2018-11-12T07:39:59-06:00 2017-12-31 341851358 CBIZ MHM LLC 530 HOWELL ROAD SUITE 209 GREENVILLE SC 29615 990 2017-01-01 231667011 DELTA DENTAL OF PENNSYLVANIA DELT 7177668500 ONE DELTA DRIVE MECHANICSBURG PA 17055 JEANNE FOSTER V.P., FINANCE 7177668500 2018-10-26 1 KELLIE A LANFORD P00538614 8642412001 2018-10-30 162.231.92.163 2018-11-12 07:32:43 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 457EDB2BE6E124B7C9E7654176383C617BDC297E 2017 2019-02-21 02:37:17Z JEANNE FOSTER ONE DELTA DRIVE MECHANICSBURG PA 17055 704075454 0 X WWW.DELTADENTALINS.COM X 1964 PA TO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS, SERVICE, TECHNOLOGY, AND PROFESSIONAL SUPPORT. 16 7 716 0 0 0 0 0 656890708 691591503 2262821 2934111 8187069 2913153 667340598 697438767 735946 3147250 590942182 615097678 24788196 32135464 0 0 0 30142447 31102717 646608771 681483109 20731827 15955658 205154062 228010155 68553243 72583225 136600819 155426930 TO ADVANCE DENTAL HEALTH AND ACCESS THROUGH EXCEPTIONAL DENTAL BENEFITS, SERVICE, TECHNOLOGY, AND PROFESSIONAL SUPPORT. 0 0 672994941 697438767 THE ORGANIZATION PROVIDED DENTAL BENEFIT COVERAGE FOR 2,359,938BENEFICIARIES IN 2017 PRIMARILY THROUGH CONTRACTS WITH INDEPENDENTDENTISTS SERVING 1,501 PURCHASING GROUPS. THE ORGANIZATION PAID MORETHAN $615.1 MILLION FOR DENTAL CARE DURING 2017. 3147250 3147250 THE ORGANIZATION MADE GRANTS DURING 2017 TO FOSTER IMPROVED ACCESSTO DENTAL HEALTH CARE TREATMENT, TO SUPPORT PROFESSIONAL DENTALEDUCATION, AND TO PROVIDE ORAL HEALTH INSTRUCTION FOR PATIENTS. 676142191 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 1 0 0 0 0 0 1 1 0 0 1 93322 0 1 716 1 0 1 BB 0 0 0 0 X 16 7 0 0 1 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X JEANNE FOSTER VP FINANCE 7177668500 ONE DELTA DRIVE MECHANICSBURG PA 17055 X CARTER JR EUGENE F CHAIR 2.00 1.00 X 36312 78000 0 MAHER DEBRA G VICE CHAIR; DIRECTOR, DENTEGRA GROUP, INC. 2.00 1.00 X 16200 75000 0 WENGER PHILIP R SECRETARY 2.00 X 17400 0 0 BECK JR JOSEPH P TREASURER 2.00 X 22200 0 0 BLACK JANICE R IMMEDIATE PAST CHAIR 1.00 X 15000 0 0 BERGERT GLEN F CPA CONSULTANT 2.00 3.00 X 23312 176320 0 BRUNO MICHELLE A DIRECTOR 1.00 X 17400 0 0 CLARK III RICHARD J DDS DIRECTOR 1.00 X 8650 0 0 JUST GEORGE M DDS DIRECTOR 1.00 X 17400 0 0 KOBAYASHI LORI L DIRECTOR 1.00 X 17400 0 0 KOTCHICK CHRISTOPHER J DMD DIRECTOR 1.00 X 0 0 0 LITTLE SCOTT Q DDS DIRECTOR 1.00 X 18512 0 0 SHIRLEY ERIC L DMD DIRECTOR 1.00 X 17400 0 0 SMELTZER JAMES A CPA DIRECTOR 2.00 X 23312 0 0 SMIGA ERIC R DMD DIRECTOR 1.00 X 18512 0 0 SNYDER FRANK DIRECTOR 1.00 X 17400 0 0 VEIHDEFFER L WILLIAM DMD DIRECTOR 1.00 X 17400 0 0 WOLGIN JOSHUA B DMD DIRECTOR 1.00 X 18512 0 0 BARTH ANTHONY S PRESIDENT/CEO 4.00 46.00 X 0 5419731 560033 CASTRO MICHAEL J EXE. VICE PRES./CFO 4.00 46.00 X 0 1932561 -194805 HANKINSON MICHAEL G EXE. VICE PRES./CLO 4.00 46.00 X 0 1581367 51438 MARTINEZ BELINDA EXE. VICE PRES. 4.00 46.00 X 0 1712146 1753534 PATEL NILESH C EXE. VICE PRES./COO 4.00 46.00 X 0 1651334 43610 CHAVARRIA SARAH SR. VICE PRES. 4.00 46.00 X 0 190878 20701 DOERING RICK R SR. VICE PRES. 4.00 46.00 X 0 1329689 62629 GAREN KIRSTEN E SR. VICE PRES. 4.00 46.00 X 0 200435 30195 JACKSON KEVIN L SR. VICE PRES. 4.00 46.00 X 0 1067618 68482 WEBER ALICIA F SR. VICE PRES. 4.00 46.00 X 0 1162697 58111 YALE KENNETH P DDS SR. VICE PRES. 4.00 46.00 X 0 361831 55946 FOSTER JEANNE VICE PRES. 29.00 21.00 X 536837 0 136129 GRAYBILL RICHARD VICE PRES. 29.00 21.00 X 427671 0 119550 RODZINKA BARBARA A VICE PRES. 29.00 21.00 X 422881 0 70150 COOVER ROBERT DIRECTOR SALES 40.00 X 349232 0 126891 HAM TAMMY DIRECTOR ACCOUNT SERVICES 40.00 X 242970 0 80767 KETELSLEGER JAMES DIRECTOR ACCOUNTING & FINANCIAL REPORTING 40.00 X 245224 0 85596 KILBER DAVID E DENTAL DIRECTOR 40.00 X 259188 0 65330 MCKEE TIMOTHY SALES ACCOUNT EXECUTIVE 40.00 X 481458 0 85450 RADINE GARY D FORMER - OFFICER 0.00 0.00 X 0 211836 292699 3287783 17151443 3572436 123 1 1 0 AEROTECK PROFESSIONAL SERVICES 3689 COLLECTION CENTER DRIVE CHICAGO IL 60693 TEMP EMPLOYEES 401949 ARMANINO MCKENNA LLP 12667 ALCOSTA BLVD SUITE 580 SAN RAMON CA 94583 AUDITING 382100 TEKSYSTEMS PO BOX 198568 ATLANTA GA 303848568 TEMP EMPLOYEES 210644 ROBERT HALF TECHNOLOGY 12400 COLLECTIONS CENTER DR CHICAGO IL 60693 TEMP EMPLOYEES 130607 DATAQUEST 4807 JONESTOWN RD SUITE 247 HARRISBURG PA 17109 IT EMPLOYMENT CONTRACT 101474 5 DIRECT PREMIUMS 524114 691591503 691591503 691591503 2907479 2907479 6663319 6636687 26632 26632 26632 DRC DIVIDEND 524114 20640000 20640000 BAD DEBT EXPENSE 524114 -154160 -154160 EQUITY LOSS IN DRC 524114 -17411362 -17411362 -161325 -161325 2913153 697438767 697438767 0 0 3147250 3147250 615097678 615097678 3287783 2985743 302040 21208135 19259797 1948338 2805727 2547972 257755 3331443 3025392 306051 1502376 1364357 138019 4934 4934 300379 300379 366708 366708 260396 236474 23922 2829610 2569661 259949 6254078 5679532 574546 1114943 1012516 102427 803837 729991 73846 14889 14889 563788 511994 51794 548857 498435 50422 COMMISSIONS 11729161 11729161 0 ADMINISTRATIVE FEES 2987935 2713441 274494 MISC EXPENSES 1244589 1130252 114337 DDPA DUES, MEMBERSHIPS 877004 796436 80568 1201609 1091220 110389 681483109 676142191 5340918 0 8060252 3626107 46926067 49623889 1360000 0 2428174 1981178 22692163 13665794 9892161 9026369 86403945 130676005 48956231 31352040 1127232 1724567 205154062 228010155 60377051 64856267 3467522 4046006 4708670 3680952 68553243 72583225 X 0 0 0 0 136600819 155426930 136600819 155426930 205154062 228010155 15955658 2870453 0 X 0 1 X 1 0 1484639 1484639 9863607 4518223 5345384 2243521 2166735 76786 2410062 1913975 496087 6690334 5066861 1623473 9026369 DELTA DENTAL INSURANCE COMPANY 4885 C DELTA REINSURANCE CORPORATION 31347155 F 31352040 DUE TO SUBSIDIARIES AND AFFILIATES 3680952 3680952 X 249552606 0 249552606 447886161 447886161 697438767 233596948 0 233596948 447886161 447886161 681483109 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 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENT IN DELTA REINSURANCE CORPORATION 31347155 0 0 0 0 0 0 31347155 0 31347155 0 0 1 0 0 0 1 DELTA DENTAL COMMUNITY CARE FOUNDATION 560 MISSION STREET STE 1300 SAN FRANCISCO CA 94105 371570764 501(C)(3) 2422650 TO PROVIDE DENTAL EDUCATION TRUSTEES UNIVERSITY OF PA SMD 240 S 40TH ST PHILADELPHIA PA 19140 231352685 501(C)(3) 650000 TO PROVIDE DENTAL EDUCATION CHILDREN'S ORAL HEALTH INSTITUTE 9199 REISTERSTOWN RD OWINGS MILLS MD 21117 522048036 501(C)(3) 20000 TO PROVIDE DENTAL EDUCATION THE FOUNDATION FOR ENHANCING COMMUNITIES 200 N 3RD ST 8TH FL HARRISBURG PA 17101 010564355 501(C)(3) 20000 TO PROVIDE DENTAL EDUCATION TRES BONNE ANNEE 6426 ONE NORTH SECOND STREET HARRISBURG PA 17101 251888180 501(C)(3) 10000 TO PROVIDE DENTAL EDUCATION COOL CARS FOR KIDS INC 424 BRENTWOOD RD BALA CYNWYD PA 19004 813917740 501(C)(3) 10000 TO PROVIDE DENTAL EDUCATION SISTERS OF THE HUMILITY OF MARY PO BOX 354 VILLA MARIA PA 16155 250989253 501(C)(3) 5000 TO PROVIDE DENTAL EDUCATION MISC SMALL DONATIONS LESS THAN 5000 9600 TO PROVIDE DENTAL EDUCATION 17 0 PART I, LINE 2: THE ORGANIZATION AWARDS GRANTS FOR PROGRAMS THAT FOSTER DENTAL HEALTH AND EDUCATION. THROUGH THESE GRANTS THE ORGANIZATION HELPS FINANCE HEALTH, EDUCATION, AND RESEARCH PROJECTS IN DENTISTRY, HEALTH AND HUMAN SERVICES, AND CIVIC AND COMMUNITY AFFAIRS. THE TWO GRANTS ARE: (1) THE DENTAL HEALTH AND EDUCATION CONTRIBUTION, WHICH SUPPORTS DENTAL HEALTH AND AWARENESS PROGRAMS AND (2) THE STANDARD DENTAL RESEARCH GRANT, WHICH SUPPORTS PROFESSIONAL RESEARCH RELATED TO DENTAL HEALTH. GRANTS ARE AWARDED TO GROUPS THAT: (1) PROVIDE DENTISTRY FOR ECONOMICALLY DISADVANTAGED PERSONS; (2) PROVIDE DENTISTRY FOR GROUPS THAT ARE DENTALLY UNDERSERVED; (3) PROVIDE EDUCATION TO ADVANCE THE AWARENESS OR THE SCIENCE OF DENTISTRY; (4) PROMOTE PUBLIC DENTAL HEALTH; AND (5) ARE INVOLVED IN COMMUNITY ACTIVITIES RELATED TO DENTAL CARE. GRANT GUIDELINES: PRIORITY WILL GO TO PROJECTS THAT FOCUS ON ISSUES RELATED TO THE DELIVERY OF ORAL HEALTH CARE, INCLUDING THOSE WITH SIGNIFICANT POTENTIAL FOR IMPROVING ORAL HEALTH AND REDUCING TREATMENT COSTS. PRIORITY CONSIDERATION WILL GO TO RESEARCHERS FROM THE DENTAL SCHOOLS IN THE ENTERPRISE STATES, BUT WILL NOT BE LIMITED TO THESE INSTITUTIONS. PRIORITY WILL GO TO TWO TYPES OF STUDIES: (1) PILOT OR FEASIBILITY STUDIES LIKELY TO ENHANCE THE INVESTIGATOR'S CHANCE FOR LONG-TERM FUNDING FROM OTHER SOURCES; AND (2) COMPLETE PROJECTS CONSIDERED TO BE OF INTEREST TO THE HEALTH, EDUCATION, AND RESEARCH FUND, FOR WHICH OTHER SOURCES OF FUNDS ARE TRADITIONALLY UNAVAILABLE OR INSUFFICIENT. PRIORITY WILL GO TO STUDIES THAT EVALUATE THE OUTCOME OF PREVENTATIVE AND TREATMENT PROCEDURES. RETROSPECTIVE STUDIES OR THOSE INVOLVING ANALYSIS OF EXISTING DATA SHOULD BE CONSIDERED, RATHER THAN LONG-TERM FOLLOW-UP STUDIES, IN ORDER TO REDUCE THE YEARS REQUIRED TO OBTAIN DATA. OVERHEAD CHARGES WITHIN EACH ELIGIBLE GRANT WILL BE LIMITED TO EIGHT PERCENT. THE FUND WILL NORMALLY MAKE ONE TO TWO STANDARD RESEARCH GRANTS PER YEAR. INDIVIDUAL GRANTS WILL GENERALLY NOT EXCEED $40,000. 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. A SCREENING COMMITTEE REVIEWS ALL APPLICATIONS, WITH FINAL GRANT DECISIONS MADE BY THE FUND'S ADMINISTRATIVE COMMITTEE. X X X 1 1 X X X X X 0 1 0 1 0 1 0 1 0 BERGERT GLEN F CPA CONSULTANT 23312 176320 0 0 0 0 0 0 0 0 23312 176320 0 0 BARTH ANTHONY S PRESIDENT/CEO 0 1150000 0 4134625 0 135106 0 529628 0 30405 0 5979764 0 0 CASTRO MICHAEL J EXE. VICE PRES./CFO 0 566496 0 1289511 0 76554 0 -220930 0 26125 0 1737756 0 0 HANKINSON MICHAEL G EXE. VICE PRES./CLO 0 459996 0 1022084 0 99287 0 28350 0 23088 0 1632805 0 0 MARTINEZ BELINDA EXE. VICE PRES. 0 509850 0 1148146 0 54150 0 1731642 0 21892 0 3465680 0 0 PATEL NILESH C EXE. VICE PRES./COO 0 504000 0 1123030 0 24304 0 34707 0 8903 0 1694944 0 0 CHAVARRIA SARAH SR. VICE PRES. 0 135519 0 50000 0 5359 0 13175 0 7526 0 211579 0 0 DOERING RICK R SR. VICE PRES. 0 407692 0 822436 0 99561 0 41037 0 21592 0 1392318 0 0 GAREN KIRSTEN E SR. VICE PRES. 0 192000 0 0 0 8435 0 20160 0 10035 0 230630 0 0 JACKSON KEVIN L SR. VICE PRES. 0 393001 0 630919 0 43698 0 38377 0 30105 0 1136100 0 0 WEBER ALICIA F SR. VICE PRES. 0 400000 0 720950 0 41747 0 34641 0 23470 0 1220808 0 0 YALE KENNETH P DDS SR. VICE PRES. 0 341923 0 0 0 19908 0 28350 0 27596 0 417777 0 0 FOSTER JEANNE VICE PRES. 259000 0 244284 0 33553 0 115874 0 20255 0 672966 0 0 0 GRAYBILL RICHARD VICE PRES. 217369 0 185798 0 24504 0 112286 0 7264 0 547221 0 0 0 RODZINKA BARBARA A VICE PRES. 236207 0 175201 0 11473 0 51702 0 18448 0 493031 0 0 0 COOVER ROBERT DIRECTOR SALES 136937 0 188499 0 23796 0 103871 0 23020 0 476123 0 0 0 HAM TAMMY DIRECTOR ACCOUNT SERVICES 132171 0 105159 0 5640 0 63879 0 16888 0 323737 0 0 0 KETELSLEGER JAMES DIRECTOR ACCOUNTING & FINANCIAL REPO 155523 0 85343 0 4358 0 66641 0 18955 0 330820 0 0 0 KILBER DAVID E DENTAL DIRECTOR 171635 0 81876 0 5677 0 47559 0 17771 0 324518 0 0 0 MCKEE TIMOTHY SALES ACCOUNT EXECUTIVE 68429 0 405555 0 7474 0 65754 0 19696 0 566908 0 0 0 RADINE GARY D FORMER - OFFICER 0 200000 0 0 0 11836 0 292699 0 0 0 504535 0 0 PART I, LINE 1A FIRST CLASS BUSINESS TRAVEL IS REIMBURSED TO THE EXECUTIVE VICE PRESIDENTS, SENIOR VICE PRESIDENTS, AND GROUP VICE PRESIDENTS. FIRST CLASS BUSINESS TRAVEL IS NOT TREATED AS TAXABLE COMPENSATION. THE PRESIDENT AND EXECUTIVE VICE PRESIDENTS MAY BE REIMBURSED FOR ONE HEALTH OR SOCIAL CLUB UPON APPROVAL BY THE PRESIDENT. ONE SENIOR EXECUTIVE RECEIVED THIS BENEFIT IN 2017. THE COST OF THIS BENEFIT IS INCLUDED IN TAXABLE COMPENSATION. 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. THESE REIMBURSEMENTS ARE INCLUDED IN THE TAXABLE COMPENSATION OF THE REIMBURSED EMPLOYEES. PART I, LINE 3: COMPENSATION PAID TO THE CEO IS APPROVED BY THE EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS. THE COMMITTEE APPROVES COMPENSATION FOR THE ENSUING YEAR AFTER REVIEWING COMPARABILITY DATA PRESENTED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT, AN ASSESSMENT OF THE CEO'S PERFORMANCE OVER THE PRECEDING YEAR, AND THE ORGANIZATION'S PROGRAM ACCOMPLISHMENTS FOR THE YEAR. PART I, LINE 4B: CERTAIN EXECUTIVES PAID BY A RELATED ORGANIZATION PARTICIPATE IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PROGRAM. THE RELATED ORGANIZATION PROVIDES A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO CERTAIN OF ITS SENIOR EXECUTIVES AS SELECTED BY THE BOARD OF DIRECTORS. THE SUPPLEMENTAL RETIREMENT BENEFIT IS BASED ON EACH EXECUTIVE'S COMPENSATION AND YEARS OF SERVICE TO THE ENTERPRISE. THE BENEFIT IS SUBJECT TO THE RISK OF FORFEITURE IF REQUIRED YEARS OF SERVICE ARE NOT MET. ANNUAL DEFERRED COMPENSATION RELATED TO THIS PLAN IS REPORTED IN SCHEDULE J, PART II, COLUMN (C) FOR EACH PARTICIPANT AND REFLECTS THE CURRENT YEAR INCREASE OR DECREASE IN THE RELATED ORGANIZATION'S PENSION BENEFIT OBLIGATION ("PBO"), CALCULATED PURSUANT TO GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THE PBO INCREASE OR DECREASE INCLUDES CHANGES IN ACTUARIAL ASSUMPTIONS (E.G., APPLICABLE DISCOUNT RATE), AS WELL AS CHANGES IN COMPENSATION AND YEARS OF SERVICE. IN 2017, ANTHONY BARTH, MICHAEL CASTRO, AND BELINDA MARTINEZ PARTICIPATED IN THE PLAN. 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, CUSTOMER SATISFACTION 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. UPON DELEGATION OF THE BOARD TO THE EXECUTIVE COMMITTEE, THE CEO, AND THE MANAGEMENT COMMITTEE, THEY HAVE THE SOLE AND ABSOLUTE DISCRETION TO DETERMINE 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. 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) THE MAJORITY OF THE ORGANIZATION'S OFFICERS ARE PAID BY A RELATED ORGANIZATION. ACCORDINGLY, THEIR COMPENSATION IS REPORTED ON ROW (II). RICHARD J CLARK III DDS PARTICIPATING PROVIDER 450408 DENTAL CLAIM PAYMENTS 0 CHRISTOPHER J KOTCHICK DMD PARTICIPATING PROVIDER 333423 DENTAL CLAIM PAYMENTS 0 ERIC L SHIRLEY DMD PARTICIPATING PROVIDER 218520 DENTAL CLAIM PAYMENTS 0 ERIC R SMIGA DMD PARTICIPATING PROVIDER 176063 DENTAL CLAIM PAYMENTS 0 JOSHUA B WOLGIN DMD PARTICIPATING PROVIDER 155630 DENTAL CLAIM PAYMENTS 0 GODIVA CHOCOLATIER INC DIRECTOR DEBRA MAHER IS AN EXECUTIVE OF GODIVA CHOCOLATIER, INC. 583876 PREMIUM REVENUE 0 RUE21 DIRECTOR LORI KOBAYASHI IS AN EXECUTIVE OF RUE21 497837 PREMIUM REVENUE 0 FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS FOR THE COMPANY WERE AMENDED IN 2017 TO MAKE OFFICER TERMS SEPARATE FROM AND ACCRETIVE TO DIRECTOR TERMS, TO ESTABLISH A MAXIMUM OF THREE ONE-YEAR TERMS FOR ALL OFFICERS, AND TO PROVIDE FOR THE POSITION OF IMMEDIATE PAST CHAIR AS AN EX OFFICIO MEMBER OF THE BOARD AND EXECUTIVE COMMITTEE WITHOUT VOTE. IN ADDITION, PROVISIONS REGARDING THE STANDING COMMITTEES WERE AMENDED TO REFLECT CURRENT PRACTICE BY ELIMINATING THE DENTAL AFFAIRS COMMITTEE. 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 EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SERVES AS THE COMPENSATION COMMITTEE AND 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 YEAR. COMPENSATION PAID TO DIRECTORS IS APPROVED BY THE EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS 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 2017 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 35.4 MILLION ENROLLEES AND PROCESSING 47 MILLION CLAIMS. TOTAL REVENUE FOR THE ENTERPRISE WAS APPROXIMATELY $9.2 BILLION IN 2017. THE ORGANIZATION REPRESENTS APPROXIMATELY 8% 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. 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