2025-11-13T07:52:55-06:00 2024-12-31 540504608 BROWN EDWARDS & COMPANY LLP 3906 ELECTRIC ROAD ROANOKE VA 24018 990 2024-01-01 540844477 DELTA DENTAL OF VIRGINIA DELT 5409898000 5415 AIRPORT ROAD ROANOKE VA 240121303 R JAMES BARKER SECRETARY/TREASURER 5409898000 2025-11-10 1 0 PATRICK PITTMAN P00587461 5403450936 2025-11-10 2024 2025-03-06 01:10:19Z R JAMES BARKER 5415 AIRPORT ROAD ROANOKE VA 240121303 877742661 0 X WWW.DELTADENTALVA.COM X 1964 VA IMPROVE THE PUBLIC'S ORAL HEALTH. 10 9 75 0 0 0 0 0 801789932 854025829 5694351 7498309 25159 16379 807509442 861540517 2143539 2086663 0 0 11708780 12083823 0 0 0 777909296 832906374 791761615 847076860 15747827 14463657 198461939 207660484 69020399 71928450 129441540 135732034 ADVANCE THE PUBLIC'S ORAL HEALTH BY PROVIDING QUALITY DENTAL BENEFITS AT AFFORDABLE COST. 0 0 752996923 0 854025829 GROUP AND INDIVIDUAL PREPAID DENTAL CARE WAS PROVIDED FOR SUBSCRIBERS AND FAMILIES IF ENROLLED. 2086663 2086663 DELTA DENTAL OF VIRGINIA SUPPORTS ITS MISSION BY CONTRIBUTING TO THE DELTA DENTAL OF VIRGINIA FOUNDATION. THE FOUNDATION WORKS TO IMPROVE THE ORAL HEALTH OF ALL VIRGINIANS THROUGH FINANCIAL SUPPORT AND RESEARCH, EDUCATION INITIATIVES, AND PROGRAMS THAT PROVIDE ACCESS TO THE UNDERSERVED. THE COMPANY ALSO SUPPORTS OTHER NON-PROFIT ORGANIZATIONS WITHIN THE COMMUNITY. 755083586 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 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 0 0 1 62238 0 1 75 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X R JAMES BARKER 5409898000 5415 AIRPORT ROAD ROANOKE VA 24012 MS LAURA W THOMAS CHAIRMAN OF THE BOARD 2.00 4.00 X X 56375 0 0 MR THOMAS R BYRD DIRECTOR 2.00 4.00 X 0 57500 0 MR DANIEL E DRAPER DIRECTOR 1.00 2.00 X 1125 33500 0 MS JACQUELYN E STONE DIRECTOR 2.00 1.00 X 28875 0 0 MR DOUGLAS JUANARENA DIRECTOR 1.00 3.00 X 0 36375 0 MS SHARON M MUSCARELLA DIRECTOR 3.00 0.00 X 34138 0 0 DR A CAROLE PRATT DIRECTOR 3.00 1.00 X 32383 0 0 DR MCKINLEY L PRICE DIRECTOR 4.00 1.00 X 34625 0 0 DR FRANK P IUORNO JR DIRECTOR 3.00 0.00 X 28875 0 0 MR FRANK L LUCIA PRESIDENT & CEO 1.00 41.00 X X 0 2005346 100417 MR R JAMES BARKER SECRETARY/TREASURER 0.00 40.00 X 0 807215 88939 MR DAVID NOTARI SENIOR VP & COO 40.00 0.00 X 786996 0 100017 MR BRADLEY KNOPF VICE PRESIDENT 40.00 0.00 X 498817 0 62863 MR CHRISTOPHER PYLE VICE PRESIDENT 40.00 0.00 X 484866 0 55060 MR JASON REYNOLDS STAFF 40.00 0.00 X 282088 0 55717 MS MELISSA KIRSH STAFF 40.00 0.00 X 383301 0 71648 MR BRIAN KRAINER STAFF 40.00 0.00 X 297300 0 63674 MR MATTHEW MACDONALD STAFF 40.00 0.00 X 348852 0 74192 MR JOHN WILSON STAFF 40.00 0.00 X 263714 0 41390 3562330 2939936 713917 37 0 1 0 WYSSTA SERVICES INC PO BOX 86 STEVENS POINT WI 54481 TPA SERVICES 8208128 ENCARA INC 4515 AIRPORT ROAD ROANOKE VA 24012 MARKETING SERVICES 2778958 NEMER FIEGER & ASSOCIATES INC 6250 EXCELSIOR BLVD MINNEAPOLIS MN 55416 ADVERTISING SERVICES 410121 BLACKROCK INVESTMENT MANAGEMENT LLC PO BOX 978604 DALLAS TX 753978604 INVESTMENT MANAGEMENT 276063 INTERACTIVE DESIGN GROUP INC 301 6TH STREET SW ROANOKE VA 24016 ARCHITECT 167209 6 ASC CONTRACTS 524114 519273721 519273721 RISK PREMIUMS 524114 305219643 305219643 ASC FEES EARNED 524114 29532465 29532465 854025829 5361467 5361467 863396 847017 16379 16379 16379 15591969 1900000 14239456 1115671 1352513 784329 2136842 2136842 861540517 854025829 0 7514688 2086663 2086663 2394371 2394371 7489928 7489928 802293 802293 843478 843478 553753 553753 30728407 30728407 29845 29845 85264 85264 367531 367531 29612871 29612871 1126588 1126588 411057 411057 145931 145931 306241 306241 21214 21214 DENTAL CLAIMS 752996923 752996923 BROKERAGE COMMISSIONS A 8684827 8684827 STATE PREMIUM TAXES AND 6332151 6332151 BUSINESS DUES AND ASSOC 917263 917263 1140261 1140261 847076860 755083586 91993274 0 449 449 44297672 45380470 45008635 46734461 360989 306142 11943312 3597029 9460517 8346283 96275500 104082598 2100 2100 3056077 2807981 198461939 207660484 17493187 18260085 51527212 53668365 69020399 71928450 X 0 0 0 0 129441540 135732034 129441540 135732034 198461939 207660484 X 14463657 3826837 -12000000 X X 0 1 X 1 0 29500 29500 1 VIRGINIA SENATE DEMOCRAT CAUCUS PO BOX 71596 RICHMOND VA 23255 500 HOUSE DEMOCRATIC CAUCUS 1021 E CARY ST STE 1275 RICHMOND VA 23219 500 VIRGINIA FUTURE GENERATIONS PAC PO BOX 3604 RICHMOND VA 23235 500 REPUBLICAN COMMONWEALTH LEADERSHIP PAC PO BOX 71596 RICHMOND VA 23255 500 FRIENDS OF TODD PILLION 851 FRENCH MOORE JR BLVD ABINGTON VA 24210 500 MCNAMARA FOR DELEGATE PO BOX 21094 ROANOKE VA 24018 750 BALLARD FOR DELEGATE PO BOX 341 PEARISBURG VA 24134 500 DEEDS FOR STATE SENATE PO BOX 5462 CHARLOTTESVILLE VA 22905 750 MARSHALL FOR DELEGATE PO BOX 439 DANVILLE VA 24543 250 LUCAS FOR SENATE PO BOX 700 PORTSMOUTH VA 23705 750 SUROVELL FOR STATE SENATE PO BOX 289 MOUNT VERNON VA 22121 750 SUETTERLEIN FOR SENATE PO BOX 20237 ROANOKE VA 24018 250 FRIENDS OF LUKE TORIAN 4222 FORTUNA PLAZA 659 DUMFRIES VA 22025 750 SICKLES FOR DELEGATE PO BOX 10628 FRANCONIA VA 22310 500 PRICE FOR DELEGATE PO BOX 196 NEWPORT NEWS VA 23607 500 HAYES FOR DELEGATE 732 EDEN WAY N SUITE E 183 CHESAPEAKE VA 23320 500 HOUSE REPUBLICAN CAMPAIGN COMMITTEE PO BOX 71596 HENRICO VA 23255 750 FRIENDS OF LAMONT BAGBY PO BOX 15512 RICHMOND VA 23227 750 SULLIVAN FOR DELEGATE PO BOX 50753 ARLINGTON VA 22205 750 MICHAEL WEBERT FOR DELEGATE PO BOX 469 WARRENTON VA 20188 500 WILT FOR DELEGATE PO BOX 1425 HARRISONBURG VA 22803 500 FRIENDS OF MARK OBENSHAIN 2712 MALLARDS COURT RICHMOND VA 23233 750 FRIENDS OF DAVID BULOVA PO BOX 106 FAIRFAX STATION VA 22039 250 FRIENDS OF MARCUS SIMON PO BOX 958 FALLS CHURCH VA 22040 500 KARRIE DELANEY FOR DELEGATE PO BOX 230542 CENTREVILLE VA 20120 750 KRIZEK FOR DELEGATE 2201 WHITEOAKS DRIVE ALEXANDRIA VA 22306 250 LOPEZ FOR DELEGATE PO BOX 40366 ARLINGTON VA 22204 750 LOCKE FOR SENATE PO BOX 9048 HAMPTON VA 23670 750 MCPIKE FOR SENATE PO BOX 2819 WOODBRIDGE VA 22195 750 WILLETT FOR DELEGATE PO BOX 29428 HENRICO VA 23242 250 FRIENDS OF DON SCOTT 355 CRAWFORD STREET PORTSMOUTH VA 23704 1000 J WARD FOR DELEGATE PO BOX 7310 HAMPTON VA 23666 750 TERRY L AUSTIN FOR HOUSE OF DELEGATE PO BOX 398 BUCHANAN VA 24066 500 FRIENDS OF AMANDA BATTEN PO BOX 194 NORGE VA 23127 250 FRIENDS OF CHARNIELE HERRING PO BOX 11779 ALEXANDRIA VA 22312 750 HOPE FOR VIRGINIA PO BOX 3148 ARLINGTON VA 22203 250 DESTEPH FOR SENATE 588 CENTRAL DRIVE VIRGINIA BEACH VA 23454 750 FRIENDS OF MICHELLE MALDONADO 11151 VALLEY VIEW DRIVE 642 BRISTOW VA 20136 750 CANDI KING FOR VA PO BOX 524 DUMFRIES VA 22026 500 CHRIS RUNION FOR DELEGATE PO BOX 202 BRIDGEWATER VA 22812 500 WREN WILLIAMS FOR DELEGATE PO BOX 192 PEARISBURG VA 24134 500 MIKE JONES FOR DELEGATE PO BOX 25174 RICHMOND VA 23260 750 MICHAEL FEGGANS FOR VIRGINIA 900 COMMONWEALTH PLACE PMB 2141 VIRGINIA BEACH VA 23464 750 FRIENDS OF IRENE SHIN PO BOX 5501 HERNDON VA 20172 500 ADELE FOR DELEGATE PO BOX 5512 ARLINGTON VA 22205 250 PEAKE FOR SENATE 4925 BOONSBORO ROAD BOX 172 LYNCHBURG VA 24503 500 ROUSE FOR SENATE PO BOX 2864 VIRGINIA BEACH VA 23450 500 FRIENDS OF BRYCE REEVES PO BOX 7022 FREDERICKSBURG VA 22404 750 DESTINY FOR VIRGINIA 9962 BROOK RD 671 GLEN ALLEN VA 23059 750 FRIENDS OF CONVIRS-FOWLER PO BOX 6769 VIRGINIA BEACH VA 23456 500 MCDOUGLE FOR VIRGINIA PO BOX 187 MECHANICSVILLE VA 23111 750 STANLEY FOR SENATE 13508 BOOKER T WASHINGTON HWY MONETA VA 24121 500 ELECT CHRIS HEAD PO BOX 19130 ROANOKE VA 24019 500 RASOUL FOR DELEGATE 1417 PETERS CREEK ROAD NW ROANOKE VA 24017 250 O'QUINN FOR DELEGATE PO BOX 16325 BRISTOL VA 24209 500 MARSDEN FOR DELEGATE PO BOX 10889 BURKE VA 22009 750 2622902 2622902 8913991 3341556 5572435 306942 155996 150946 99477 99477 0 8346283 DEPOSITS 6686098 ADV. PREMIUMS AND DEPOSITS 28354813 RATE STABILIZATION RESERVE 3066680 DENTAL SERVICE CLAIMS RESERVES 13933801 BONUS ACCRUAL 546682 DEFERRED COMPENSATION 457B PLAN 1080291 53668365 864765154 3826837 3826837 860938317 367531 234669 602200 861540517 846474660 0 846474660 367531 234669 602200 847076860 PART XI, LINE 4B - OTHER ADJUSTMENTS: MISCELLANEOUS EXPENSE NETTED AGAINST SALE OF ASSETS 234,669. PART XII, LINE 4B - OTHER ADJUSTMENTS: MISCELLANEOUS EXPENSES 234,669. 1 DELTA DENTAL OF VIRGINIA FOUNDATION 5415 AIRPORT ROAD ROANOKE VA 24012 453230862 1991491 0 FUNDING TO SUPPORT DELTA DENTAL FOUNDATION AND FURTHER ITS MISSION VIRGINIA COMMEMORATIONS INC 1001 E BROAD ST STE 240 RICHMOND VA 23219 810703911 10000 0 VIC 250TH ANNIVERSARY SPONSOR BOYS & GIRLS CLUBS OF SW VIRGINIA 1714 9TH ST SE ROANOKE VA 24013 541867366 30000 0 2024 DELTA DENTAL PRESENTING SPONSOR 3 PART I LINE 2: THE COMPANY HAS PROCEDURES TO ENSURE THAT ALL PROVIDED ASSISTANCE IS PROPERLY APPROVED BY MANAGEMENT. CONTRIBUTIONS TO THE DELTA DENTAL OF VIRGINIA FOUNDATION ARE APPROVED BY THE BOARD OF DIRECTORS. X 1 1 X X X X X X 0 1 0 0 0 0 0 1 0 MR FRANK L LUCIA PRESIDENT & CEO 0 914248 0 1073362 0 17736 0 69000 0 31417 0 2105763 0 0 MR R JAMES BARKER SECRETARY/TREASURER 0 457957 0 347623 0 1635 0 69000 0 19939 0 896154 0 0 MR DAVID NOTARI SENIOR VP & COO 529622 0 246790 0 10584 0 69000 0 31017 0 887013 0 0 0 MR BRADLEY KNOPF VICE PRESIDENT 278854 0 217544 0 2419 0 40650 0 22213 0 561680 0 0 0 MR CHRISTOPHER PYLE VICE PRESIDENT 328483 0 155769 0 614 0 41667 0 13393 0 539926 0 0 0 MS MELISSA KIRSH STAFF 297101 0 83839 0 2361 0 41931 0 29717 0 454949 0 0 0 MR MATTHEW MACDONALD STAFF 262351 0 85030 0 1471 0 41931 0 32261 0 423044 0 0 0 MR BRIAN KRAINER STAFF 161415 0 134893 0 992 0 37056 0 26618 0 360974 0 0 0 MR JASON REYNOLDS STAFF 82785 0 198857 0 446 0 34605 0 21112 0 337805 0 0 0 MR JOHN WILSON STAFF 94864 0 166983 0 1867 0 31903 0 9487 0 305104 0 0 0 PART I, LINE 1A 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 IS 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 2024. 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 A, LINE 4 THE ARTICLES OF INCORPORATION WERE AMENDED AND RESTATED ON DECEMBER 11, 2024. THE AMENDMENT SET A RANGE FOR THE NUMBER OF DIRECTORS TO A MINIMUM OF SEVEN (7) AND A MAXIMUM OF SEVENTEEN (17) ESTABLISHED TERMS OF THREE (3) YEARS AND LIMITED THE NUMBER OF CONSECUTIVE TERMS A DIRECTOR COULD SERVE TO NO MORE THAN FOUR (4). A COPY OF THE AMENDED AND RESTATED ARTICLES ARE ATTACHED. FORM 990, PART VI, SECTION A, LINE 6 DELTA DENTAL OF VIRGINIA IS A NON-STOCK CORPORATION ORGANIZED UNDER TITLE 13.1 OF THE CODE OF VIRGINIA. CORVESTA, INC. IS THE SOLE MEMBER OF DDVA AS DEFINED IN SECTION 13.1-803 OF THE CODE OF VIRGINIA. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER ELECTS THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER VOTES ON QUESTIONS OF MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION; AND AMENDING THE ARTICLES OF INCORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE FULL DOCUMENT IS MADE AVAILABLE TO THE BOARD OF DIRECTORS PRIOR TO FILING. ALSO, MEMBERS OF THE BOARD OF DIRECTORS REVIEW THE PREPARATION PROCESS WITH SENIOR MEMBERS OF MANAGEMENT. FORM 990, PART VI, SECTION B, LINE 12C DELTA DENTAL OF VIRGINIA 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 THE APPLICABLE FORMS ARE AVAILABLE FOR PUBLIC INSPECTION VIA REQUEST AND REGULATORY FILINGS. FORM 990, PART XI, LINE 9: SURPLUS TRANSFER TO HOLDING COMPANY -12,000,000. FORM 990, PART XII, LINE 2C THERE HAVE BEEN NO CHANGES TO DELTA DENTAL OF VIRGINIA'S OVERSIGHT PROCESS OF THE AUDIT OR ITS SELECTION OF AN INDEPENDENT AUDITOR. CORVESTA INC 5415 AIRPORT ROAD ROANOKE VA 24012 205945158 HOLDING COMPANY VA 501(C)(4) N/A 0 DELTA DENTAL OF VIRGINIA FOUNDATION 5415 AIRPORT ROAD ROANOKE VA 24012 453230862 PROMOTION AND ADVANCEMENT OF ORAL HEALTH FOR THE PEOPLE OF VA VA 501(C)(3) LINE 12A, I DELTA DENTAL OF VIRGINIA 1 REVOLV INC 5415 AIRPORT ROAD ROANOKE VA 24012 271018474 PROVIDES TPA SERVICES TO DENTAL INSURANCE COMPANIES VA N/A C 0 STRYDEN INC 5415 AIRPORT ROAD ROANOKE VA 24012 352637734 PROVIDES VISION CARE INSURANCE VA N/A C 0 1 1 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 1 0 DELTA DENTAL OF VIRGINIA FOUNDATION B 1991491 FAIR MARKET VALUE