2022-11-10T08:09:41-06:00 2021-12-31 341851358 CBIZ MHM LLC 530 HOWELL ROAD SUITE 209 GREENVILLE SC 29615 990 2021-01-01 231667011 DELTA DENTAL OF PENNSYLVANIA DELT 7177668500 ONE DELTA DRIVE MECHANICSBURG PA 17055 ALICIA F WEBER CFO 4159748577 2022-11-09 1 ALICIA WEBER XXX-XX-XXXX KELLIE A LANFORD P00538614 8642412001 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z ALICIA F WEBER 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 875081423 0 X WWW.DELTADENTALINS.COM X 1964 PA TO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS, SERVICE, TECHNOLOGY, AND PROFESSIONAL SUPPORT. 10 8 868 0 0 0 0 0 731004082 853824293 5066869 5224575 1678780 820297 737749731 859869165 2459602 3619520 641467427 743887822 33444562 38659525 0 0 0 43274428 42646447 720646019 828813314 17103712 31055851 340073068 366035375 118444604 108189922 221628464 257845453 TO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS, SERVICE, TECHNOLOGY, AND PROFESSIONAL SUPPORT. 0 0 818084002 859869165 THE ORGANIZATION PROVIDED DENTAL BENEFIT COVERAGE FOR 2,676,802BENEFICIARIES IN 2021 PRIMARILY THROUGH CONTRACTS WITH INDEPENDENTDENTISTS SERVING 1,798 PURCHASING GROUPS. THE ORGANIZATION PAID MORETHAN $743.8 MILLION FOR DENTAL CARE DURING 2021. 3619520 3619520 THE ORGANIZATION MADE GRANTS DURING 2021 TO FOSTER IMPROVED ACCESSTO DENTAL HEALTH CARE TREATMENT, TO SUPPORT PROFESSIONAL DENTALEDUCATION, AND TO PROVIDE ORAL HEALTH INSTRUCTION FOR PATIENTS. 821703522 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 1 92952 0 1 868 1 0 1 BB 0 0 0 0 0 0 X 10 8 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X ALICIA F WEBER CFO 4159748577 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 X CASTRO MICHAEL J PRESIDENT/CEO 4.00 46.00 X 0 5529566 35347 WEBER ALICIA F EVP CHIEF FINANCIAL OFFICER 4.00 46.00 X 0 2217654 58540 CHAVARRIA SARAH EVP/CHIEF PEOPLE OFFICER 4.00 46.00 X 0 2061696 60119 HANKINSON MICHAEL G EVP CHIEF LEGAL OFFICER 4.00 46.00 X 0 2009319 49925 JACKSON KEVIN L EVP/CHIEF GROWTH OFFICER 4.00 46.00 X 0 1933949 66239 GILBERT LEROY R JR EVP/CHIEF OPERATIONS OFFICER 4.00 46.00 X 0 1612264 47914 TITCOMBE DOMINIC EVP/CHIEF INFORMATION OFFICER 4.00 46.00 X 0 1463523 62514 FOSTER JEANNE M VP FINANCE 29.00 21.00 X 636044 0 42180 RODZINKA BARBARA A VP ENT OPER SHARED SERVICES 29.00 21.00 X 619797 0 54360 CEMBROLA MICHAEL VP SALES 29.00 21.00 X 618441 0 50747 GRAYBILL RICHARD C VP UNDERWRITING AND ACTUARIAL 29.00 21.00 X 551440 0 41436 COOVER ROBERT D DIRECTOR SALES 40.00 0.00 X 493172 0 60383 MCKEE TIMOTHY SALES ACCOUNT EXECUTIVE 40.00 0.00 X 423272 0 51954 WEIS JOHN P DIRECTOR INFRASTRUCTURE & OPERATIONS 40.00 0.00 X 338406 0 54667 SIMPKINS JASON E DIRECTOR UNDERWRITING 40.00 0.00 X 282982 0 49020 MOORMAN ROGER W SALES ACCOUNT EXECUTIVE 40.00 0.00 X 270768 0 49426 CLARKE JAMIE VICE PRESIDENT NETWORK DEVELOPMENT 29.00 21.00 X 208824 0 22206 BERGERT GLEN F CPA DIRECTOR 2.00 5.00 X 30600 156200 0 MACGILVRAY JENNIFER VICE PRESIDENT CLAIMS PROCESSING 29.00 21.00 X 173753 0 12866 DAVIS CHRISTOPHER T VP SALES 29.00 21.00 X 120808 0 21587 MAHER DEBRA G CHAIR 2.00 2.00 X 42400 16200 0 BECK JR JOSEPH P DIRECTOR 2.00 0.00 X 27000 0 0 CARTER JR EUGENE F DIRECTOR 2.00 0.00 X 27000 0 0 WENGER PHILIP R VICE CHAIR 2.00 2.00 X 27000 16200 0 BRUNO MICHELLE A DIRECTOR 1.00 0.00 X 17400 0 0 SNYDER FRANK DIRECTOR 1.00 0.00 X 17400 0 0 VEIHDEFFER L WILLIAM DMD DIRECTOR 1.00 0.00 X 17400 0 0 KOTCHICK CHRISTOPHER J DIRECTOR 1.00 0.00 X 0 0 0 LITTLE SCOTT Q DDS DIRECTOR 1.00 0.00 X 0 0 0 4943907 17016571 891430 117 0 1 0 ELEVATED RESOURCES 3990 WESTERLY PL STE 270 NEWPORT BEACH CA 92603 TEMP SERVICES 697365 ARMANINO MCKENNA LLP PO BOX 398285 SAN FRANSISCO CA 94139 AUDIT SERVICES 296950 MCCLURE COMPANY PO BOX 1579 HARRISBURG PA 17105 BUILDING MAINTENANCE 237769 EXECUTIVE MANAGEMENT SERVICES INC PO BOX 501818 INDIANAPOLIS IN 46250 CLEANING SERVICES 208452 SECURITAS SECURITY SERVICES USA INC PO BOX 403412 ATLANTA GA 30384 SECURITY SERVICES 190835 11 DIRECT PREMIUMS 524114 853824293 853824293 853824293 4708980 4708980 15727853 15212258 515595 515595 515595 GAIN FROM SUBSIDIARY 524114 1656902 1656902 MISC EXPENSES 524114 -227248 -227248 BAD DEBT EXPENSE 524114 -609357 -609357 820297 859869165 859869165 0 0 3619520 3619520 743887822 743887822 3135307 2912907 222400 25945287 23212380 2732907 2325290 2105082 220208 5552119 5026326 525793 1701522 1540386 161136 110238 110238 381524 381524 144489 144489 384993 348534 36459 2802298 2536917 265381 839226 759750 79476 1431430 1431430 1421425 1286814 134611 283852 256971 26881 31226 28269 2957 16213 16213 601802 544810 56992 769967 697050 72917 COST TRANSFERS 16109238 14583673 1525565 COMMISSIONS 12990614 12990614 OUTSIDE SERVICES 1929110 1746421 182689 ADMINISTRATIVE EXPENSE 1294345 1171769 122576 1104457 999864 104593 828813314 821703522 7109792 0 79129894 74231952 308803 4011291 61472684 60164399 5000000 1300501 1447934 21564894 13109073 8097770 8455821 145443178 181043380 44320238 31680598 340073068 366035375 70112698 74154217 5075085 6087008 43256821 27948697 118444604 108189922 X 0 0 0 0 221628464 257845453 221628464 257845453 340073068 366035375 31055851 5161138 0 X 0 1 X 1 0 1484639 1484639 10195707 5423596 4772111 2928575 2588788 339787 6259020 4537039 1721981 696953 559650 137303 8455821 DELTA DENTAL INSURANCE COMPANY 4885 C SECURITIES 31675713 F 31680598 PAYABLES TO AFFILIATES 7424152 PREFUNDED DEPOSITS 1862613 REFUNDABLE BALANCES 18661932 27948697 X 314468965 5161138 5161138 309307827 144489 550416849 550561338 859869165 278251976 0 278251976 144489 550416849 550561338 828813314 PART X, LINE 2: THE COMPANY IS A TAX-EXEMPT ORGANIZATION ORGANIZED UNDER SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE AND, AS SUCH, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE FINANCIAL STATEMENTS. CURRENT ACCOUNTING GUIDANCE CLARIFIES HOW UNCERTAINTIES IN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE PRESCRIBES A FINANCIAL STATEMENT RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. POSITIONS INCLUDE THOSE WITH RESPECT TO THE COMPANY'S TAX EXEMPT STATUS AND WITH RESPECT TO INCOME TAXES ON UNRELATED BUSINESS INCOME. THE COMPANY HAS DETERMINED THAT SUCH TAX POSITIONS DO NOT RESULT IN UNCERTAINTIES REQUIRING RECOGNITION. PART XI, LINE 4B - OTHER ADJUSTMENTS: ADMINISTRATIVE SERVICE CONTRACTS CLAIM REIMBURSEMENT REVENUE PART XII, LINE 4B - OTHER ADJUSTMENTS: CLAIMS ACCRUED FOR ADMINISTRATIVE SERVICE CONTRACTS PART X, LINE 1, (4) REFUNDABLE BALANCES: ON MARCH 11, 2020, THE WORLD HEALTH ORGANIZATION DECLARED A NOVEL STRAIN OF CORONAVIRUS (COVID-19) AS A GLOBAL PANDEMIC. THE COVID-19 OUTBREAK HAS CAUSED BUSINESS DISRUPTION THROUGH MANDATED AND VOLUNTARY CLOSINGS OF BUSINESSES AND SHELTER IN PLACE ORDERS. THESE DISRUPTIONS IMPACTED THE ORGANIZATION'S CUSTOMERS' ABILITY TO OBTAIN DENTAL SERVICES. THE ORGANIZATION HAS TAKEN A POSITION AND COMMITTED TO ITS CUSTOMERS, PROVIDERS, AND REGULATORS TO NOT EXCESSIVELY PROFIT FROM THE PANDEMIC. TO THIS END, IN 2020, THE ORGANIZATION ESTABLISHED ESTIMATED RESERVES REPRESENTING EXCESS UNDERWRITING GAINS IN THE AMOUNT OF $32.2 MILLION. DURING 2021, RESERVE AMOUNTS WERE USED TO SUPPORT CUSTOMERS THROUGH ONGOING PAYMENT RELIEF AND OTHER PROGRAMS RESULTING IN A REMAINING BALANCE OF $17.6 MILLION AT DECEMBER 31, 2021. IN ADDITION, CERTAIN CONTRACTS PROVIDE THAT PREMIUMS RECEIVED IN EXCESS OF CLAIMS INCURRED AND ADMINISTRATIVE FEES ARE EITHER REFUNDABLE TO THE GROUPS AT THE EXPIRATION OF THE AGREEMENTS OR APPLIED AGAINST FUTURE PREMIUN PAYMENTS. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENT IN DELTA REINSURANCE CORPORATION 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 PART III ACCOUNTING METHOD: PART I, LINE 3, COLUMN (F): THE COMPANY HAD AN INVESTMENT IN DELTA REINSURANCE COMPANY (DRC) THROUGH OCTOBER 2021. DRC WAS DISSOLVED EFFECTIVE NOVEMBER 1, 2021 AND THE ORGANIZATION REALIZED A GAIN OF $15,108,701 AS A RESULT OF THE DISSOLUTION. THE ORGANIZATION'S INVESTMENT IN DRC AT YEAR END IS ZERO. 1 DELTA DENTAL COMMUNITY CARE FOUNDATION 560 MISSION STREET ST 1300 SAN FRANCISCO CA 94105 371570764 501(C)(3) 3500000 0 TO PROVIDE DENTAL EDUCATION AMERICAN ONLINE GIVING FOUNDATION PO BOX 1010 SAFETY HARBOR FL 34695 810739440 501(C)(3) 48485 0 TO PROVIDE DENTAL EDUCATION BETHESDA MISSION WOMEN'S SHELTER 611 REILY ST HARRISBURG PA 17102 231389397 501(C)(3) 15000 0 TO PROVIDE DENTAL EDUCATION COOL CARS FOR KIDS INC 424 BRENTWOOD RD BALA CYNWYD PA 19004 813917740 501(C)(3) 15000 0 TO PROVIDE DENTAL EDUCATION SNEAKERS FOR SOLDIERS PO BOX 454 CHESTER SPRINGS PA 19425 832554857 501(C)(3) 15000 0 TO PROVIDE DENTAL EDUCATION PEYTON WALKER FOUNDATION 2929 GETTYSBURG RD CAMP HILL PA 17011 464655102 501(C)(3) 15000 0 TO PROVIDE DENTAL EDUCATION THE FOUNDATION FOR ENHANCING COMMUNITIES 200 N 3RD ST 8TH FL HARRISBURG PA 17101 475091216 501(C)(3) 13000 0 TO PROVIDE DENTAL EDUCATION 7 0 PART I, LINE 2: THE ORGANIZATION AWARDS GRANTS AND PROVIDES OTHER ASSISTANCE THROUGH CONTRIBUTIONS AND/OR SPONSORSHIPS FOR PROGRAMS THAT FOSTER DENTAL HEALTH AND EDUCATION, AS WELL AS COMMUNITY SUPPORT. THROUGH THESE GRANTS, CONTRIBUTIONS AND SPONSORSHIPS, THE ORGANIZATION HELPS FINANCE HEALTH, EDUCATION, AND RESEARCH PROJECTS IN DENTISTRY, HEALTH AND HUMAN SERVICES, AND CIVIC AND/OR COMMUNITY ACTIVITIES. INDIVIDUAL GRANTS, CONTRIBUTIONS AND/OR SPONSORSHIPS WILL GENERALLY NOT EXCEED $100,000 WITH EXCEPTION OF THE CONTRIBUTION MADE TO THE DELTA DENTAL COMMUNITY CARE FOUNDATION. GRANTS WILL BE LIMITED TO ONE-YEAR PROJECTS, SUBJECT TO RENEWAL. EXCEPT IN SPECIAL CASES, AN ORGANIZATION/ENTITY WILL NOT BE ELIGIBLE FOR MORE THAN ONE GRANT DURING ANY YEAR. X 1 1 0 1 0 1 0 1 0 1 0 CASTRO MICHAEL J PRESIDENT/CEO 0 990000 0 4486038 0 53528 0 887 0 34460 0 5564913 0 0 WEBER ALICIA F EVP CHIEF FINANCIAL OFFICER 0 698462 0 1464997 0 54195 0 31125 0 27415 0 2276194 0 0 CHAVARRIA SARAH EVP/CHIEF PEOPLE OFFICER 0 628923 0 1405121 0 27652 0 30450 0 29669 0 2121815 0 0 HANKINSON MICHAEL G EVP CHIEF LEGAL OFFICER 0 574231 0 1337366 0 97722 0 30450 0 19475 0 2059244 0 0 JACKSON KEVIN L EVP/CHIEF GROWTH OFFICER 0 574231 0 1321192 0 38526 0 31779 0 34460 0 2000188 0 0 GILBERT LEROY R JR EVP/CHIEF OPERATIONS OFFICER 0 550809 0 1043799 0 17656 0 30450 0 17464 0 1660178 0 0 TITCOMBE DOMINIC EVP/CHIEF INFORMATION OFFICER 0 499231 0 945201 0 19091 0 30450 0 32064 0 1526037 0 0 FOSTER JEANNE M VP FINANCE 291643 0 313429 0 30972 0 30450 0 11730 0 678224 0 0 0 RODZINKA BARBARA A VP ENT OPER SHARED SERVICES 279593 0 320127 0 20077 0 30450 0 23910 0 674157 0 0 0 CEMBROLA MICHAEL VP SALES 256053 0 355521 0 6867 0 30450 0 20297 0 669188 0 0 0 GRAYBILL RICHARD C VP UNDERWRITING AND ACTUARIAL 249875 0 279006 0 22559 0 30450 0 10986 0 592876 0 0 0 COOVER ROBERT D DIRECTOR SALES 178876 0 286174 0 28122 0 30450 0 29933 0 553555 0 0 0 MCKEE TIMOTHY SALES ACCOUNT EXECUTIVE 77388 0 338150 0 7734 0 30450 0 21504 0 475226 0 0 0 WEIS JOHN P DIRECTOR INFRASTRUCTURE & OPERATIONS 193452 0 120147 0 24807 0 29160 0 25507 0 393073 0 0 0 SIMPKINS JASON E DIRECTOR UNDERWRITING 164612 0 114067 0 4303 0 24260 0 24760 0 332002 0 0 0 MOORMAN ROGER W SALES ACCOUNT EXECUTIVE 72802 0 187036 0 10930 0 27430 0 21996 0 320194 0 0 0 CLARKE JAMIE VICE PRESIDENT NETWORK DEVELOPMENT 125192 0 81000 0 2632 0 12609 0 9597 0 231030 0 0 0 BERGERT GLEN F CPA DIRECTOR 30600 156200 0 0 0 0 0 0 0 0 30600 156200 0 0 MACGILVRAY JENNIFER VICE PRESIDENT CLAIMS PROCESSING 70400 0 100000 0 3353 0 6600 0 6266 0 186619 0 0 0 PART I, LINE 1A FINANCIAL AND TAX PLANNING EXPENSES ARE REIMBURSED TO EMPLOYEES AT THE DIRECTOR OR ABOVE LEVELS OF MANAGEMENT. A COMPANY POLICY OUTLINES THE MAXIMUM REIMBURSEMENT ALLOWED FOR EACH MANAGEMENT LEVEL. TWO COMPANY EXECUTIVES RECEIVED REIMBURSEMENTS FOR FINANCIAL AND TAX PLANNING EXPENSES IN 2021. PART I, LINE 3 COMPENSATION PAID TO THE CEO AND EXECUTIVE VICE PRESIDENTS IS APPROVED BY THE COMPENSATION COMMITTEE OF THE ORGANIZATION. THE COMPENSATION COMMITTEE APPROVES COMPENSATION FOR THE ENSUING YEAR AFTER REVIEWING COMPARABILITY DATA PRESENTED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT, AN ASSESSMENT OF EACH OFFICER'S PERFORMANCE OVER THE PRECEDING YEAR, AND THE ORGANIZATION'S PROGRAM ACCOMPLISHMENTS FOR THE PRIOR YEAR. COMPENSATION PAID TO DIRECTORS IS ALSO APPROVED BY THE COMPENSATION COMMITTEE AFTER REVIEWING COMPARABILITY DATA IN A BENCHMARKING STUDY PREPARED AND PRESENTED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT RETAINED BY THE BOARD OF DIRECTORS. THESE PROCESSES WERE FOLLOWED FOR 2021 COMPENSATION. PART I, LINE 4B EFFECTIVE FEBRUARY 6, 2020, THE ORGANIZATION'S SUPPLEMENTAL NON-QUALIFIED RETIREMENT PROGRAM WAS IRREVOCABLY TERMINATED. AS A RESULT OF THE PLAN'S TERMINATION, THE PLAN'S SUBSTANTIAL RISK OF FORFEITURE LAPSED, AND BENEFITS VESTED RESULTING IN A TAXABLE TRANSACTION FOR THE REMAINING PLAN PARTICIPANTS. THE PARTICIPANT'S TAXABLE TRANSACTION WAS REFLECTED IN THE ORGANIZATION'S FORM 990 IN PART VII, SECTION A AND IN SCHEDULE J, PART II FOR THE TAX YEAR ENDED DECEMBER 31, 2020. ALL REMAINING PLAN BENEFITS WERE PAID IN A LUMP SUM TO THE REMAINING PARTICIPANTS (MICHAEL J. CASTRO) ON MARCH 1, 2021. PART I, LINES 5A AND 6A: DELTA DENTAL OF PENNSYLVANIA MAINTAINS A LONG-TERM INCENTIVE PLAN (LTIP) FOR ELIGIBLE EMPLOYEES OF THE ORGANIZATION, LINKING COMPENSATION TO THE COMPANY'S PERFORMANCE. USING SUCCESS METRICS SUCH AS REVENUES, NET GAIN AS A PERCENTAGE OF REVENUES, AND OTHERS, ALLOWS THE COMPANY TO ACCURATELY MEASURE ITS GROWTH, INFORM ON PROGRESS OF ITS BUSINESS TRANSFORMATION, AND EMPOWER CONTINUED SUCCESS. THE LTIP IS UNFUNDED AND ALL PAYMENTS FROM THE LTIP ARE DERIVED FROM THE GAINS OF THE COMPANY. AS SUCH, THERE IS NO GUARANTEE OF INCENTIVE PAYMENTS UNDER THE LTIP. THE CEO MAKES RECOMMENDATIONS TO THE COMPENSATION COMMITTEE FOR ITS REVIEW AND APPROVAL REGARDING THE PERFORMANCE OBJECTIVES, BOTH FINANCIAL AND NON-FINANCIAL, UPON WHICH PAYMENT OF AWARDS ARE BASED AND THE TIME PERIOD DURING WHICH PERFORMANCE SHALL BE MEASURED. EACH LTIP PLAN SPANS THREE YEARS, OVERLAPPING WITH CURRENT PLANS. THESE AMOUNTS ARE INCLUDED IN TAXABLE COMPENSATION. PART I, LINE 7 THE PRESIDENT OF THE ORGANIZATION, WITH BOARD OF DIRECTORS APPROVAL, MAY GRANT AN ANNUAL BONUS TO ALL MANAGEMENT EMPLOYEES. THESE AMOUNTS ARE INCLUDED IN TAXABLE COMPENSATION. PART II, ROW (II): SOME OF THE ORGANIZATION'S OFFICERS ARE PAID BY A RELATED ORGANIZATION. ACCORDINGLY, THEIR COMPENSATION IS REPORTED ON ROW (II). CHRISTOPHER J KOTCHICK DDS PARTICIPATING PROVIDER 257652 DENTAL CLAIM PAYMENTS 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE CLASS OF MEMBERS, DESIGNATED CORPORATE MEMBERS, WHO ARE DIRECTORS OF DENTEGRA GROUP, INC., THE ORGANIZATION'S PARENT HOLDING COMPANY. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S DIRECTORS VOTE ON PERSONS NOMINATED AS DIRECTORS FOR ENDORSEMENT TO THE CORPORATE MEMBERS, WHO ELECT THE DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE CORPORATE MEMBERS MUST APPROVE ANY CHANGES TO SPECIFIED BYLAWS PROVISIONS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S CFO AND LEGAL COUNSEL OVERSEE THE COMPLETION OF THE FORM 990 AND, PRIOR TO FILING, REVIEW IT WITH THE PRESIDENT/CEO AND WITH THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY, AND BETWEEN ANNUAL STATEMENTS IS REQUIRED TO DISCLOSE ANY NEW POSITION OR RELATIONSHIP FORMED THAT POTENTIALLY RAISES A CONFLICT OF INTEREST. LEGAL COUNSEL REVIEWS THESE DISCLOSURES AND REPORTS THE INFORMATION TO THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PAID TO THE CEO AND EXECUTIVE VICE PRESIDENTS IS APPROVED BY THE COMPENSATION COMMITTEE OF THE ORGANIZATION. THE COMPENSATION COMMITTEE APPROVES COMPENSATION FOR THE ENSUING YEAR AFTER REVIEWING COMPARABILITY DATA PRESENTED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT, AN ASSESSMENT OF EACH OFFICER'S PERFORMANCE OVER THE PRECEDING YEAR, AND THE ORGANIZATION'S PROGRAM ACCOMPLISHMENTS FOR THE PRIOR YEAR. COMPENSATION PAID TO DIRECTORS IS ALSO APPROVED BY THE COMPENSATION COMMITTEE AFTER REVIEWING COMPARABILITY DATA IN A BENCHMARKING STUDY PREPARED AND PRESENTED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT RETAINED BY THE BOARD OF DIRECTORS. THESE PROCESSES WERE FOLLOWED FOR 2021 COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION ANNUALLY INCLUDES MAJOR PORTIONS OF ITS FINANCIAL STATEMENT IN A PUBLISHED ANNUAL REPORT THAT IS MADE AVAILABLE TO PERSONS OR ENTITIES KNOWN TO HAVE AN INTEREST IN THE ORGANIZATION, AND IS AVAILABLE TO THE LARGER PUBLIC UPON REQUEST. STATUTORY FINANCIAL STATEMENTS ARE INCLUDED IN QUARTERLY AND ANNUAL RETURNS TO STATE DEPARTMENTS OF INSURANCE REGULATING THE ORGANIZATION WHICH RETURNS ARE AVAILABLE TO THE PUBLIC. THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. FORM 990, PART VII; SCHEDULE J; SCHEDULE R: THE ORGANIZATION, REGULATED BY THE PENNSYLVANIA INSURANCE DEPARTMENT, IS A MEMBER OF THE DELTA DENTAL OF CALIFORNIA ENTERPRISE COMPANIES, WHICH INCLUDE DELTA DENTAL OF CALIFORNIA, DELTA DENTAL OF PENNSYLVANIA AND AFFILIATED COMPANIES OPERATING IN 15 STATES, THE DISTRICT OF COLUMBIA, PUERTO RICO AND THE U.S. VIRGIN ISLANDS. THE ENTERPRISE COMPANIES COMPRISE ONE OF THE NATION'S LARGEST DENTAL BENEFITS DELIVERY SYSTEMS COVERING 38.6 MILLION ENROLLEES AND PROCESSING 52.4 MILLION CLAIMS. TOTAL REVENUE FOR THE ENTERPRISE EXCEEDED 9.5 BILLION IN 2021. THE ORGANIZATION REPRESENTS APPROXIMATELY 9% OF TOTAL ENTERPRISE REVENUES. DELTA DENTAL OF DELAWARE INC ONE DELTA DRIVE MECHANICSBURG PA 17055 510228088 DENTAL INSURANCE DE 501(C)(4) DENTEGRA GROUP INC 0 DELTA DENTAL OF WEST VIRGINIA INC ONE DELTA DRIVE MECHANICSBURG PA 17055 550523124 DENTAL INSURANCE WV 501(C)(4) DENTEGRA GROUP INC 0 DELTA DENTAL OF THE DISTRICT OF COLUMBIA ONE DELTA DRIVE MECHANICSBURG PA 17055 521479587 DENTAL INSURANCE DC 501(C)(4) DENTEGRA GROUP INC 0 DELTA DENTAL COMMUNITY CARE FOUNDATION 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 371570764 CHARITABLE ORGANIZATION CA 501(C)(3) PF DENTEGRA GROUP INC 0 DELTA DENTAL OF CALIFORNIA 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 941461312 DENTAL INSURANCE CA 501(C)(4) DENTEGRA GROUP INC 0 DELTA DENTAL OF NEW YORK ONE DELTA DRIVE MECHANICSBURG PA 17055 111980218 DENTAL INSURANCE NY 501(C)(4) DENTEGRA GROUP INC 0 DELTA REINSURANCE CORPORATION CGI TOWER 2ND FLOOR WARRENS ST. MICHAEL BB 980096711 REINSURANCE BB DELTA DENTAL OF PENNSYLVANIA C 1 DENTEGRA GROUP INC 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 943386049 HOLDING COMPANY DE N/A C 0 DENTEGRA INSURANCE COMPANY 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 751233841 INSURANCE COMPANY DE DDC INSURANCE HOLDINGS INC C 0 DENTEGRA INSURANCE CO OF NEW ENGLAND 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 300318743 INSURANCE COMPANY MA DDC INSURANCE HOLDINGS INC C 0 ALPHA DENTAL OF NEVADA INC 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 880244893 INSURANCE COMPANY NV DDC INSURANCE HOLDINGS INC C 0 ALPHA DENTAL OF UTAH INC 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 860672505 INSURANCE COMPANY UT DDC INSURANCE HOLDINGS INC C 0 ALPHA DENTAL PROGRAMS INC 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 742447512 INSURANCE COMPANY TX DDC INSURANCE HOLDINGS INC C 0 ALPHA DENTAL OF ALABAMA INC 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 630796079 INSURANCE COMPANY AL DDC INSURANCE HOLDINGS INC C 0 ALPHA DENTAL OF NEW MEXICO INC 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 330279230 INSURANCE COMPANY NM DDC INSURANCE HOLDINGS INC C 0 ALPHA DENTAL OF ARIZONA INC 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 930939835 INSURANCE COMPANY AZ DDC INSURANCE HOLDINGS INC C 0 DENTEGRA SEGUROS DENTALES SA INSURGENTES SUR 826 PISO 15 COL DEL VALLE FC DF 01300 MX INSURANCE COMPANY MX DENTEGRA INSURANCE COMPANY C 0 DELTA DENTAL OF PUERTO RICO 14 CALLE 2 SUITE 200 GUAYNABO RQ 00968 660436769 INSURANCE COMPANY RQ DELTA DENTAL OF CALIFORNIA C 0 SERVICIOS DENTALES DENTEGRA SA DE CV INSURGENTES SUR 826 PISO 15 COL DEL VALLE FC DF 01300 MX INSURANCE ADMINISTRATION MX DENTEGRA INSURANCE COMPANY C 0 DELTA DENTAL INSURANCE COMPANY 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 942761537 INSURANCE COMPANY DE DDC INSURANCE HOLDINGS INC C 0.00120 0 DDC INSURANCE HOLDINGS INC 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 274251930 HOLDING COMPANY DE DELTA DENTAL OF CALIFORNIA C 0 ALLIED ADMINISTRATORS INC 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 941713371 THIRD PARTY ADMIN SERVICES CA DDC INSURANCE HOLDINGS INC C 0 DELTA DENTAL IPA OF NEW YORK 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 384063658 INDEPENDENT PRACTICE ASSOCIATION NY DDC INSURANCE HOLDINGS INC C 0 CONVECTION HUB INC 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 825288274 HEALTH AND WELLNESS DE DDC INSURANCE HOLDINGS INC C 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 DELTA DENTAL OF CALIFORNIA L 9029860 DELTA DENTAL OF CALIFORNIA M 28093423 DELTA DENTAL OF CALIFORNIA P 20786059 DELTA DENTAL OF CALIFORNIA Q 486808 DELTA DENTAL OF DELAWARE L 6466424 DELTA DENTAL OF DELAWARE Q 10287 DELTA DENTAL OF DISTRICT OF COLUMBIA L 2077281 DELTA DENTAL OF DISTRICT OF COLUMBIA P 3000 DELTA DENTAL OF NEW YORK L 35995998 DELTA DENTAL OF NEW YORK P 2096400 DELTA DENTAL OF NEW YORK Q 78057 DELTA DENTAL OF WEST VIRGINIA L 4000491 DELTA DENTAL OF WEST VIRGINIA Q 11992 DELTA DENTAL INSURANCE COMPANY L 3067239 DELTA DENTAL INSURANCE COMPANY M 4847498 DELTA DENTAL INSURANCE COMPANY P 68862 DELTA DENTAL INSURANCE COMPANY Q 1091992 DENTEGRA INSURANCE COMPANY P 491089 ALLIED ADMINISTRATORS INC M 3912934 DELTA DENTAL COMMUNITY CARE FOUNDATION B 3500000 DENTEGRA INSURANCE COMPANY Q 15063 DELTA DENTAL OF WEST VIRGINIA P 350 DELTA DENTAL OF DISTRICT OF COLUMBIA Q 76 DELTA REINSURANCE CORPORATION S 20202616