS TX 75312 PRINTING AND MAILING SERVICES 490972 9 DENTAL BENEFIT COVERAG 900099 278344590 278344590 PATIENT DIRECT MEMBER 900099 91386 91386 278435976 2738639 2738639 557354 509536 47818 47818 47818 6493956 6430119 63837 63837 63837 OTHER INCOME 900099 58733 58733 DELTA U 900099 27859 27859 DELTA USA 900099 7192 7192 93784 281380054 278529760 0 2850294 8300000 8300000 4187476 471769 3715707 7022975 355733 6667242 1407388 1407388 1809006 220066 1588940 769098 58799 710299 1234416 1234416 122030 122030 36100 36100 150137 150137 9836215 57046 9779169 1668362 1668362 1392372 360476 1031896 1846014 531021 1314993 227826 227826 183925 720 183205 337138 337138 728534 160000 568534 222933 222933 NET SUBSCRIBER CLAIMS 235431687 235431687 MEMBERSHIP DUES 392540 392540 OFFICE FACILITY 277577 277577 DELTA USA CHARGES 88554 88554 81122 1261 79861 277753425 246037132 31716293 0 11255890 10376609 11614681 12247032 958694 1682010 18423993 8917172 9784567 9506821 63545832 77647925 1760000 1600000 213741 149851 99133405 113210248 9752347 12319906 170000 5382750 4124336 4030718 2712194 3201805 16758877 24935179 X 82374528 88275069 82374528 88275069 99133405 113210248 3626629 2273912 0 X 0 1 X 1 0 1733869 1733869 5772224 5227144 4552822 6446546 5690756 4364350 1326406 9506821 RESERVE & DEPOSITS 475270 SUPPLEMENTAL RETIREMENT PLAN 2601684 RIGHT OF USE LIABILITY 124851 3201805 X PART X, LINE 2: WITH THE EXCEPTION OF DELTA DENTAL PRACTICE SUPPORT (DPS), DELTA DENTAL PLAN OF OKLAHOMA (THE PLAN) IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE AND SECTION 501(C)(3) FOR THE RELATED FOUNDATION, AND ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. NET INCOME GENERATED BY DPS WILL BE TAXABLE WHEN IT OCCURS. SINCE INCEPTION, DPS'S OPERATIONS HAVE BEEN MINIMAL AND NO TAX IS REFLECTED IN THE ACCOMPANYING FINANCIAL STATEMENTS. MANAGEMENT HAS EVALUATED THE PLAN'S TAX POSITIONS AND CONCLUDED THAT THE PLAN HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE CONSOLIDATED FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. 1 DELTA DENTAL OF OKLAHOMA FOUNDATION PO BOX 54709 OKLAHOMA CITY OK 73154 274417052 501(C)(3) 8300000 0 GENERAL SUPPORT 1 0 PART I, LINE 2: THE ORGANIZATION MONITORS TO ENSURE THAT THE CHARITABLE PURPOSES ARE SATISFIED AND REQUIRES SUPPORTING DOCUMENTATION FROM THE RECIPIENT ORGANIZATION TO CONFIRM USE. X X 0 1 0 0 0 0 0 0 0 JOHN GLADDEN PRESIDENT AND CEO AND BOARD CHAIR 740325 0 107527 0 282609 0 41250 0 22874 0 1194585 0 0 0 TANIA FOSS CHIEF OPERATING & PRIVACY OFFICER 291045 0 43815 0 22241 0 82878 0 31789 0 471768 0 0 0 ASHLEY ALBRIGHT CHIEF FINANCIAL OFFICER 294402 0 41831 0 4592 0 80302 0 30979 0 452106 0 0 0 DAVID JONES CHIEF INFORMATION & SECURITY OFFICER 269692 0 39955 0 6655 0 78308 0 29679 0 424289 0 0 0 LAN MILLER CHIEF SALES OFFICER 216089 0 31877 0 17017 0 64972 0 30836 0 360791 0 0 0 SAMUEL DECH VICE PRESIDENT OF IT 156103 0 18561 0 2441 0 40213 0 28621 0 245939 0 0 0 JOE RODANO VP OF FINANCE 158107 0 18337 0 3435 0 29146 0 22772 0 231797 0 0 0 MARTHA TUMELSON DIRECTOR OF HUMAN RESOURCES 153176 0 15140 0 4254 0 22047 0 16163 0 210780 0 0 0 PAUL BRAY DIRECTOR, CLAIMS SYSTEM ARCHITECTURE 139784 0 14325 0 3578 0 21030 0 31788 0 210505 0 0 0 JAMES WILLIAMS DIRECTOR OF APPLICATIONS DEVELOPMENT 137095 0 13449 0 3304 0 19413 0 23519 0 196780 0 0 0 AMANDA BRAY DIRECTOR OF CORPORATE COMMUNICATIONS 116118 0 11668 0 3125 0 17462 0 29292 0 177665 0 0 0 CRYS VAN DUSEN MANAGER, SOFTWARE ENGINEERING 119266 0 11850 0 2880 0 17295 0 14394 0 165685 0 0 0 CASSANDRA DAVIS DIRECTOR OF FINANCE 116092 0 11031 0 3082 0 15731 0 12309 0 158245 0 0 0 PART I, LINE 4B THE ORGANIZATION PROVIDES A SUPPLEMENTAL RETIREMENT PLAN FOR CERTAIN EXECUTIVES. THE FOLLOWING INDIVIDUALS PARTICIPATE IN THE PLAN AND RECEIVED CURRENT YEAR CONTRIBUTIONS AS FOLLOWS: JOHN GLADDEN $184,001 (VESTED) TANIA FOSS $42,037 DAVID JONES $37,601 LAN MILLER $30,784 ASHLEY ALBRIGHT $39,227 SAMUEL DECH $17,501 JOE RODANO $16,656 FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING INDIVIDUALS HAVE A BUSINESS RELATIONSHIP BY VIRTUE OF THEIR POSITIONS AS OFFICERS OF DELTA DENTAL OF OKLAHOMA DENTAL PRACTICE SUPPORT: JOHN GLADDEN, TANIA FOSS, AND ASHLEY ALBRIGHT. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE CORPORATION SHALL BE EVERY PARTICIPATING DENTIST AND ANY OTHER PROVIDER OF HEALTH SERVICES THAT HAS BEEN ELECTED TO MEMBERSHIP, IF ANY, WHO ARE UNDER CONTRACT WITH THE CORPORATION. A DIRECTOR SERVING AS A PUBLIC DIRECTOR SHALL BE CONSIDERED A MEMBER OF THE CORPORATION AND, THEREFORE, PERMITTED TO VOTE. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS ARE ELECTED BY THE MEMBERSHIP (OUR PARTICIPATING DENTISTS). EVERY YEAR, ONE-THIRD IS VOTED UPON BY THE MEMBERSHIP EITHER IN PERSON, BY MAIL BALLOT OR BY PROXY AND EACH ARE ELECTED TO A THREE YEAR TERM. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD WILL BE EMAILED A COPY OF THE FORM 990 PRIOR TO FILING THE RETURN FOR DISCUSSION AND COMMENT. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY HAVING MEMBERS ANNUALLY SIGN AN AGREEMENT AND DISCLOSING ANY BUSINESS RELATIONSHIPS WHICH CONFLICT THEIR DUTIES OF DELTA DENTAL PLAN OF OKLAHOMA. SHOULD A CONFLICT ARISE WHEREBY THE MEMBERS FIDUCIARY RESPONSIBILITY TO DELTA DENTAL MAY OR COULD BE, IN ANY MANNER, AFFECTED, THE MEMBER WILL NOTIFY THE REMAINDER OF THE BOARD OF DIRECTORS, STATING THE CONFLICT AND RECUSING THEMSELVES FROM VOTING THEREON. ENFORCEMENT OF STANDARDS SHALL BE TIMELY, CONSISTENT AND EFFECTIVE. POTENTIAL OR SUSPECTED COMPLIANCE ISSUES ARE RESOLVED THROUGH INVESTIGATION, POLICY AND PROCEDURE REVIEW, ATTORNEY CONSULTATION, AND/OR DISCIPLINARY ACTIONS, UP TO AND INCLUDING TERMINATION. FORM 990, PART VI, SECTION B, LINE 15 DDOK HIRED AND RETAINS THE KORN FERRY AS A CONSULTANT. THEY EVALUATE THE JOB DESCRIPTION AND COMPARE IT TO MARKET ANALYSIS DATA TO DETERMINE COMPENSATION LEVELS. THIS ANALYSIS IS PRESENTED TO THE FINANCE AND AUDIT COMMITTEE FOR REVIEW AND APPROVAL FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION LISTS THE GOVERNING DOCUMENTS THROUGH THE DEPARTMENT OF INSURANCE. THE DOCUMENTS ARE ALSO AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A REPORTABLE COMPENSATION PAID TO THE ORGANIZATION'S DIRECTORS REFLECTED ON PART VII, SECTION A INCLUDES COMPENSATION FOR DENTAL SERVICES IN ADDITION TO COMPENSATION FOR SERVICES IN THE CAPACITY AS A DIRECTOR OF THE ORGANIZATION. DELTA DENTAL OF OKLAHOMA FOUNDATION PO BOX 54709 OKLAHOMA CITY OK 73154 274417052 DENTAL HEALTH AND EDUCATION OK 501(C)(3) LINE 12A, I DELTA DENTAL PLAN OF OKLAHOMA 1 DELTA DENTAL PLAN OF OKLAHOMA POLITICAL ACTION COMMITTEE PO BOX 54709 OKLAHOMA CITY OK 73154 815050812 POLITICAL SUPPORT OK 527 DELTA DENTAL PLAN OF OKLAHOMA 1 DELTA DENTAL OF OK DENTAL PRACTICE SUPPORT INC PO BOX 54709 OKLAHOMA CITY OK 73154 461958347 SUPPORT SERVICES OK DELTA DENTAL PLAN OF OKLAHOMA C 1.00000 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 DELTA DENTAL OF OKLAHOMA FOUNDATION B 8300000 FMV