2021-11-15T08:16:23-06:00 2020-12-31 540504608 BROWN EDWARDS & COMPANY LLP 319 MCCLANAHAN STREET SW ROANOKE VA 24014 990 2020-01-01 205945158 CORVESTA INC CORV 5409898000 4818 STARKEY ROAD ROANOKE VA 240188542 R JAMES BARKER CHIEF FINANCIAL OFFICER 5409898000 2021-11-11 1 R JAMES BARKER 999009999 PATRICK PITTMAN P00587461 5403450936 2021-11-10 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z R JAMES BARKER 4818 STARKEY ROAD ROANOKE VA 240188542 435783 0 X WWW.CORVESTA.COM X 2006 VA PROVIDE OPPORTUNITIES THROUGH A HOLDING COMPANY IN SUPPORT OF THE MISSION OF DELTA DENTAL OF VA. 9 8 142 0 0 0 0 0 0 0 5454848 386474 0 0 5454848 386474 0 0 0 0 22669913 22428427 0 0 0 953051 15193679 23622964 37622106 -18168116 -37235632 94628007 98197330 53704913 55906494 40923094 42290836 GUIDING, MONITORING AND COORDINATING THE ACTIVITIES OF ITS SUBSIDIARY, DELTA DENTAL OF VIRGINIA ("DDVA") AND OTHER AFFILIATED ENTITIES, TO ACHIEVE THE TAX-EXEMPT HEALTH CARE PURPOSES OF DDVA IN AN EFFICIENT AND INTEGRATED MANNER. 0 0 GUIDING, MONITORING AND COORDINATING THE ACTIVITIES OF ITS SUBSIDIARY, DELTA DENTAL OF VIRGINIA ("DDVA") AND OTHER AFFILIATED ENTITIES, TO ACHIEVE THE TAX-EXEMPT HEALTH CARE PURPOSES OF DDVA IN AN EFFICIENT AND INTEGRATED MANNER. 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 27 0 1 142 1 0 0 0 0 0 0 0 0 0 0 1 0 X 9 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X R JAMES BARKER 5409898000 4818 STARKEY ROAD ROANOKE VA 24018 MR THOMAS R BYRD CHAIRMAN OF THE BOARD 4.00 2.00 X X 41550 0 0 MS JEANNE ARMENTROUT DIRECTOR 3.00 0.00 X 29050 0 0 MR BARRY E DUVAL DIRECTOR 2.00 1.00 X 23950 0 0 MR JAMES C HALE DIRECTOR 3.00 0.00 X 25550 0 0 MR DOUGLAS JUANARENA DIRECTOR 3.00 1.00 X 25000 0 0 MS PAMELA S SCHUTZ DIRECTOR 3.00 1.00 X 30100 0 0 MR JAN S SESSOR DIRECTOR 3.00 1.00 X 23950 0 0 MS LAURA W THOMAS DIRECTOR 4.00 2.00 X 11200 30000 0 MR FRANK L LUCIA PRESIDENT & CEO 40.00 2.00 X X 1261140 0 84298 MR R JAMES BARKER CHIEF FINANCIAL OFFICER 40.00 0.00 X 533182 0 72341 MR CHAD MCINTOSH GENERAL COUNSEL 40.00 0.00 X 452708 0 63522 MR ROBERT K SANCHEZ SVP, OPERATIONS & TECHNOLOGY 40.00 0.00 X 554394 0 45077 MS STACY CAMPBELL VICE PRESIDENT 40.00 0.00 X 428383 0 48170 MS KATHARINE CLAYTOR VICE PRESIDENT 40.00 0.00 X 381461 0 57297 MR DAVID P MITCHELL VICE PRESIDENT 40.00 0.00 X 340781 0 49576 MS LORA J WILKINSON VICE PRESIDENT 40.00 0.00 X 385418 0 54180 MR COREY GANTZHORN STAFF 40.00 0.00 X 188637 0 30198 MR RAMANA GARIMELLA STAFF 40.00 0.00 X 220706 0 41799 MR BRIAN HOSTETLER STAFF 40.00 0.00 X 227416 0 47305 MR PRASHANTH LAKSHMIKANTHA STAFF 40.00 0.00 X 176756 0 51908 MS DEBORAH S MARTIN STAFF 40.00 0.00 X 212337 0 39849 5573669 30000 685520 70 0 1 0 HEALTHEDGE SOFTWARE INC 30 CORPORATE DRIVE BURLINGTON MA 01803 SOFTWARE DEVELOPMENT 4198510 ACCION LABS US INC DDI PLAZZA 1 1225 WASHINGTON PIKE BRIDGEVILLE PA 15017 CONTRACT PROGRAMMING 2062620 TEK SYSTEMS PO BOX 198568 ATLANTA GA 303848568 CONTRACT PROGRAMMING 601696 CAPITAL TECHSEARCH INC 1600 BELLEVILLE STREET RICHMOND VA 23230 CONTRACT PROGRAMMING 485558 ACCION DIGITAL INC 1121 BOYCE ROAD SUITE 1400 PITTSBURGH PA 15241 CONTRACT PROGRAMMING 481719 10 435783 435783 49309 -49309 -49309 -49309 386474 0 0 386474 X 5022278 5022278 12905032 12905032 1625837 1625837 1714221 1714221 1161059 1161059 144525 144525 78000 78000 71831 71831 8147273 8147273 42849 42849 1739881 1739881 415759 415759 479565 479565 157734 157734 70391 70391 4009246 4009246 EQUIPMENT RENTAL & SOFT 3475099 3475099 TEMPORARY HELP 222706 222706 MISCELLANEOUS OPERATING 82049 82049 DATA PROCESSING COSTS 42344 42344 -3985573 -3985573 37622106 0 37622106 0 19877374 20980521 442933 707645 966880 1061730 57574992 13432910 43677523 44142082 16111774 16510511 11152468 12613197 2399055 2181644 94628007 98197330 9378764 9206467 44326149 46700027 53704913 55906494 X 0 0 0 0 40923094 42290836 40923094 42290836 94628007 98197330 X -37235632 38603374 X X 0 1 X 1 0 57574992 13432910 44142082 44142082 INVESTMENT IN REVOLV, INC. 2701685 C INVESTMENT IN ENCARA, INC 381046 C INVESTMENT IN STRYDEN, INC. 4688207 C INVESTMENT IN LINKDDS 2500000 C INVESTMENT IN SPRINGROCK VENTURES, LP 450000 C INVESTMENT IN ARMATA PHARMACEUTICALS, INC 1892259 F 12613197 X 668099628 667713154 667713154 386474 0 386474 650833960 613211854 613211854 37622106 0 37622106 PART X, LINE 2: CORVESTA AND DDVA ARE EXEMPT FROM FEDERAL INCOME TAX UNDER THE PROVISIONS OF PUBLIC LAW 99-514, TAX REFORM ACT OF 1986, ACT SECTION 1012(C)(4)(C)(IV) AND HAVE RECEIVED FAVORABLE DETERMINATION LETTERS FROM THE IRS UNDER CODE SECTION 501(C)(4). THE FOUNDATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER CODE SECTION 501(C)(3). INCOME TAXES ARE PROVIDED FOR THE TAX EFFECTS OF REVOLV'S AND STRYDEN'S TRANSACTIONS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS AND CONSIST OF TAXES CURRENTLY DUE OR REFUNDABLE, PLUS DEFERRED TAXES RELATED PRIMARILY TO NET OPERATING LOSSES AND THE DIFFERENCES BETWEEN THE TAX AND FINANCIAL REPORTING BASES OF PROPERTY AND EQUIPMENT. THE DEFERRED TAXES REPRESENT THE FUTURE TAX RETURN CONSEQUENCES OF THOSE DIFFERENCES, WHICH WILL EITHER BE TAXABLE OR DEDUCTIBLE WHEN THE ASSETS AND LIABILITIES ARE RECOVERED OR SETTLED. BECAUSE OF THE NATURE OF CORVESTA'S BUSINESS, AND THAT OF ITS SUBSIDIARIES, AND AS A MATTER OF POLICY, MANAGEMENT BELIEVES THERE HAVE BEEN NO MATERIAL AGRESSIVE POSITIONS TAKEN IN THE ENTITY'S TAX AND INFORMATIONAL RETURN FILINGS FOR ANY REPORTING PERIODS OPEN TO NORMAL JURISDICTIONAL EXAMINATION. ACCORDINGLY, NO LIABILITY FOR UNRECOGNIZED TAX BENEFITS (OR ASSOCIATED PENALTIES AND INTEREST) IS PROVIDED. PART XI, LINE 2D - OTHER ADJUSTMENTS: DELTA DENTAL OF VIRGINIA REVENUE 663,362,763. ELIMINATING ENTRY-REVOLV OTHER CLAIMS PROCESSING FEES PROVIDED DD -19,397,171. REVOLV, INC. REVENUE 19,879,601. OTHER INCOME CORVESTA 5,517,076. STRYDEN, INC. REVENUE 287,397. INTERCOMPANY INCOME INCLUDED IN INVESTMENT INCOME -1,936,512. PART XII, LINE 2D - OTHER ADJUSTMENTS: DELTA DENTAL OF VIRGINIA EXPENSES 647,201,291. REVOLV EXPENSES 20,535,786. STRYDEN EXPENSES 472,043. CORVESTA OTHER EXPENSES EXCLUDED -82,991. ELIMINATION OF ALLOCATED EXPENSES TO SUBS -54,914,275. X X 1 1 X X X X X X 0 1 0 0 0 0 0 1 0 MR FRANK L LUCIA PRESIDENT & CEO 712389 0 530823 0 17928 0 56000 0 28298 0 1345438 0 0 0 MR R JAMES BARKER CHIEF FINANCIAL OFFICER 374140 0 157350 0 1692 0 56000 0 16341 0 605523 0 0 0 MR ROBERT K SANCHEZ SVP, OPERATIONS & TECHNOLOGY 373677 0 169951 0 10766 0 16943 0 28134 0 599471 0 0 0 MR CHAD MCINTOSH GENERAL COUNSEL 312826 0 137806 0 2076 0 35464 0 28058 0 516230 0 0 0 MS STACY CAMPBELL VICE PRESIDENT 295116 0 130261 0 3006 0 35464 0 12706 0 476553 0 0 0 MS LORA J WILKINSON VICE PRESIDENT 216281 0 167083 0 2054 0 35123 0 19057 0 439598 0 0 0 MS KATHARINE CLAYTOR VICE PRESIDENT 264397 0 114713 0 2351 0 35464 0 21833 0 438758 0 0 0 MR DAVID P MITCHELL VICE PRESIDENT 238256 0 99461 0 3064 0 35464 0 14112 0 390357 0 0 0 MR BRIAN HOSTETLER STAFF 189107 0 38008 0 301 0 18442 0 28863 0 274721 0 0 0 MR RAMANA GARIMELLA STAFF 185694 0 34587 0 425 0 25803 0 15996 0 262505 0 0 0 MS DEBORAH S MARTIN STAFF 176921 0 33742 0 1674 0 24418 0 15431 0 252186 0 0 0 MR PRASHANTH LAKSHMIKANTHA STAFF 151825 0 24233 0 698 0 22084 0 29824 0 228664 0 0 0 MR COREY GANTZHORN STAFF 159098 0 24239 0 5300 0 3773 0 26425 0 218835 0 0 0 PART I, LINE 1A ALL ITEMS CHECKED ON LINE 1A FOLLOW THE POLICY GUIDELINES ADOPTED BY THE ORGANIZATION: FIRST-CLASS OR CHARTER TRAVEL-WE FOLLOW ADOPTED POLICY FOR BOTH FIRST-CLASS OR CHARTER TRAVEL. IN SUMMARY, FIRST-CLASS TRAVEL IS NOT ALLOWED EXCEPT BY SPECIFIC GUIDANCE IN THE T & E POLICY (I.E. EXCEPTIONALLY LONG FLIGHT, ETC.) TRAVEL FOR COMPANIONS-WE FOLLOW ADOPTED CORPORATE TRAVEL AND ENTERTAINMENT (T&E) POLICY FOR COMPANIONS. IN SUMMARY, SPOUSAL TRAVEL IS NOT COVERED UNLESS SPECIFIC CRITERIA ARE MET. PART I, LINE 4B THE PLANS WERE ESTABLISHED VIA THIS ORGANIZATION'S AND THE RELATED ORGANIZATION'S MANAGEMENT DEVELOPMENT & COMPENSATION COMMITTEE'S COMPENSATION AND BENEFIT REVIEW WHICH IS IN ACCORDANCE WITH THE PROCESS OUTLINED BY THE IRS FOR SETTING REASONABLE COMPENSATION. THESE PLANS ARE IN ACCORDANCE WITH SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS AS PER IRS SECTIONS 409(A). THERE WERE NO LUMP SUM PAYMENTS PAID FROM THIS ORGANIZATION NOR A RELATED ORGANIZATION IN 2020. PART I, LINE 7 A PORTION OF EACH PERSON'S COMPENSATION IS AT RISK PROVIDING KEY METRICS AND GOALS ARE ACHIEVED. THE RESPECTIVE PROGRAMS FOR DISQUALIFIED PERSONS ARE SUBJECT TO THE MANAGEMENT DEVELOPMENT & COMPENSATION COMMITTEE'S COMPENSATION AND BENEFIT REVIEW PROCESS WHICH IS IN ACCORDANCE WITH THE PROCESS OUTLINED BY THE IRS FOR SETTING REASONABLE COMPENSATION. FORM 990, PART VI, SECTION B, LINE 11B MEMBERS OF THE BOARD OF DIRECTORS WILL REVIEW THE DOCUMENT WITH SENIOR MANAGEMENT MEMBERS. THE REVIEW WILL BE DOCUMENTED AT THE SUBSEQUENT BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C CORVESTA, INC. REQUIRES CORPORATE OFFICERS AND EACH DIRECTOR ON THE BOARD OF DIRECTORS TO COMPLETE AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT THAT IS BASED ON IRS GUIDANCE. IN ADDITION, THE CONFLICT OF INTEREST POLICY REQUIRES DISCLOSURE OF ALL CONFLICTS, POTENTIAL CONFLICTS, OR ANY MATTER THAT MAY GIVE RISE TO THE APPEARANCE OF A CONFLICT. THE FORMS ARE REVIEWED BY THE COMPLIANCE OFFICER AND REPORTED TO THE CEO AND THE APPROPRIATE COMMITTEE(S) OF THE BOARD. THE FORMS ARE FURTHER AVAILABLE TO, AND REVIEWED BY, OUR AUDITORS AND THE BOI. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION ARRANGEMENTS FOR THE CEO AND OTHER DISQUALIFIED PERSONS ARE REVIEWED AND APPROVED BY THE MANAGEMENT DEVELOPMENT AND COMPENSATION COMMITTEE OF OUR BOARD OF DIRECTORS. THIS COMMITTEE CONSISTS ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE ANY CONFLICTS OF INTEREST AS TO THE ARRANGEMENTS BEING REVIEWED. THE COMMITTEE FOLLOWS THE PROCESSES OUTLINED BY THE IRS FOR SETTING REASONABLE COMPENSATION. THE COMMITTEE REVIEWS AND RELIES UPON COMPARABILITY DATA AND THE EXPERT RECOMMENDATIONS PROVIDED BY AN INDEPENDENT COMPENSATION CONSULTANT. DELIBERATIONS AND DECISIONS OF THE COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED. THIS PROCESS IS UNDERTAKEN AT LEAST ANNUALLY WITH RESPECT TO THE CEO AND ALL OTHER DISQUALIFIED PERSONS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON DEMAND. FORM 990, PART IX, LINE 11G PROFESSIONAL SERVICES & FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 8,147,273. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,147,273. FORM 990, PART XI, LINE 9: REVOLV, INC. LOSS -656,185. ALLOCATED EXPENSES TO SUBS 39,431,358. STRYDEN LOSS -171,799. FORM 990, PART XII, LINE 2C THERE HAVE BEEN NO CHANGES TO CORVESTA INC.'S OVERSITE PROCESS OF THE AUDIT OR ITS SELECTION OF AN INDEPENDENT AUDITOR. DELTA DENTAL OF VIRGINIA 4818 STARKEY ROAD ROANOKE VA 24018 540844477 PROVIDES DENTAL BENEFITS AND SERVICES VA 501(C)4 CORVESTA INC 1 DELTA DENTAL OF VIRGINIA FOUNDATION INC 4818 STARKEY ROAD ROANOKE VA 24018 453230862 PROMOTION AND ADVANCEMENT OF ORAL HEALTH FOR THE PEOPLE OF VA VA 501(C)3 LINE 12A, I DELTA DENTAL OF VIRGINIA 0 REVOLV INC 4818 STARKEY ROAD ROANOKE VA 24018 271018474 PROVIDES TPA SERVICES TO DENTAL INSURANCE COMPANIES VA CORVESTA INC C -656185 4577652 1.00000 1 STRYDEN INC 4818 STARKEY ROAD ROANOKE VA 24018 352637734 PROVIDES VISION CARE INSURANCE VA CORVESTA INC C -171799 4771651 1.00000 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 REVOLV INC Q 5143370 FAIR MARKET VALUE REVOLV INC Q 552285 FAIR MARKET VALUE DELTA DENTAL OF VIRGINIA K 405120 FAIR MARKET VALUE DELTA DENTAL OF VIRGINIA Q 25354621 FAIR MARKET VALUE DELTA DENTAL OF VIRGINIA Q 5735564 FAIR MARKET VALUE STRYDEN INC Q 158131 FAIR MARKET VALUE