2025-11-05T09:35:44-06:00 2024-12-31 991856619 GRANT THORNTON ADVISORS LLC 53 STATE STREET SUITE 1600 BOSTON MA 02109 990 2024-01-01 362612058 DELTA DENTAL OF ILLINOIS DELT 6307184700 111 SHUMAN BOULEVARD NAPERVILLE IL 60563 JOHN DECRISTOFARO AVP FINANCE & CONTROLLER 6307184700 2025-11-05 1 1 ERIN COUTURE P01390592 3128560200 2025-11-05 2024 2025-03-06 01:10:19Z PRAVEEN THADANI 111 SHUMAN BOULEVARD NAPERVILLE IL 60563 1033301367 0 X WWW.DELTADENTALIL.COM X 1967 IL IMPROVE THE ORAL HEALTH OF ILLINOIS RESIDENTS BY PROVIDING DENTAL BENEFITS & OTHER SERVICES. 13 9 211 0 0 0 0 0 1009444876 1018917200 320343 3435712 16440 16440 1009781659 1022369352 979240 464743 923001594 939190243 23202079 22538154 0 0 0 62900764 61116026 1010083677 1023309166 -302018 -939814 212518929 216301789 54279839 55654022 158239090 160647767 IMPROVE THE ORAL HEALTH OF ILLINOIS RESIDENTS BY PROVIDING DENTAL BENEFITS & OTHER SERVICES. 0 0 999770190 464743 1018917200 DELTA DENTAL OF ILLINOIS (DDIL) IS A NOT-FOR-PROFIT CORPORATION WHICH MAINTAINS AND OPERATES A DENTAL CARE PLAN TO APPROXIMATELY 2,807,000 INDIVIDUALS. DDIL IS COMMITTED TO ITS MISSION TO DELIVER EXCEPTIONAL SERVICES TO OUR STAKEHOLDERS AND IMPROVE THE ORAL HEALTH OF THE COMMUNITIES WE SERVE. IN 2024, DDIL GRANTED $464,743 TO DELTA DENTAL OF ILLINOIS FOUNDATION, A 501(C)(3) CHARITABLE ORGANIZATION TO PROMOTE THE IMPROVEMENT OF DENTAL EDUCATION AND ACCESS TO DENTAL CARE IN ILLINOIS. 999770190 0 0 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 1 72560 0 1 211 1 0 0 0 0 0 0 1 0 X 13 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X JOHN DECRISTOFARO 6307184700 111 SHUMAN BOULEVARD NAPERVILLE IL 60563 OMAR DUQUE COMMITTEE CHAIR 3.00 0.00 X 52038 0 0 DEAN MALONE COMMITTEE CHAIR 3.00 0.00 X 51268 0 0 DR GENARO ROMO CHAIRMAN 5.00 0.00 X X 84724 0 0 JANE HAYS VICE CHAIR 3.00 0.00 X 57852 0 0 DR CISSY FURUSHO COMMITTEE CHAIR 3.00 0.00 X 47392 0 0 DR FRANK MAGGIO DIRECTOR 2.00 0.00 X 44500 0 0 LORI GOLD PATTERSON DIRECTOR 2.00 0.00 X 41944 0 0 JOSEPH LEO COMMITTEE CHAIR 3.00 0.00 X 41111 0 0 CLARENCE RED III DIRECTOR (AS OF 01/2024) 2.00 0.00 X 41000 0 0 TODD PETERSEN DIRECTOR (AS OF 01/2024) 2.00 0.00 X 41000 0 0 BRIAN SAMMARCO PAST CHAIR 2.00 0.00 X 51837 0 0 DR RONALD RIGGINS DIRECTOR 2.00 0.00 X 21500 0 0 PEGGY GARTIN DIRECTOR (AS OF 01/2024) 2.00 0.00 X 0 0 0 JOHN MAPLES PRESIDENT & CEO 40.00 5.00 X 1700983 0 7384 TERRI BON TREAS, SEC., VP OF FIN & CFO 40.00 5.00 X 717411 0 44859 KARYN GLOGOWSKI VP/DIRECTOR OF SALES 40.00 0.00 X 469016 0 42503 ALEXANDRA PIETRINI VP, GENERAL COUNSEL 40.00 5.00 X 423578 0 34424 RHEAANA TOWNER GUESS VP PEOPLE & DIVERSITY OFFICER 40.00 0.00 X 409948 0 31267 MICHAEL WHITE VP & GM TRUASSURE 40.00 0.00 X 389372 0 2054 ANN MARIE WALKER VP CORP. COMMUNICATIONS 40.00 0.00 X 383087 0 21302 LORA VITEK EXECUTIVE DIRECTOR OF FOUNDATION 5.00 40.00 X 238106 0 19303 JENNIFER HOCKIN VP OPERATIONS 40.00 0.00 X 302014 0 30200 ROBERT MAXWELL SR SALES EXECUTIVE 40.00 0.00 X 183363 0 44659 JOHN DECRISTOFARO SR. DIRECTOR FINANCE & CONTROLLER 40.00 0.00 X 256480 0 32329 STACY BEITZEL MANAGER CLIENT RELATIONS 40.00 0.00 X 266176 0 25726 LYNN FILIPPELLI DIRECTOR HUMAN RESOURCES 40.00 0.00 X 228170 0 35596 DR JASON GRINTER DIRECTOR DENTAL SERVICES 40.00 0.00 X 245761 0 25544 6789631 0 397150 48 0 1 0 WYSSTA SERVICES INC 3100 BUSINESS PARK DRIVE STEVENS POINT WI 54482 ADMIN SYSTEMS 4075550 GLOWTOUCH LLC 9931 CORPORATE CAMPUS DR STE 1400 LOUISVILLE KY 40223 SUPPORT AGENT CALL CENTER 1253392 RICHARDS GRAPHIC COMMUNICATIONS 2700 VAN BUREN ST BELLWOOD IL 60104 PRINT VENDOR 1189349 VENTURES SOLUTIONS INC 1170 GREY FOX ROAD ARDEN HILLS MN 55112 INVOICE/CHECK PRINT VENDOR 1140065 ENCARA INC 5415 AIRPORT ROAD ROANOKE VA 24012 MARKETING 1113173 34 PREMIUMS 524114 1018917200 1018917200 1018917200 989993 989993 16440 0 16440 16440 16440 13377734 10932015 2445719 2445719 2445719 1022369352 1018917200 0 3452152 464743 464743 939190243 939190243 6114282 6114282 113036 113036 11773674 6739606 5034068 950197 367082 583115 2259154 991139 1268015 1327811 521113 806698 437391 437391 315747 315747 325840 325840 1696534 578826 1117708 2528514 237937 2290577 526312 503308 23004 27369862 27400718 -30856 4139438 2262580 1876858 77670 19751 57919 57127 14588 42539 820399 152759 667640 725743 725743 BROKER COMMISSIONS 13819409 13819409 IT PLATFORM MULTIYEAR T 3511972 3511972 PRINTING & PUBLICATIONS 1451473 1211493 239980 INSURANCE DEPT. FEES 1201005 1133629 67376 2111590 649294 1462296 1023309166 999770190 23538976 0 13082694 5898308 38877531 33269391 1391281 2026707 25633288 14805378 11316388 10827910 110463902 121139422 36848814 42479040 0 0 538319 661011 212518929 216301789 22113468 20291225 7679601 8989011 24486770 26373786 54279839 55654022 X 0 0 0 0 158239090 160647767 158239090 160647767 212518929 216301789 -939814 3348491 0 X X 0 1 X 1 0 0 0 0 0 1 0 3625539 3625539 16066877 9396601 6670276 0 3291795 2836793 455002 2649077 2571984 77093 10827910 CLOSELY-HELD EQUITY INTERESTS 19272057 F INVESTMENT IN JOINT VENTURES 14506311 F LIMITED PARTNERSHIP 8700672 F 42479040 UNPAID CLAIMS AND CLAIMS ADJUSTMENT 17682000 SELF-INSURED UNPAID CLAIMS 8034438 INTERCOMPANY PAYABLE 657348 26373786 X 241224804 0 241224804 781144548 781144548 1022369352 246057535 0 246057535 325839 776925792 777251631 1023309166 PART X, LINE 2: ASC 740 FOOTNOTE: DELTA DENTAL OF ILLINOIS IS ORGANIZED AS A NONPROFIT DENTAL CARE PLAN FOR FEDERAL INCOME TAX PURPOSES UNDER SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE AND, AS SUCH, DOES NOT PAY FEDERAL INCOME TAXES. DELTA DENTAL OF ILLINOIS IS EXEMPT FROM STATE INCOME TAXES. THERE WERE NO SIGNIFICANT PENALTIES OR INTEREST RECOGNIZED DURING THE YEAR OR ACCRUED AT YEAR END. PART XI, LINE 4B - OTHER ADJUSTMENTS: ASC REVENUE 777,435,579. GROSS RENTAL INCOME 16,440. NII\EQUITY IN SUBS\INVESTMENT FEES 989,992. REALIZED GAINS 2,445,719. MISC REVENUE 256,818. PART XII, LINE 4B - OTHER ADJUSTMENTS: SELF IMPOSED RENT -1,206,400. ASC CLAIMS 743,799,593. ASC ADMIN 33,635,986. DEPRECIATION 642,321. DISCOUNT TIRES CLAIMS 54,292. 1 DELTA DENTAL OF ILLINOIS FOUNDATION 111 SHUMAN BOULEVARD NAPERVILLE IL 60563 262700504 501(C)(3) 464743 0 PROMOTE ORAL HEALTH OF IL RESIDENTS 1 PART I, LINE 2: GRANTS AND OTHER ASSISTANCE DELTA DENTAL OF ILLINOIS DIRECTORS AND OFFICERS HAVE THE MAJORITY OF SEATS ON THE DELTA DENTAL OF ILLINOIS FOUNDATION BOARD, AND THEREFORE MONITOR AND APPROVE HOW GRANT MONEY IS USED AND TRACKED. X 1 1 X X X X X 0 0 0 0 0 0 0 1 0 JOHN MAPLES PRESIDENT & CEO 878945 0 787674 0 34364 0 0 0 7384 0 1708367 0 0 0 TERRI BON TREAS, SEC., VP OF FIN & CFO 501027 0 206928 0 9456 0 30500 0 14359 0 762270 0 0 0 KARYN GLOGOWSKI VP/DIRECTOR OF SALES 295294 0 167707 0 6015 0 29077 0 13426 0 511519 0 0 0 ALEXANDRA PIETRINI VP, GENERAL COUNSEL 285932 0 128088 0 9558 0 23000 0 11424 0 458002 0 0 0 RHEAANA TOWNER GUESS VP PEOPLE & DIVERSITY OFFICER 277270 0 123120 0 9558 0 15019 0 16248 0 441215 0 0 0 ANN MARIE WALKER VP CORP. COMMUNICATIONS 265529 0 108000 0 9558 0 18802 0 2500 0 404389 0 0 0 MICHAEL WHITE VP & GM TRUASSURE 269870 0 109944 0 9558 0 0 0 2054 0 391426 0 0 0 JENNIFER HOCKIN VP OPERATIONS 237740 0 54716 0 9558 0 30200 0 0 0 332214 0 0 0 STACY BEITZEL MANAGER CLIENT RELATIONS 164001 0 95857 0 6318 0 25544 0 182 0 291902 0 0 0 JOHN DECRISTOFARO SR. DIRECTOR FINANCE & CONTROLLER 198720 0 56236 0 1524 0 22205 0 10124 0 288809 0 0 0 DR JASON GRINTER DIRECTOR DENTAL SERVICES 201585 0 42898 0 1278 0 20800 0 4744 0 271305 0 0 0 LYNN FILIPPELLI DIRECTOR HUMAN RESOURCES 187731 0 39917 0 522 0 30500 0 5096 0 263766 0 0 0 LORA VITEK EXECUTIVE DIRECTOR OF FOUNDATION 159422 0 69120 0 9564 0 11802 0 7501 0 257409 0 0 0 ROBERT MAXWELL SR SALES EXECUTIVE 94770 0 82894 0 5699 0 30500 0 14159 0 228022 0 0 0 PART I, LINE 1A HEALTH AND SOCIAL DUES THE CEO'S SOCIAL DUES (COUNTRY CLUB) ARE PAID BY THE ORGANIZATION. ONLY ONE MONTH WAS PAID IN 2024. PART I, LINE 7 NON-FIXED PAYMENTS AS INDICATED IN SCHEDULE J, PART II, PERSONS LISTED ON FORM 990, PART VII, SECTION A RECEIVED A BONUS BASED ON PERFORMANCE AND THE FINANCIAL RESULTS OF THE ORGANIZATION. THIS BONUS WAS APPROVED BY THE BOARD. DR CISSY FURUSHO DIRECTOR 345431 COMPENSATION 0 DR RONALD RIGGINS DIRECTOR 182936 COMPENSATION 0 DR GENARO ROMO DIRECTOR 645484 COMPENSATION 0 DR CLARENCE RED III DIRECTOR 369411 COMPENSATION 0 SCHEDULE L, PART IV: TRANSACTIONS WITH INTERESTED PERSONS(A) NAME OF PERSON: DR. CISSY FURUSHO THROUGH DRS KOLLMAN & FURUSHO DENTISTRY(D) DESCRIPTION OF TRANSACTION: PAYMENTS TO DENTAL PRACTICE FOR DENTAL SERVICES PROVIDED UNDER DENTAL INSURANCE POLICY. COMPENSATION WAS AT AN ARM'S LENGTH.(A) NAME OF PERSON: DR. RONALD RIGGINS THROUGH RIVERSIDE DENTISTRY LLC(D) DESCRIPTION OF TRANSACTION: PAYMENTS TO DENTAL PRACTICE FOR DENTAL SERVICES PROVIDED UNDER DENTAL INSURANCE POLICY. COMPENSATION WAS AT AN ARM'S LENGTH.(A) NAME OF PERSON: DR. GENARO ROMO THROUGH ROMO DENTAL PC & ROMO DENTAL II PC(D) DESCRIPTION OF TRANSACTION: PAYMENTS TO DENTAL PRACTICE FOR DENTAL SERVICES PROVIDED UNDER DENTAL INSURANCE POLICY. COMPENSATION WAS AT AN ARM'S LENGTH.(A) NAME OF PERSON: DR. CLARENCE RED III THROUGH R&R ORTHODONTICS LLC & RED ORTHODONTICS LTD(D) DESCRIPTION OF TRANSACTION: PAYMENTS TO DENTAL PRACTICE FOR DENTAL SERVICES PROVIDED UNDER DENTAL INSURANCE POLICY. COMPENSATION WAS AT AN ARM'S LENGTH. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS UNDER THE ENABLING STATUTE THAT GOVERNS THE ORGANIZATION - THE ILLINOIS DENTAL SERVICE PLAN ACT - THE MEMBERS OF DELTA DENTAL OF ILLINOIS ARE THE PARTICIPATING DENTISTS (DEFINED AS ANY DENTIST LICENSED IN ILLINOIS TO PRACTICE DENTISTRY WHO IS REPUTABLE AND IN GOOD STANDING AND HAS SIGNED AN AGREEMENT TO BECOME A PARTICIPATING DENTIST OF THE ORGANIZATION) AND THE GROUP SUBSCRIBERS WHO PURCHASE A DENTAL BENEFIT PROGRAM FROM THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR STOCKHOLDERS WHO MAY ELECT AT THE ANNUAL MEMBERSHIP MEETING OF THE ORGANIZATION, THE MEMBERS REFERENCED IN PART VI, LINE 6 ELECT THE MEMBERS OF THE GOVERNING BODY, I.E. DIRECTORS, WHOSE TERM OF DIRECTORSHIP HAS EXPIRED. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS OR STOCKHOLDERS WHO MAY ELECT AT THE ANNUAL MEMBERSHIP MEETING OF THE ORGANIZATION, THE MEMBERS REFERENCED IN PART VI, LINE 6 ELECT THE MEMBERS OF THE GOVERNING BODY, I.E. DIRECTORS, WHOSE TERM OF DIRECTORSHIP HAS EXPIRED. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF THE ORGANIZATION RETAINS THE SERVICES OF A PROFESSIONAL SERVICES FIRM TO ASSIST IN THE PREPARATION OF THE ORGANIZATION'S FORM 990. THE PROFESSIONAL SERVICES FIRM ASSISTS MANAGEMENT IN PREPARING AND FINALIZING THE FORM 990. THE DRAFT OF FORM 990, INCLUDING ALL SCHEDULES, IS REVIEWED BY THE AUDIT AND FINANCE COMMITTEE, AND THEN DISTRIBUTED TO ALL VOTING MEMBERS OF THE GOVERNING BODY, I.E. THE DIRECTORS. THE ORGANIZATION'S MANAGEMENT, AND IF NEEDED THE PROFESSIONAL SERVICES FIRM, ADDRESS ANY QUESTIONS OR COMMENTS SUBMITTED BY THE ORGANIZATION'S GOVERNING BODY BEFORE FILING ITS FORM 990. AFTER THE AUDIT AND FINANCE COMMITTEE'S REVIEW AND MANAGEMENT ADDRESSES QUESTIONS OR COMMENTS FROM THE DIRECTORS, THE DRAFT FORM 990 IS FINALIZED AND FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY MONITORING & ENFORCEMENT LEGAL COUNSEL FOR THE ORGANIZATION REVIEWS THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ANNUALLY WITH THE OFFICERS, DIRECTORS (TRUSTEES) AND KEY EMPLOYEES. AFTER THIS REVIEW, THE INDIVIDUALS OCCUPYING THESE POSITIONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. POTENTIAL CONFLICTS ARE LOGGED WITH THE SECRETARY OF THE ORGANIZATION AND ANY CHANGES TO THE DISCLOSURE FORM ARE TO BE REPORTED TO THE CORPORATE COUNSEL OF THE ORGANIZATION. IF A CONFLICT ARISES, THESE INDIVIDUALS ARE ASKED TO RECUSE THEMSELVES. FORM 990, PART VI, SECTION B, LINE 15 PROCESS OF DETERMINING COMPENSATION CEO AND OTHER TOP MANAGEMENT OFFICIALS COMPENSATION IS REVIEWED BY THE BOARD OF DIRECTORS. THE BOARD PERIODICALLY ENGAGES AN INDEPENDENT CONSULTING FIRM TO ADVISE OF COMPENSATION LEVELS OF SIMILARLY SITUATED CEOS AND OTHER TOP MANAGEMENT OFFICIALS BASED UPON SURVEYS AND DATA PROVIDED BY OTHER ORGANIZATIONS AS LISTED ON THEIR FORM 990. THIS DATA, OR THE DATA DELTA DENTAL OF ILLINOIS 36-2612058 REPRESENTED TO THE COMPENSATION COMMITTEE AT SCHEDULED MEETINGS AND MINUTES OF THESE MEETINGS ARE CONTEMPORANEOUSLY PREPARED. THE COMMITTEE MAKES A RECOMMENDATION FOR CEO COMPENSATION TO THE BOARD FOR APPROVAL. EXECUTIVE COMPENSATION IS REVIEWED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE THROUGH APPLICABLE GOVERNMENTAL AGENCIES; THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON WRITTEN REQUEST TO THE ORGANIZATION. PART XII, LINE 2B THE ORGANIZATION'S 2024 AUDITED FINANCIAL STATEMENTS WERE PREPARED ON THE STATUTORY BASIS OF ACCOUNTING. HOWEVER, IN ORDER TO PROVIDE FULL TRANSPARENCY AND ACCURATELY REPRESENT THE ACTIVITIES OF THE ORGANIZATION, THE FORM 990 IS PREPARED USING THE ACCRUAL METHOD OF ACCOUNTING. THE RECONCILIATION BETWEEN THE AUDITED STATUTORY FINANCIAL STATEMENTS AND THE FINANCIALS PRESENTED ON THE FORM 990 IS ILLUSTRATED IN THE SCHEDULE D RECONCILIATIONS. DELTA DENTAL OF ILLINOIS FOUNDATION 111 SHUMAN BOULEVARD NAPERVILLE IL 60563 262700504 ORAL HEALTH IL 501(C)(3) LINE 7 DDIL 1 NORTHWINDS TECHNOLOGY SOLUTION 111 SHUMAN BOULEVARD NAPERVILLE IL 60563 TECHNOLOGY DE DDIL DDWI & CORVESTA -615357 11080125 0 1 0.33330 CONCORDE INVESTMENT HOLDING LLC 1513 COUNTY CLUB ROAD SHERWOOD AR 72120 INVESTMENT HOLDING COMPANY DE TRUTEC HOLDING COMPANY OMEGA ADMINISTRATORS -72406 8524416 0 1 0.50000 TRUASSURE INSURANCE COMPANY 111 SHUMAN BOULEVARD NAPERVILLE IL 60563 363757528 DENTAL INS. IL TRUTEC HOLDING COMPANY C -2670282 10189852 1.00000 1 PROTEC INSURANCE COMPANY 111 SHUMAN BOULEVARD NAPERVILLE IL 60563 320416457 HEALTH INS. IL TRUTEC HOLDING COMPANY C 1124054 10868538 1.00000 1 TRUASSURE INSURANCE COMPANY OF COLORADO 111 SHUMAN BOULEVARD NAPERVILLE IL 60563 812595283 DENTAL INS. CO TRUTEC HOLDING COMPANY C 68410 2203873 1.00000 1 TRUTEC HOLDING COMPANY 111 SHUMAN BOULEVARD NAPERVILLE IL 60563 611744536 INSURANCE HOLDING COMPANY IL DDIL C 1000 1.00000 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 DELTA DENTAL OF ILLINOIS FOUNDATION B 88568 FMV NORTHWINDS TECHNOLOGY SOLUTIONS LLC M 21511828 FMV DELTA DENTAL OF ILLINOIS FOUNDATION O 376175 FMV TRUASSURE INSURANCE COMPANY Q 1502462 FMV PROTEC INSURANCE COMPANY Q 591243 FMV NORTHWINDS TECHNOLOGY SOLUTIONS LLC P 3283906 FMV NORTHWINDS TECHNOLOGY SOLUTIONS LLC Q 300698 FMV PROTEC INSURANCE COMPANY R 6817726 FMV CONCORDE INVESTMENT HOLDING LLC B 7912849 FMV