Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | TAX FORM 990 WAS PREPARED, REVIEWED AND FILED BY RSM MCGLADREY, THE EXTERNAL AUDITORS OF DENTAL BENEFIT PLANS OF MINNESOTA. THE COMPANY PROVIDED ALL INFORMATION TO RSM MCGLADREY, INCLUDING OFFICER AND DIRECTOR COMPENSATION DISCLOSURES. COMPANY MANAGEMENT ALSO REVIEWED THE RETURN. THE COMPANY HAS ENGAGED OUTSIDE LEGAL EXPERTISE FROM TIME TO TIME IN PRIOR YEARS TO VALIDATE FULL DISCLOSURE AS PART OF ITS PREPARATION PROCESS. A COPY OF THE RETURN WAS PROVIDED TO THE CHAIRMAN OF THE BOARD AND THE CHAIRMAN OF THE BOARD'S PERSONNEL AND COMPENSATION COMMITTEE. THE PERSONNEL AND COMPENSATION COMMITTEE REVIEWS AND DISCUSSES THE RETURN, AND PRESENTS ITS REVIEW TO THE FULL BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | ON AN ANNUAL BASIS ALL MANAGEMENT PERSONNEL MUST COMPLETE AND SIGN A CONFLICT OF INTEREST STATEMENT WHICH ARE SUBMITTED TO THE CHAIRMAN OF THE AUDIT COMMITTEE FOR REVIEW AND DISCUSSION AT A MEETING OF THE FULL AUDIT COMMITTEE. THE AUDIT COMMITTEE CHAIRMAN THEN PRESENTS THE RESULTS TO THE FULL BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION B, LINE 15: OFFICERS OF THE FILING ORGANIZATION ARE NOT COMPENSATED BY THE FILING ORGANIZATION. INDIVIDUALS SERVING AS OFFICERS OF THE FILING ORGANIZATION SERVE IN THE SAME OR SIMILAR CAPACITY FOR A RELATED 501(C)(4) ORGANIZATION, DENTAL BENEFIT PLANS OF MINNESOTA (DBPM). ALL COMPENSATION RECEIVED BY OFFICERS OF THE FILING ORGANIZATION (IN THEIR CAPACITIES AS EMPLOYEES OF DBPM) IS PAID BY DBPM AND DBPM IS RESPONSIBLE FOR COMPENSATION SETTING POLICY AND PROCEDURE. | ||
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST. STATUTORY FINANCIAL STATEMENTS ARE FILED WITH THE MINNESOTA DEPARTMENT OF COMMERCE AND THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS AS A MATTER OF PUBLIC RECORD. GAAP BASIS FINANCIALS ARE AVAILABLE UPON REQUEST. | |
| HOURS FOR RELATED ORGANIZATIONS | FORM 990, PART VII | DAVID B. MORSE, PRESIDENT OF DELTA DENTAL OF MINNESOTA (DDMN) ALSO ACTS AS CEO OF DENTAL BENEFIT PLANS OF MINNESOTA (DBPM), A RELATED ORGANIZATION. THE 25 HOURS REPORTED IN PART VII REPRESENTS THE AVERAGE HOURS PER WEEK FOR THE FILING ORGANIZATION ONLY. ALL COMPENSATION FOR SERVICES IS PAID BY DBPM. DIRECTORS OF DDMN MAY ALSO SERVE AS A DIRECTOR FOR DBPM. ALL COMPENSATION FOR THE TOTAL HOURS SERVED AS A DIRECTOR IS PAID BY DBPM. THE HOURS REFLECTED IN PART VII REPRESENT THE AVERAGE HOURS PER WEEK FOR THE FILING ORGANIZATION ONLY. |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 3,065,902. CHANGE IN OTHER COMPREHENSIVE INCOME 1,454,380. TOTAL TO FORM 990, PART XI, LINE 5: 4,520,282. |
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