DELTA DENTAL PLAN OF MICHIGAN: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- DELTA DENTAL PLAN OF MICHIGAN (EIN 38-1791480)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-13
- IRS object ID
- 201303179349303015
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-13T12:23:08-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381357951 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORANPLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 MICHIGAN AVE PO BOX 2500 | AddressLine1 |
| City | EAST LANSING | City |
| State | MI | State |
| ZIP Code | 488262500 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381791480 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL PLAN OF MICHIGAN INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | DELT | NameControl |
| Phone | 5173496000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4100 OKEMOS ROAD | AddressLine1 |
| City | OKEMOS | City |
| State | MI | State |
| ZIP Code | 48864 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GORAN JURKOVIC | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 5173496000 | Phone |
| Date Signed | 2013-11-11 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SUSAN MIENCIER CPA | Name |
| PTIN | P00842339 | PTIN |
| Phone | 5173326200 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | LAURA L CZELADA | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4100 OKEMOS ROAD | AddressLine1 |
| City | OKEMOS | City |
| State | MI | State |
| ZIP Code | 48864 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1620778564 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.DDPMI.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1957 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | TO BE THE LEADER IN OUR MARKETS, TO DELIVER UNMATCHED QUALITY AND VALUE IN OUR PROGRAMS AND SERVICES, AND TO VIGOROUSLY PROMOTE THE IMPORTANCE OF ORAL HEALTH AS AN ESSENTIAL PART OF OVERALL HEALTH. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 18 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 15 | NbrIndependentVotingMembers |
| Total Nbr Employees | 821 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 9726656 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -731097 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 1319971581 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 1418932444 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3095297 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4954065 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 52993475 | OtherRevenuePriorYear |
| Other Revenue Current Year | 57697337 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1376060353 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1481583846 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 6068000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 98210 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 1182628421 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 1262553497 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 66254288 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 79566773 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 79230240 | OtherExpensePriorYear |
| Other Expenses Current Year | 83895504 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1334180949 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1426113984 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 41879404 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 55469862 | RevenuesLessExpensesCY |
| Total Assets BOY | 418291162 | TotalAssetsBOY |
| Total Assets EOY | 485073759 | TotalAssetsEOY |
| Total Liabilities BOY | 154393088 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 177476965 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 263898074 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 307596794 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO BE THE LEADER IN OUR MARKETS, TO DELIVER UNMATCHED QUALITY AND VALUE IN OUR PROGRAMS AND SERVICES, AND TO VIGOROUSLY PROMOTE THE IMPORTANCE OF ORAL HEALTH AS AN ESSENTIAL PART OF OVERALL HEALTH. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 1359323074 | Expense |
| Grants | 98210 | Grants |
| Revenue | 1466446875 | Revenue |
| Description | PROMOTING DENTAL CAREDELTA DENTAL PLAN OF MICHIGAN, INC. IS A LEADING GROUP DENTAL BENEFITS PROVIDER IN THE MIDWEST. THE PURPOSE OF THE ORGANIZATION IS TO ADVANCE AND PROMOTE THE IMPROVEMENT OF ORAL HEALTH. THIS IS DONE BY OFFERING INNOVATIVE, COST-EFFECTIVE PRODUCTS THAT MEET THE NEEDS OF CUSTOMERS. THIS WAS DEMONSTRATED IN 2012 BY PAYING OUT OVER $1.26 BILLION IN CLAIMS AND BY PROVIDING DENTAL BENEFITS FOR THE PUBLIC AND ADVANCING THE SCIENCE OF DENTISTRY. IN ADDITION, OVER 8 MILLION CLAIMS WERE PROCESSED FOR OVER 2.3 MILLION SUBSCRIBERS.COST SAVING STRATEGIESDELTA DENTAL BENEFIT PLANS ARE COMMITTED TO SAVING GROUPS AND SUBSCRIBERS MONEY. THE DELTA DIFFERENCE IS AN INTEGRATION OF ACTIVITIES; SUCH AS COST MANAGEMENT POLICIES, FEE REDUCTION AGREEMENTS WITH DENTISTS, AND AN ANTI-FRAUD HOTLINE, PUT TO WORK ENSURING QUALITY, COST-EFFECTIVE DENTAL BENEFIT DELIVERY. IN 2012, THE DELTA DIFFERENCE SAVED GROUPS AND SUBSCRIBERS NEARLY $1 BILLION. IN ADDITION, THE DELTA DIFFERENCE HELPS KEEP OUR TREND BELOW THE NATIONAL INFLATIONARY TREND IN DENTAL BENEFITS.ANOTHER COST SAVING STRATEGY WAS THE ADVENT OF A SECURE WEB SITE ALLOWING DENTAL OFFICES TO SUBMIT AND REVIEW CLAIMS, CHECK ELIGIBILITY AND GET REIMBURSED VIA ELECTRONIC DIRECT DEPOSIT. MANY DENTISTS MAIL CLAIMS INCURRING POSTAGE COSTS UP TO 70 CENTS PER CLAIM. BY USING THE DENTAL OFFICE TOOLKIT, THESE COSTS ARE REDUCED TO ZERO. THE ONLINE TOOL REDUCES STAFF TIME FOR CLAIMS PROCESSING AND WILL ULTIMATELY LOWER THE COST OF DOING BUSINESS FOR EVERYONE, INCLUDING CUSTOMERS AND SUBSCRIBERS.QUALITY INITIATIVES AND RESULTSBRINGING QUALITY TO ALL WE DO IS THE QUALITY POLICY FOR DELTA DENTAL PLAN OF MICHIGAN, INC. THE AFFILIATED DELTA DENTAL PLANS OF MICHIGAN, OHIO AND INDIANA HOLD THE PRESTIGIOUS ISO 9001 CERTIFICATION, UNDERSCORING OUR COMMITMENT TO PROVIDING QUALITY PRODUCTS AND SERVICES THAT SURPASS CUSTOMERS EXPECTATIONS. QUALITY STANDARDS ARE EXTREMELY RIGOROUS AND GUARANTEE THAT DELTA DENTAL HAS DOCUMENTED ITS QUALITY PROCEDURES AND SYSTEMS THROUGHOUT THE COMPANY. THE LONGSTANDING COMMITMENT TO PROVIDING QUALITY TO CUSTOMERS, DENTISTS, SUBSCRIBERS AND OTHER BUSINESS PARTNERS HAS NOW BEEN INTERNATIONALLY RECOGNIZED.QUALITY SERVICE IS ALSO MEASURED THROUGH INTERNAL AUDITS. RESULTS INDICATE OVER 98 PERCENT OF CLAIMS ARE PROCESSED WITHIN 10 WORKING DAYS.COMMITMENT TO THE COMMUNITYDELTA DENTAL PLAN OF MICHIGAN, INC. BELIEVES ADVANCES IN DENTAL RESEARCH AND ENHANCED EDUCATIONAL OPPORTUNITIES FOR DENTISTS GO A LONG WAY TOWARD IMPROVING ORAL HEALTH. THE COMPANY IS A KEY PLAYER IN GROUNDBREAKING RESEARCH ON TRENDS IN ORAL HEALTH IN THE INSURED POPULATION. THE DELTA DENTAL FUND, THE COMPANYS PHILANTHROPIC AFFILIATE, ENCOURAGES ADVANCES IN DENTISTRY AND SUPPORTS DENTAL EDUCATION AND RESEARCH. ONLY AN ORGANIZATION OF DELTA DENTALS SIZE AND EXPERIENCE IN THE BENEFITS FIELD WOULD HAVE OVER 25 YEARS WORTH OF EXTENSIVE DATA REGARDING DENTAL TREATMENT PATTERNS OVER EXTENDED PERIODS OF TIME. BECAUSE OF ITS COMMITMENT TO ADVANCING THE SCIENCE OF DENTISTRY, EACH YEAR THE COMPANY GRANTS RESEARCHERS AT FIVE DENTAL SCHOOLS IN MICHIGAN, OHIO AND INDIANA ACCESS TO THIS IMPORTANT INFORMATION TO STUDY ORAL HEALTH TRENDS. THE RESULTS OF THEIR STUDIES WILL ADD SIGNIFICANT DATA TO THE BODY OF KNOWLEDGE IN THE FIELD OF DENTISTRY.SINCE IT WAS FORMED IN 1980, THE DELTA DENTAL FUND HAS GRANTED ALMOST $16 MILLION TOWARD THE ADVANCEMENT OF DENTAL SCIENCE AND IMPROVEMENT OF THE ORAL HEALTH OF THE PUBLIC. DELTA DENTAL FUND REGULARLY PROVIDES FUNDING FOR PROGRAMS THAT HELP AT-RISK POPULATIONS AND INDIVIDUALS WITH SPECIAL NEEDS OBTAIN DENTAL TREATMENT, FOR SCHOLARSHIP AND LEADERSHIP AWARDS TO DENTAL STUDENTS, FOR GRANTS TO PURCHASE LEARNING TOOLS AND OTHER PROGRAMS TO DENTAL SCHOOLS, FOR CONTINUING EDUCATION PROGRAMS FOR THE DENTAL PROFESSION, AND FOR EDUCATIONAL MATERIALS ON THE IMPORTANCE OF ORAL HEALTH AND HAZARDS TO ORAL HEALTH.IN 2012, DELTA DENTAL FUND PROVIDED GRANTS TOTALING NEARLY $1 MILLION FOR DENTAL AND COMMUNITY RELATIONS PROJECTS. AMONG THEM WAS A GRANT TO THE OHIO STATE UNIVERSITY COLLEGE OF DENTISTRY TO SUPPORT THE MOBILE DENTAL CLINIC IT OPERATES TO PROVIDE DENTAL TREATMENT TO THOUSANDS OF CHILDREN IN COLUMBUS, OHIO, WHO LACK ACCESS TO DENTAL CARE.DELTA DENTAL PLAN OF MICHIGAN IS ALSO COMMITTED TO THE COMMUNITY. DELTA DENTAL HAS ALWAYS BEEN KEENLY AWARE OF ITS CIVIC AND SOCIAL RESPONSIBILITY. DELTA DENTAL PLANS ARE PROUD TO SHARE, THROUGH DIRECT FINANCIAL CONTRIBUTIONS, WITH HUNDREDS OF COMMUNITY AGENCIES AND GROUPS. IN ADDITION, EMPLOYEES LOG COUNTLESS HOURS OF THEIR OWN TIME AS VOLUNTEERS. COMMUNITY SUPPORT GENERALLY FALLS UNDER THE BROAD CATEGORIES THAT PROVIDE SUPPORT TO AGENCIES AND INSTITUTIONS SERVING CHILDREN, SENIORS, LOW-INCOME INDIVIDUALS, MINORITIES, AND THE DISABLED AND AT-RISK INDIVIDUALS, TO ORGANIZATIONS THAT PROMOTE EDUCATION, ARTS AND RECREATION AND COMMUNITY DEVELOPMENT, AND TO CHARITABLE PROJECTS OR PROGRAMS RECOMMENDED BY EMPLOYEES, CUSTOMERS, PARTICIPATING DENTISTS AND OTHER KEY GROUPS. THROUGH A PUBLIC-PRIVATE PARTNERSHIP WITH THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH, DELTA DENTAL ADMINISTERS THE HEALTHY KIDS DENTAL AND MICHILD PROGRAMS. HEALTHY KIDS DENTAL IS A DENTAL BENEFITS PROGRAM FOR MEDICAID BENEFICIARIES UNDER AGE 21. IT IS AVAILABLE IN 75 COUNTIES AND COVERS BASIC DENTAL HEALTH BENEFITS SUCH AS X-RAYS, CLEANINGS, CAVITY FILLINGS, ROOT CANALS, TOOTH EXTRACTIONS AND DENTURES. MORE THAN 442,000 MICHIGAN CHILDREN ARE SERVED BY THIS PROGRAM.MICHILD IS AN INSURANCE PROGRAM THAT IS STATE AND FEDERALLY FUNDED WHICH MAKES COMPREHENSIVE HEALTH AND DENTAL COVERAGE AVAILABLE TO UNINSURED LOW AND MIDDLE INCOME CHILDREN UNDER 19 YEARS OF AGE. DELTA DENTAL PLAN OF MICHIGAN HAS APPLIED ITS ADMINISTRATIVE EXPERTISE AND DENTIST NETWORKS TO IMPROVING ORAL HEALTH CARE FOR THIS SEGMENT OF THE POPULATION ALSO.UNEQUALED ACCESS TO DENTISTSTHE BENEFITS OF DELTA DENTAL ARE NOW AVAILABLE BEYOND THIS NATIONS BORDERS. THROUGH A PARTNERSHIP WITH INTERNATIONAL SOS ASSISTANCE, INC., DELTA DENTAL ENROLLEES CAN NOW RECEIVE EXPERT TREATMENT FOR NON-EMERGENCY AND EMERGENCY DENTAL CARE WHEN THEY ARE OUTSIDE OF THE UNITED STATES.FOR FIVE DECADES, DELTA DENTAL HAS HELPED PROMOTE ORAL HEALTH BY DESIGNING AND ADMINISTERING INNOVATIVE, COST-EFFECTIVE DENTAL BENEFIT PROGRAMS. EXPERTS AT PLAN DESIGN, DELTA DENTAL HAS CREATED DENTAL BENEFIT PROGRAMS THAT MEET CUSTOMER COST-OBJECTIVES WHILE HELPING TO IMPROVE AND MAINTAIN ORAL HEALTH.THE PROGRAMS FEATURE LARGE PANELS OF FULL-TIME PARTICIPATING DENTISTS. IN FACT, 3 OUT OF 4 DENTISTS NATIONWIDE PARTICIPATE WITH DELTA DENTAL. THIS KIND OF REACH HAS ENABLED MILLIONS OF PEOPLE TO RECEIVE COST-EFFECTIVE DENTAL CARE.DELTA DENTALS GROUP MEMBERS ARE AFFORDED ADDED PROTECTION BECAUSE THEY GUARANTEE THAT PARTICIPATING DENTISTS WILL ACCEPT THEIR PAYMENT FOR COVERED SERVICES AND THAT NO CHARGES, OTHER THAN CO-PAYMENTS AND DEDUCTIBLES WILL BE BILLED. THIS LOWERS CLAIM COSTS FOR CUSTOMERS AND REDUCES OUT-OF-POCKET COSTS FOR SUBSCRIBERS.WITH TWO NETWORKS OF FULL-TIME PARTICIPATING DENTISTS IN ONE INTEGRATED CLAIMS SYSTEM, DELTA DENTAL CAN DELIVER TO CUSTOMERS AND GROUP MEMBERS, THE GREATEST ACCESS AT THE BEST COST. | Description |
| Total Program Service Expense | 1359323074 | TotalProgramServiceExpense |
| Described In501 C3 | 0 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 1 | PoliticalActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 53335 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 821 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 18 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 15 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GORAN JURKOVIC CHIEF FINANCIAL OFFICER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5173496000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4100 OKEMOS ROAD | AddressLine1 |
| City | OKEMOS | City |
| State | MI | State |
| ZIP Code | 48864 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (36 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| DOUGLAS R ANDERSON | |||||||||
| DIRECTOR | 5.00 | 11.00 | X | 11537 | 5900 | 17000 | |||
| TODD V ESTER DDS | |||||||||
| DIRECTOR THRU APRIL | 5.00 | 0.00 | X | 12837 | 0 | 0 | |||
| JOSHUA S HOWIE | |||||||||
| MEMBER AT LARGE | 5.00 | 5.00 | X | 24200 | 3300 | 0 | |||
| BRUCE BAIRD DDS | |||||||||
| DIRECTOR | 5.00 | 12.00 | X | 17900 | 75300 | 0 | |||
| FATHER JACK H BAKER | |||||||||
| DIRECTOR | 5.00 | 5.00 | X | 22800 | 7400 | 0 | |||
| LISA DANCSOK | |||||||||
| DIRECTOR | 5.00 | 5.00 | X | 22800 | 3300 | 0 | |||
| RORY GAMBLE | |||||||||
| DIRECTOR | 5.00 | 5.00 | X | 17900 | 700 | 0 | |||
| JOSEPH C HARRIS DDS | |||||||||
| TREASURER & SECRETARY | 5.00 | 6.00 | X | 27537 | 5300 | 0 | X | ||
| JEFFREY A KELLER | |||||||||
| DIRECTOR | 5.00 | 5.00 | X | 2100 | 0 | 0 | |||
| TERRI A MILLER CPCU | |||||||||
| DIRECTOR | 5.00 | 5.00 | X | 25600 | 2600 | 0 | |||
| TIMOTHY E MOFFIT DMA | |||||||||
| DIRECTOR | 5.00 | 10.00 | X | 26137 | 6100 | 0 | |||
| C RICHARD SEITZ | |||||||||
| DIRECTOR | 5.00 | 8.00 | X | 22100 | 20700 | 0 | |||
| BRUCE R SMITH | |||||||||
| VICE CHAIRPERSON | 5.00 | 12.00 | X | 27700 | 26040 | 0 | X | ||
| TERENCE R COMAR DDS MS | |||||||||
| CHAIRPERSON | 5.00 | 7.00 | X | 40137 | 11800 | 0 | X | ||
| JAMES P HALLAN | |||||||||
| IMMEDIATE PAST CHAIRPERSON | 5.00 | 11.00 | X | 30197 | 16250 | 0 | |||
| STEPHEN A EKLUND DDA MHSA | |||||||||
| DIRECTOR | 5.00 | 1.00 | X | 700 | 132700 | 0 | |||
| ANN MARIE FLERMOEN | |||||||||
| DIRECTOR | 5.00 | 10.00 | X | 5166 | 500 | 16140 | |||
| KELLY JUBB SCHNEIDERER | |||||||||
| MEMBER AT LARGE | 5.00 | 10.00 | X | 11600 | 4290 | 17000 | |||
| THOMAS FLESZAR DDS MS | |||||||||
| CEO 1/1/12 - 4/1/12, DIRECTOR | 35.00 | 15.00 | X | 6519088 | 0 | 62294 | X | ||
| GORAN JURKOVIC CPA | |||||||||
| CHIEF FINANCIAL OFFICER | 26.50 | 23.50 | 545232 | 0 | 302478 | X | |||
| LAURA L CZELADA | |||||||||
| CEO, PRESIDENT | 38.00 | 12.00 | 1103469 | 0 | 659905 | X | |||
| LUIGI BATTAGLIERI | |||||||||
| DIRECTOR THRU APRIL, SR. V-P & CHIEF REL. OFFICER | 50.00 | 0.00 | 160546 | 0 | 17123 | X | |||
| BRENDA LAIRD | |||||||||
| V-P INFORMATION TECHNOLOGY | 50.00 | 0.00 | 689668 | 0 | 52322 | X | |||
| NANCY HOSTETLER | |||||||||
| SR. V-P, OPERATIONS | 50.00 | 1.00 | 343989 | 0 | 28889 | X | |||
| JED JACOBSON DDS MS MPH | |||||||||
| SR. V-P, PROFESSIONAL SERV | 50.00 | 0.00 | 696736 | 0 | 52318 | X | |||
| TOBY HALL | |||||||||
| VICE PRESIDENT- CHIEF ACTUARY | 50.00 | 0.00 | 279837 | 0 | 157812 | X | |||
| KAREN GREEN | |||||||||
| V-P INFORMATICS/QUALITY AS | 50.00 | 0.00 | 308012 | 0 | 24602 | X | |||
| SHERRY CRISP | |||||||||
| SR. V-P, OPERATIONS | 50.00 | 0.00 | 2224740 | 0 | 9995 | X | |||
| EDWARD ZOBECK | |||||||||
| SR. V-P, CORP & PUBLIC AFFAIRS | 40.00 | 10.00 | 1768040 | 0 | 360123 | X | |||
| RANDY TASCO | |||||||||
| V-P SALES & ACCT MGT | 50.00 | 0.00 | 395927 | 0 | 792674 | X | |||
| JON GROAT | |||||||||
| VP & GENERAL COUNSEL | 42.00 | 8.00 | 292318 | 0 | 24678 | X | |||
| MICHAEL BOBAK | |||||||||
| SALES AND ACCT MANAGER | 50.00 | 0.00 | 234045 | 0 | 40206 | X | |||
| ANTHONY ROBINSON | |||||||||
| VICE PRESIDENT- SALES | 50.00 | 0.00 | 328561 | 0 | 41725 | X | |||
| NICHOLAS CORRIDOR | |||||||||
| ACCOUNT EXECUTIVE | 50.00 | 0.00 | 223763 | 0 | 41588 | X | |||
| SARA EZIUKA | |||||||||
| ACCOUNT EXECUTIVE | 50.00 | 0.00 | 299697 | 0 | 63359 | X | |||
| MARY BOFANTE | |||||||||
| ACCOUNT EXECUTIVE | 50.00 | 0.00 | 202405 | 0 | 29249 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 16965021 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 322180 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 2811480 | TotalOtherCompensation |
| Number Individuals GT100 K | 133 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MESSA | |||||
| 1480 KENDALE BLVD | EAST LANSING | MI | 48826 | COMMISSIONS | 2673353 |
| GS&F | |||||
| 4235 HILLSBORO PIKE | NASHVILLE | TN | 37215 | ADVERTISING | 2473061 |
| CLOVER CONSULTING | |||||
| 400 E DIVISION STE 6 PMB 163 | ROCKFORD | MI | 49341 | IT SERVICES | 1448049 |
| THE ARSENAL GROUP LLC | |||||
| PO BOX 1562 | BIRMINGHAM | MI | 48009 | CONSULTING | 869762 |
| TEK SYSTEMS | |||||
| PO BOX 198568 | ATLANTA | GA | 30384 | IT SERVICES | 755934 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 42 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| DENTAL CARE REVENUE | 624100 | 1407811050 | 1407811050 | ||
| E-COMMERCE SOLUTIONS | 518210 | 11048384 | 1393812 | 9653646 | $926 |
| IS EXTERNAL SERVICES | 524292 | 73010 | 73010 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 1418932444 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4931738 | TotalRevenueColumn |
| Exclusion | $4,931,738 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 17879124 | Securities |
| Other | 121337921 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 17997471 | Securities |
| Other | 121197247 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -118347 | Securities |
| Other | 140674 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22327 | TotalRevenueColumn |
| Exclusion | $22,327 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| ADMINISTRATIVE REIMBURSEMENT | 900099 | 57386092 | 57386092 | |
| MISCELLANEOUS INCOME | 900099 | 311245 | $311,245 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 57697337 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1481583846 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1466590954 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 9726656 | UnrelatedBusinessRevenue |
| Exclusion | $5,266,236 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 98210 | Total |
| Program Services | 98210 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1262553497 | Total |
| Program Services | 1262553497 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16012014 | Total |
| Program Services | 10407809 | ProgramServices |
| Management And General | 5604205 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49420641 | Total |
| Program Services | 28584766 | ProgramServices |
| Management And General | 20835875 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1089227 | Total |
| Program Services | 548375 | ProgramServices |
| Management And General | 540852 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8725277 | Total |
| Program Services | 4848243 | ProgramServices |
| Management And General | 3877034 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4319614 | Total |
| Program Services | 2544749 | ProgramServices |
| Management And General | 1774865 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1581715 | Total |
| Program Services | 805643 | ProgramServices |
| Management And General | 776072 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 691630 | Total |
| Management And General | 691630 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 487726 | Total |
| Management And General | 487726 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 227001 | Total |
| Management And General | 227001 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11906813 | Total |
| Program Services | 7550971 | ProgramServices |
| Management And General | 4355842 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2852472 | Total |
| Program Services | 643107 | ProgramServices |
| Management And General | 2209365 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11937555 | Total |
| Program Services | 10277143 | ProgramServices |
| Management And General | 1660412 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7353135 | Total |
| Program Services | 5403948 | ProgramServices |
| Management And General | 1949187 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2640531 | Total |
| Program Services | 1031 | ProgramServices |
| Management And General | 2639500 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3401520 | Total |
| Program Services | 2556372 | ProgramServices |
| Management And General | 845148 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 606813 | Total |
| Program Services | 225985 | ProgramServices |
| Management And General | 380828 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10729626 | Total |
| Program Services | 4882468 | ProgramServices |
| Management And General | 5847158 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 638957 | Total |
| Management And General | 638957 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| E-COMMERCE EXPENSES | 10585365 | 0 | 10585365 |
| COMMISSIONS | 10342173 | 10342173 | 0 |
| PROCESSING FEES | 3342370 | 3342370 | 0 |
| RISK SHARE CHARGES | 2066215 | 1925412 | 140803 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2503887 | Total |
| Program Services | 1780802 | ProgramServices |
| Management And General | 723085 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1426113984 | Total |
| Program Services | 1359323074 | ProgramServices |
| Management And General | 66790910 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2118 | BOY |
| EOY | 2117 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66986349 | BOY |
| EOY | 89369594 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78680856 | BOY |
| EOY | 73476537 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14698754 | BOY |
| EOY | 17546504 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 188778600 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 82772855 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 117796125 | BOY |
| EOY | 106005745 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 118203049 | BOY |
| EOY | 153954258 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21578555 | BOY |
| EOY | 41638150 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 345356 | BOY |
| EOY | 3080854 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 418291162 | BOY |
| EOY | 485073759 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43730556 | BOY |
| EOY | 43983611 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 110662532 | BOY |
| EOY | 133493354 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 154393088 | BOY |
| EOY | 177476965 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15744473 | BOY |
| EOY | 15744473 | EOY |
Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5122500 | BOY |
| EOY | 5122500 | EOY |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 243031101 | BOY |
| EOY | 286729821 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 263898074 | BOY |
| EOY | 307596794 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 418291162 | BOY |
| EOY | 485073759 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 55469862 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 8752540 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -20523682 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Political Expenditures | 10000 | PoliticalExpenditures |
| Amt Of Internal Funds Contributed | 10000 | AmtOfInternalFundsContributed |
| Total Exmpt Function Expenditures | 10000 | TotalExmptFunctionExpenditures |
| Form1120 Pol Filed | 1 | Form1120PolFiled |
Sec527 Pol Orgs Sec527PolOrgs
Name Of527 Organization NameOf527Organization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOVERNORS CLUB (527 PLAN) | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 4925 | AddressLine1 |
| City | TROY | City |
| State | MI | State |
| ZIP Code | 48099 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450950905 | EIN |
| Amt Pd From Internal Funds | 10000 | AmtPdFromInternalFunds |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ORGANIZATIONS DIRECT AND INDIRECT POLITICAL CAMPAIGN ACTIVITIES: | Identifier |
| Return Reference | PART I-A, LINE 1: | ReturnReference |
| Explanation | CONTRIBUTION TO THE GOVERNOR'S CLUB OF $10,000 | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7859592 | OtherCostOrOtherBasis |
| Book Value | 7859592 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 103760024 | OtherCostOrOtherBasis |
| Depreciation | 22053495 | Depreciation |
| Book Value | 81706529 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 28650193 | OtherCostOrOtherBasis |
| Depreciation | 22464022 | Depreciation |
| Book Value | 6186171 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 48508791 | OtherCostOrOtherBasis |
| Depreciation | 38255338 | Depreciation |
| Book Value | 10253453 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 106005745 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (3 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| DDIC. STOCK | 200217 | C |
| INVESTMENT IN RSS, LLC - 100% | 1515636 | C |
| INVESTMENT IN RHC | 39922297 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 41638150 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| IBNR - CLAIM ADJUSTMENT RESERVES | $36,450,722 |
| UNEARNED PREMIUMS | $27,965,026 |
| FAS 158 FUNDED STATUS | $69,077,606 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 133493354 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X, LINE 2: | ReturnReference |
| Explanation | AS OF DECEMBER 31, 2012 AND 2011, THE ENTERPRISE'S UNRECOGNIZED TAX BENEFITS WERE NOT SIGNIFICANT. THERE WERE NO SIGNIFICANT PENALTIES OR INTEREST RECOGNIZED DURING THE YEARS OR ACCRUED AT YEAR END. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|---|---|
| MICHIGAN ECONOMIC DEVELOPMENT FOUNDATION | |||||||||
| PO BOX 13063 | LANSING | MI | 48901 | 382527475 | 501(C)(3) | 15000 | CASH | N/A | SUPPORT DENTAL EDUCATION AND RESEARCH PROGRAMS |
| BLESSINGS IN A BACKPACK | |||||||||
| 4121 SHELBYVILLE RD | LOUISVILLE | KY | 40207 | 261964620 | 501(C)(3) | 46991 | CASH | N/A | CHARITABLE DONATION |
| NEW ENERGY TO REINVENT MICHIGAN | |||||||||
| PO BOX 15246 | LANSING | MI | 48901 | 450888727 | 501(C)(4) | 10000 | CASH | N/A | AMERICANS MISSION OF MERCY DONATION |
| HEALTHSTRIDES LTD | |||||||||
| 1105 JUDY CT | WATERSVILLE | OH | 43081 | 314662950 | 16219 | CASH | N/A | CLEVELAND OHIO HEART WALK | |
| FOUNDATION TO REINVENT MICHIGAN | |||||||||
| PO BOX 4927 | TROY | MI | 48099 | 275278263 | 501(C)(3) | 10000 | CASH | N/A | SUPPORT OF THE EFFORTS TO REINVENT MICHIGAN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 2 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: CONTRIBUTIONS ARE MADE AT BOARD MEMBER DISCRETION TO ORGANIZATIONS THAT SUPPORT DELTA DENTAL PLAN OF MICHIGAN'S MISSION. IN ORDER FOR FUNDS TO BE DISBURSED, VOUCHER RECORDS MUST PASS THROUGH THE APPROVAL PROCESS, SIMILAR TO ANY OTHER EXPENDITURE MADE BY DELTA DENTAL PLAN OF MICHIGAN. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | X | FirstClassOrCharterTravel |
| Travel For Companions | X | TravelForCompanions |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (18 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS FLESZAR DDS MS | ||||||||||||||
| CEO 1/1/12 - 4/1/12, DIRECTOR | 229871 | 0 | 1449082 | 0 | 4840135 | 0 | 57601 | 0 | 4693 | 0 | 6581382 | 0 | 0 | 0 |
| GORAN JURKOVIC CPA | ||||||||||||||
| CHIEF FINANCIAL OFFICER | 274905 | 0 | 257343 | 0 | 12984 | 0 | 282378 | 0 | 20100 | 0 | 847710 | 0 | 0 | 0 |
| LAURA L CZELADA | ||||||||||||||
| CEO, PRESIDENT | 579093 | 0 | 514288 | 0 | 10088 | 0 | 653185 | 0 | 6720 | 0 | 1763374 | 0 | 0 | 0 |
| LUIGI BATTAGLIERI | ||||||||||||||
| DIRECTOR THRU APRIL, SR. V-P & CHIEF | 152312 | 0 | 0 | 0 | 8234 | 0 | 17103 | 0 | 20 | 0 | 177669 | 0 | 0 | 0 |
| BRENDA LAIRD | ||||||||||||||
| V-P INFORMATION TECHNOLOGY | 293171 | 0 | 293842 | 0 | 102655 | 0 | 45602 | 0 | 6720 | 0 | 741990 | 0 | 0 | 0 |
| NANCY HOSTETLER | ||||||||||||||
| SR. V-P, OPERATIONS | 191203 | 0 | 138668 | 0 | 14118 | 0 | 8789 | 0 | 20100 | 0 | 372878 | 0 | 0 | 0 |
| JED JACOBSON DDS MS MPH | ||||||||||||||
| SR. V-P, PROFESSIONAL SERV | 266454 | 0 | 250633 | 0 | 179649 | 0 | 45598 | 0 | 6720 | 0 | 749054 | 0 | 0 | 0 |
| TOBY HALL | ||||||||||||||
| VICE PRESIDENT- CHIEF ACTUARY | 205034 | 0 | 61934 | 0 | 12869 | 0 | 137712 | 0 | 20100 | 0 | 437649 | 0 | 0 | 0 |
| KAREN GREEN | ||||||||||||||
| V-P INFORMATICS/QUALITY AS | 175575 | 0 | 121362 | 0 | 11075 | 0 | 4502 | 0 | 20100 | 0 | 332614 | 0 | 0 | 0 |
| SHERRY CRISP | ||||||||||||||
| SR. V-P, OPERATIONS | 196159 | 0 | 271732 | 0 | 1756849 | 0 | 7755 | 0 | 2240 | 0 | 2234735 | 0 | 1712641 | 0 |
| EDWARD ZOBECK | ||||||||||||||
| SR. V-P, CORP & PUBLIC AFFAIRS | 356188 | 0 | 358977 | 0 | 1052875 | 0 | 340023 | 0 | 20100 | 0 | 2128163 | 0 | 1042854 | 0 |
| RANDY TASCO | ||||||||||||||
| V-P SALES & ACCT MGT | 220700 | 0 | 170819 | 0 | 4408 | 0 | 772574 | 0 | 20100 | 0 | 1188601 | 0 | 0 | 0 |
| JON GROAT | ||||||||||||||
| VP & GENERAL COUNSEL | 216794 | 0 | 63663 | 0 | 11861 | 0 | 17958 | 0 | 6720 | 0 | 316996 | 0 | 0 | 0 |
| MICHAEL BOBAK | ||||||||||||||
| SALES AND ACCT MANAGER | 79497 | 0 | 154209 | 0 | 339 | 0 | 20106 | 0 | 20100 | 0 | 274251 | 0 | 0 | 0 |
| ANTHONY ROBINSON | ||||||||||||||
| VICE PRESIDENT- SALES | 185727 | 0 | 140204 | 0 | 2630 | 0 | 21625 | 0 | 20100 | 0 | 370286 | 0 | 0 | 0 |
| NICHOLAS CORRIDOR | ||||||||||||||
| ACCOUNT EXECUTIVE | 53821 | 0 | 169818 | 0 | 124 | 0 | 21488 | 0 | 20100 | 0 | 265351 | 0 | 0 | 0 |
| SARA EZIUKA | ||||||||||||||
| ACCOUNT EXECUTIVE | 53622 | 0 | 245742 | 0 | 333 | 0 | 43259 | 0 | 20100 | 0 | 363056 | 0 | 0 | 0 |
| MARY BOFANTE | ||||||||||||||
| ACCOUNT EXECUTIVE | 52047 | 0 | 149980 | 0 | 378 | 0 | 16508 | 0 | 12741 | 0 | 231654 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | FIRST CLASS TRAVEL AVAILABLE TO KEY EMPLOYEES. THIS AMOUNT WAS TREATED AS NONTAXABLE TO THE KEY EMPLOYEE. TRAVEL FOR COMPANIONS RELATED TO TRAVEL FOR A SPOUSE. THIS AMOUNT WAS TREATED AS TAXABLE TO THE BOARD MEMBER OR EMPLOYEE. VARIOUS INDIVIDUALS ON SCHEDULE J ARE ELIGIBLE FOR REIMBURSEMENT OF SUBSTANTIATED HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES. THIS BENEFIT IS NOT TAXABLE BUT THE EXPENSE MUST BE SUBSTANTIATED AS A BUSINESS EXPENSE. |
| PART I, LINE 4B | EDWARD ZOBECK= $1,042,854 SHERRY CRISP= $1,712,641 ADDITIONALLY, DELTA DENTAL PLAN OF MICHIGAN, HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). IN ORDER TO BE ELIGIBLE FOR THE SERP, AN EMPLOYEE MUST BE A SENIOR VICE PRESIDENT OR HIGHER. AN OUTSIDE INDEPENDENT ACTUARY CALCULATES THE VALUE ON AN ANNUAL BASIS. ADDITIONALLY, ALL EXECUTIVES ARE ELIGIBLE FOR A 457(F) PLAN. THIS PLAN IS FUNDED SOLELY BY EMPLOYEE CONTRIBUTIONS. THE INDIVIDUALS ARE VESTED UPON FUNDING THE 457(F) PLAN. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | COMAR COMAR PC | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | TERENCE COMAR, DIRECTOR OF DDPMI, IS AN OWNER IN COMAR & COMAR, PC. | Relationship |
| Amount Of Transaction | 159700 | AmountOfTransaction |
| Description Of Transaction | HEALTH CARE PAYMENTS | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | DELTA DENTAL PLAN OF MICHIGAN HAS A SOLE MEMBER, RENAISSANCE HEALTH SERVICE CORPORATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER HAS VOTING RIGHTS AND ELECTS DIRECTORS. | |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING ITEMS ARE SUBJECT TO APPROVAL BY THE SOLE MEMBER: IF 10% OF THE ASSETS ARE TO BE SPENT/SOLD OR A NEW PRESIDENT IS TO BE APPOINTED. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE INFORMATION PRESENTED ON THE FORM 990 IS GATHERED BY THE SENIOR TAX ADMINISTRATOR FOR THE ORGANIZATION. THE CFO REVIEWS THE INFORMATION. ONCE APPROVED THE INFORMATION IS GIVEN TO OUTSIDE TAX PREPARERS WHO PREPARE AND REVIEW THE FORM 990. ONCE COMPLETE AN ELECTRONIC COPY OF THE FORM 990 IS PUT ONTO A WEBSITE FOR THE BOARD TO REVIEW. THIS IS DONE BEFORE THE RETURN IS FILED WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE COMPANY'S VICE PRESIDENT AND GENERAL COUNSEL IS CHARGED WITH REVIEWING AND MONITORING ANY POTENTIAL CONFLICT OF INTEREST TRANSACTIONS. ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO REVIEW AND EXECUTE A CONFLICT OF INTEREST POLICY. THIS POLICY REQUIRES THAT ANY CONFLICTS OF INTEREST BE DISCLOSED ON AN ANNUAL BASIS, OR AT ANY OTHER TIME THAT THE PERSON EXECUTING THE POLICY BECOMES AWARE OF A SITUATION OR TRANSACTION THAT ACTUALLY OR POTENTIALLY CREATES A CONFLICT OF INTEREST. ALL CONFLICT OF INTEREST DISCLOSURE FORMS ARE INITIALLY REVIEWED BY THE VICE PRESIDENT AND GENERAL COUNSEL. IF A PROHIBITED TRANSACTION WERE IDENTIFIED, THE MATTER WOULD BE BROUGHT TO THE CHAIRPERSON OF THE BOARD FOR FURTHER REVIEW AND APPROPRIATE ACTION. IN THE EVENT OF A CONFLICT OF INTEREST INVOLVING A MEMBER OF THE BOARD OF DIRECTORS, SUCH AS A CONFLICT IN WHICH A MEMBER HAD AN INTEREST, THE MEMBER IS REQUIRED TO DISCLOSE THE POTENTIAL CONFLICT AND ABSTAIN FROM ANY VOTE ON THE MATTER. WHETHER FURTHER PRECAUTIONS ARE REQUIRED (E.G., PROHIBITING THE INTERESTED PARTY FROM ENGAGING IN DISCUSSIONS) WOULD DEPEND UPON THE SPECIFIC NATURE AND BACKGROUND OF THE CONFLICT. | |
| FORM 990, PART VI, SECTION B, LINE 15 | OUTSIDE COMPENSATION CONSULTANTS ARE USED TO DETERMINE MARKET DATA FOR THE EXECUTIVE POSITIONS AND FOR OTHER OFFICERS AND KEY EMPLOYEES. THE POSITIONS COVERED ARE THE CEO, COO, CAO, CIO, CFO, CSO, CMO, CRO, AND CHIEF ACTUARY. THE ORGANIZATION CONTRACTS WITH TOWERS WATSON TO DO A COMPENSATION AND REASONABLENESS ANALYSIS EVERY TWO YEARS. THE FINAL DETERMINATION OF COMPENSATION IS DONE BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, WHICH IS MADE UP OF INDEPENDENT PERSONS, AND IS BASED ON THE COMPARABILITY DATA PROVIDED BY THE COMPENSATION CONSULTANTS. THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARE CONTEMPORANEOUSLY DOCUMENTED IN THE COMMITTEE MINUTES AND APPROVED BY THE BOARD. THE COMPENSATION WAS LAST REVIEWED UNDER THIS PROCESS DURING 2012. THE REPORT BASED ON THIS REVIEW WAS THEN ISSUED BY THE CONSULTANTS IN APRIL OF 2013. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. | |
| FORM 990 PART VII: | CERTAIN OFFICERS ARE OFFICERS IN MULTIPLE RELATED ORGANIZATIONS. AVERAGE HOURS WORKED REFLECTS THE TIME SPENT IN EACH ORGANIZATION HOWEVER COMPENSATION IS REPORTED IN FULL TO AGREE TO THE W-2. ANY ALLOCATION OF COMPENSATION IS INCLUDED ON SCHEDULE R. | |
| FORM 990, PART XI, LINE 9: | GAIN ON EQUITY IN SUBSIDIARY 2,993,399. PENSION RELATED CHANGES -23,517,081. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990 PART XII LINE 2C AND 2D: | DELTA DENTAL PLAN OF MICHIGAN IS AUDITED BY AN INDEPENDENT ACCOUNTANT AS PART OF A CONSOLIDATED FINANCIAL STATEMENT ISSUED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. DELTA DENTAL PLAN OF MICHIGAN ALSO RECEIVES AN AUDITED FINANCIAL STATEMENT BY AN INDEPENDENT ACCOUNTANT THAT IS PREPARED ON A STATUTORY BASIS. THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| RENAISSANCE SYSTEMS AND SERVICES LLC | |||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 383638865 | E-COMMERCE SOLUTIONS FOR DENTISTS | MI | 11048384 | 1679833 | DELTA DENTAL PLAN OF MICHIGAN INC |
| ELECTRONIC LOCKBOX SERVICES LLC | |||||||||
| 1502 W EDGEWOOD AVENUE SUITE D | INDIANAPOLIS | IN | 46217 | 454734479 | PROVIDES ELECTRONIC CREDIT CARD PAYMENT SERVICES | MI | -362098 | 36784 | RENAISSANCE SYSTEMS AND SERVICES LLC |
Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| RENAISSANCE HEALTH SERVICE CORPORATION | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 381675667 | PROMOTING DENTAL CARE | MI | 501(C)(4) | N/A | N/A | 0 | |
| DELTA DENTAL PLAN OF OHIO | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 310685339 | PROVIDE DENTAL SERVICE PLANS | OH | 501(C)(4) | N/A | 1 | DELTA DENTAL PLAN OF MICHIGAN INC | |
| DELTA DENTAL PLAN OF INDIANA | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 351545647 | PROVIDE DENTAL SERVICE PLANS | IN | 501(C)(4) | N/A | 1 | DELTA DENTAL PLAN OF MICHIGAN INC | |
| DELTA DENTAL OF TENNESSEE | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 620812197 | PROVIDE DENTAL SERVICE PLANS | TN | 501(C)(4) | N/A | 1 | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL FUND | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 382337000 | SUPPORT DENTAL EDUCATION AND RESEARCH PROGRAMS | MI | 501(C)(3) | 11A TYPE II | 1 | DELTA DENTAL PLAN OF MICHIGAN INC | |
| DELTA DENTAL OF NEW MEXICO | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 850224562 | PROVIDE DENTAL SERVICE PLANS | NM | 501(C)(4) | N/A | 1 | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL OF KENTUCKY | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 610659432 | PROVIDE DENTAL SERVICE PLANS | KY | 501(C)(4) | N/A | 1 | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL OF NORTH CAROLINA | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 561018068 | PROVIDE DENTAL SERVICE PLANS | NC | 501(C)(4) | N/A | 1 | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL OF ARKANSAS | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 710561140 | PROVIDE DENTAL SERVICE PLANS | AR | 501(C)(4) | N/A | 1 | RENAISSANCE HEALTH SERVICE CORPORATION | |
| DELTA DENTAL OF ARKANSAS FOUNDATION | |||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 261569324 | PROVIDE DENTAL SERVICE PLANS | AR | 501(C)(3) | PF | 1 | RENAISSANCE HEALTH SERVICE CORPORATION | |
| RENAISSANCE FAMILY FOUNDATION INC | |||||||||||
| 4100 OKEMOS ROAD | OKEMOS | MI | 48864 | 461376165 | EMPHASIZE DENTAL HEALTH IN COMMUNITIES | IN | 501(C)(3) | PF | 1 | RENAISSANCE HOLDING COMPANY | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RENAISSANCE HOLDING COMPANY | ||||||||||||
| PO BOX 30381 | LANSING | MI | 48909 | 412177193 | HOLDING COMPANY | MI | RENAISSNCE HEALTH SERVICE CORPORATION | C | -197458 | 42161795 | 0.62100 | 1 |
| RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | ||||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 470397286 | INSURANCE | IN | RENAISSANCE HOLDING COMPANY | C | 1 | |||
| RENAISSANCE HEALTH INSURANCE COMPANY OF NEW YORK | ||||||||||||
| PO BOX 30416 | LANSING | MI | 489097916 | 134098096 | INSURANCE | NY | RENAISSANCE HOLDING COMPANY | C | 1 | |||
| FORE HOLDING CORPORATION | ||||||||||||
| 240 VENTURE CIRCLE | NASHVILLE | TN | 37228 | 204116122 | EMPLOYEE BENEFITS | TN | DELTA DENTAL OF TENNESSEE | C | 1 | |||
| DENTAL CHOICE INC | ||||||||||||
| 10100 LINN STATION RD SUITE 700 | LOUISVILLE | KY | 40223 | 611105118 | REAL ESTATE HOLDING COMPANY | KY | DELTA DENTAL OF KENTUCKY | C | 1 | |||
| DENTAL CHOICE AGENCY INC | ||||||||||||
| 10100 LINN STATION RD SUITE 700 | LOUISVILLE | KY | 40223 | 611336003 | PRIMARY GENERAL AGENCY FOR DDKY & DENTAL CHOICE | KY | DELTA DENTAL OF KENTUCKY | C | 1 | |||
| OMEGA ADMINISTRATORS INC | ||||||||||||
| 1513 COUNTRY CLUB ROAD | SHERWOOD | AR | 72120 | 043740469 | PROVIDING THIRD-PARTY ADMINISTRATIVE SERVICES | AR | DELTA DENTAL OF ARKANSAS | C | 1 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (11 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| DELTA DENTAL OF TENNESSEE | ||
| L | 5462127 | ACTUAL COST |
| DELTA DENTAL PLAN OF OHIO | ||
| L | 25116689 | ACTUAL COST |
| DELTA DENTAL PLAN OF INDIANA | ||
| L | 9250454 | ACTUAL COST |
| RENAISSANCE HEALTH SERVICE CORPORATION | ||
| L | 125004 | ACTUAL COST |
| DELTA DENTAL FUND | ||
| L | 157050 | ACTUAL COST |
| RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA | ||
| L | 3317986 | ACTUAL COST |
| DELTA DENTAL PLAN OF NEW MEXICO | ||
| L | 1224917 | ACTUAL COST |
| DELTA DENTAL OF KENTUCKY | ||
| L | 115599 | ACTUAL COST |
| DELTA DENTAL OF NORTH CAROLINA | ||
| D | 2700000 | LOAN COST |
| DELTA DENTAL OF NORTH CAROLINA | ||
| L | 1387797 | ACTUAL COST |
| RENAISSANCE HOLDING COMPANY | ||
| L | 70500 | ACTUAL COST |