TY 2015 Form 990

- TIN:

Form990

Department of the TreasuryInternal Revenue Service

Return of Organization Exempt From Income Tax

Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)

Do not enter social security numbers on this form as it may be made public.

Information about Form 990 and its instructions is at www.IRS.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

A For the 2015 calendar year, or tax year beginning 01-01-2015 , and ending 12-31-2015

BCheck if applicable: Address change Name change Initial return Final return/terminated Amended return Application pending

CName of organization
DELTA DENTAL OF MISSOURI

% BARBARA C BENTRUP

Doing business as

Number and street (or P.O. box if mail is not delivered to street address)
12399 GRAVOIS ROAD

Room/suite

City or town, state or province, country, and ZIP or foreign postal code
ST LOUIS, MO631271702

D Employer identification number

43-0908349

E Telephone number

G Gross receipts $ 540,941,759

F Name and address of principal officer:
EB ROB GOREN
12399 GRAVIOS ROAD
ST LOUIS,MO631271702

Tax-exempt status: 501(c)(3) 501(c) ( 4 ) LeftBullet

(insert no.) 4947(a)(1) or 527

Website:

WWW.DELTADENTALMO.COM

H(a)

Is this a group return for
subordinates? Yes No

H(b)

Are all subordinates
included?

Yes No

If "No," attach a list. (see instructions)

H(c)

Group exemption number MediumBullet

K Form of organization: Corporation Trust Association Other MediumBullet

L Year of formation: 1958

M State of legal domicile: MO

Part I

Summary

1	Briefly describe the organization’s mission or most significant activities: OUR PURPOSE IS TO IMPROVE THE DENTAL HEALTH OF THE PUBLIC BY PROMOTING PREVENTIVE DENTISTRY AND PROVIDING COMPREHENSIVE DENTAL CARE AND MAINTENANCE ON A PREPAID BASIS.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	223
6	Total number of volunteers (estimate if necessary) .............	6
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	22,759
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	508,408,359	536,864,679
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	3,058,307	2,571,063
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-4,033,200	1,314,753
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	507,433,466	540,750,495
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	493,318	1,196,413
14	Benefits paid to or for members (Part IX, column (A), line 4).....	459,511,547	485,977,171
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	19,784,069	20,963,881
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	22,143,180	23,951,695
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	501,932,114	532,089,160
19	Revenue less expenses. Subtract line 18 from line 12.......	5,501,352	8,661,335
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	146,779,168	148,371,610
21	Total liabilities (Part X, line 26).............	51,924,536	46,963,331
22	Net assets or fund balances. Subtract line 21 from line 20.....	94,854,632	101,408,279

Part II

Signature Block

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

Sign Here

	Signature of officer	Date

	Type or print name and title

Paid Preparer Use Only

Print/Type preparer's name

Preparer's signature

Date

Check if
self-employed

PTIN

Firm's name MediumBullet

Firm's EIN MediumBullet

Firm's address MediumBullet

Phone no.

May the IRS discuss this return with the preparer shown above? (see instructions) ..........YesNo

For Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 11282Y Form 990 (2015)

Form 990 (2015)

Page 2

Part III

Statement of Program Service Accomplishments

Check if Schedule O contains a response or note to any line in this Part III ..............

Briefly describe the organization’s mission: THE ORGANIZATION'S PRIMARY PURPOSE IS TO IMPROVE THE DENTAL HEALTH OF THE PUBLIC BY PROMOTING PREVENTIVE DENTISTRY AND PROVIDING COMPREHENSIVE DENTAL CARE AND MAINTENANCE ON A PREPAID BASIS.

Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ..................... Yes No

If "Yes," describe these new services on Schedule O.

Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ........................... Yes No

If "Yes," describe these changes on Schedule O.

Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.


4a	(Code: ) (Expenses $ 523,114,699 including grants of $ 1,196,413 ) (Revenue $ 536,864,679 )
	DELTA DENTAL OF MISSOURI IS A PREPAID DENTAL INSURANCE COMPANY. IN 2015, DELTA DENTAL PROCESSED 2,895,623 CLAIMS FROM CLIENT COMPANIES.

4b	(Code: ) (Expenses $ 359,395 including grants of $ ) (Revenue $ )
	DELTA DENTAL HEALTH THEATRE - SEE SCHEDULE O

4c	(Code: ) (Expenses $ 417,455 including grants of $ ) (Revenue $ )
	LAND OF SMILES - SEE SCHEDULE O

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 112,809 including grants of $ ) (Revenue $ )
4e	Total program service expenses524,004,358

Form 990 (2015)

Page 3

Part IV

Checklist of Required Schedules

Yes

Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A.....................

Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...

Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............

Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II..............

Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III.................

Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I Click to see attachment

..................

Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II Click to see attachment

...

Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment

.............

Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV Click to see attachment

..............

Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part V Click to see attachment

......

If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.

Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI. Click to see attachment

...................

11a

Yes

Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII Click to see attachment

.......

11b

Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII Click to see attachment

.......

11c

Yes

Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IX Click to see attachment

............

11d

Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part X Click to see attachment

11e

Yes

Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part X Click to see attachment

11f

Yes

12a

Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment

.................

12a

Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment

12b

Yes

Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E

14a

Did the organization maintain an office, employees, or agents outside of the United States? .....

14a

Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........

14b

Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....

Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...

Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....

Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............

Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................

20a

Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....

20a

If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?

20b

Form 990 (2015)

Page 4

Part IV

Checklist of Required Schedules (continued)

Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..... Click to see attachment

Yes

Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment

Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment

Yes

24a

Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............

24a

Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...

24b

Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............

24c

Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...

24d

25a

Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............ Click to see attachment

25a

Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I ................... Click to see attachment

25b

Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II ................ Click to see attachment

Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment

Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):

A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV ........................ Click to see attachment

28a

A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV..................... Click to see attachment

28b

An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment

28c

Yes

Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..

Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............

Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.

Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II ...........

Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I ........ Click to see attachment

Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1......................... Click to see attachment

Yes

35a

Did the organization have a controlled entity within the meaning of section 512(b)(13)?

35a

Yes

If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ... Click to see attachment

35b

Yes

Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............

Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI Click to see attachment

Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............

Yes

Form 990 (2015)

Page 5

Part V

Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........

Yes

Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..

54,674

Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .

Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................

Yes

Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................

223

If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)

Yes

Did the organization have unrelated business gross income of $1,000 or more during the year?...

Yes

If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...

Yes

At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..

Yes

If "Yes," enter the name of the foreign country: MediumBullet

TK
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).

Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..

Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?

If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............

Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...

If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................

Organizations that may receive deductible contributions under section 170(c).

Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................

If "Yes," did the organization notify the donor of the value of the goods or services provided? .....

Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................

If "Yes," indicate the number of Forms 8282 filed during the year ....

Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?

Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..

If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................

If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................

Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................

Did the sponsoring organization make any taxable distributions under section 4966?...

Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...

Section 501(c)(7) organizations. Enter:

Initiation fees and capital contributions included on Part VIII, line 12 ...

10a

Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities

10b

Section 501(c)(12) organizations. Enter:

Gross income from members or shareholders .........

11a

Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........

11b

12a

Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?

12a

If "Yes," enter the amount of tax-exempt interest received or accrued during the year.

12b

Section 501(c)(29) qualified nonprofit health insurance issuers.

Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.

13a

Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....

13b

Enter the amount of reserves on hand ............

13c

14a

Did the organization receive any payments for indoor tanning services during the tax year?.....

14a

If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..

14b

Form 990 (2015)

Page 6

Part VI

Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.

Check if Schedule O contains a response or note to any line in this Part VI ..............

Section A. Governing Body and Management

Yes

Enter the number of voting members of the governing body at the end of the tax year

If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.

Enter the number of voting members included in line 1a, above, who are independent

Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................

Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .

Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................

Yes

Did the organization become aware during the year of a significant diversion of the organization’s assets? .

Did the organization have members or stockholders? ................

Yes

Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................

Yes

Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................

Yes

Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:

The governing body? .......................

Yes

Each committee with authority to act on behalf of the governing body? ............

Yes

Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......

Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)

Yes

10a

Did the organization have local chapters, branches, or affiliates? ............

10a

Yes

If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?

10b

Yes

11a

Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................

11a

Yes

Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....

12a

Did the organization have a written conflict of interest policy? If "No," go to line 13.......

12a

Yes

Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................

12b

Yes

Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................

12c

Yes

Did the organization have a written whistleblower policy? ...............

Yes

Did the organization have a written document retention and destruction policy? .........

Yes

Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?

The organization’s CEO, Executive Director, or top management official ...........

15a

Yes

Other officers or key employees of the organization ................

15b

Yes

If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).

16a

Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................

16a

If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............

16b

Section C. Disclosure

List the States with which a copy of this Form 990 is required to be filed MediumBullet

Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.

Own website Another's website Upon request Other (explain in Schedule O)

Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.

State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBullet

BARBARA C BENTRUP12399 GRAVOIS ROAD ST LOUIS,MO631271702 (314) 656-3000

Form 990 (2015)

Page 7

Part VII

Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors

Check if Schedule O contains a response or note to any line in this Part VII ..............

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees

1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet

List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

List all of the organization’s current key employees, if any. See instructions for definition of "key employee."

List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.

Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) BENDER WILLIAM J...................................................................... DIRECTOR	2.0 ................. 0.0	X		22,582	0	0
(2) BISHOP ROSEMARY A...................................................................... DIRECTOR	2.0 ................. 0.0	X		27,882	0	0
(3) BRAUN RICHARD W...................................................................... DIRECTOR	2.0 ................. 0.0	X		28,150	0	0
(4) BUTLER ROBERT...................................................................... DIRECTOR	2.0 ................. 0.0	X		40,968	0	0
(5) CUSTARDO JOHNNY...................................................................... DIRECTOR-TERM STARTED 11/2015	0.0 ................. 0.0	X		0	0	0
(6) MANCIN MARK S...................................................................... DIRECTOR	2.0 ................. 0.0	X		16,332	0	0
(7) BERGLUND BRIAN...................................................................... DIRECTOR	2.0 ................. 0.0	X		32,950	0	0
(8) REDOHL HR...................................................................... DIRECTOR	2.0 ................. 0.0	X		30,000	0	0
(9) RHEA JAMES W...................................................................... DIRECTOR	2.0 ................. 0.0	X		19,482	0	0
(10) ROBISON EDWARD C...................................................................... DIRECTOR	2.0 ................. 0.0	X		18,108	0	0
(11) TAYLOR TIMOTHY S...................................................................... DIRECTOR	2.0 ................. 0.0	X		17,382	0	0
(12) WHITFORD JOSHUA...................................................................... DIRECTOR	2.0 ................. 0.0	X		23,100	0	0
(13) HOFFMEISTER JAMES...................................................................... DIRECTOR-TERM ENDED 11/2015	2.0 .................	X		22,700	0	0
(14) HAYNES DAVID W...................................................................... PRESIDENT & CEO	55.0 ................. 0.0	X	X	2,095,934	0	69,785
(15) GOREN EB ROB...................................................................... PRESIDENT & CEO	55.0 ................. 0.0		X	410,870	0	103,700
(16) BENTRUP BARBARA C...................................................................... CFO & CORPORATE COUNSEL	55.0 ................. 0.0		X	460,451	0	162,562
(17) MARTIN PAMELA A...................................................................... SENIOR VP & COO	55.0 ................. 0.0		X	321,978	0	130,139

Form 990 (2015)

Page 8

Part VII

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) MUDRA KARL A........................................................................ CIO	55.0 .......................0.0	X		333,931	0	93,276
(19) PATTAROZZI EDWARD A........................................................................ CHIEF SALES/MARKETING OFFICER	55.0 .......................0.0	X		393,219	0	128,958
(20) LEES JANICE M........................................................................ VP BOARD RELATIONS	50.0 .......................0.0		X	177,335	0	90,022
(21) LAFFITTE HENRY S........................................................................ VP, SALES & ACCOUNT MANAGEMENT	50.0 .......................0.0		X	366,244	0	51,999
(22) PYLE LYNN........................................................................ REGIONAL VICE PRESIDENT, SALES	50.0 .......................0.0		X	206,914	0	52,770
(23) AUBUCHON JEANNE G........................................................................ VICE PRESIDENT OF SALES	50.0 .......................0.0		X	199,984	0	59,223
(24) SAMUELS ELLEN R........................................................................ MANAGER, CORPORATE COMPLIANCE	50.0 .......................0.0		X	208,282	0	56,207

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	5,474,778	0	998,641

Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet

Yes

Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............

For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................

Yes

Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........

Section B. Independent Contractors

Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.

(A) Name and business address	(B) Description of services	(C) Compensation
MISSOURI DENTAL PROFESSIONALS, 1100 SPUR DR STE 30 MARSHFIELD,MO65706	DENTAL SERVICES	5,658,397
C HOLLANDER DDS M FERNANDEZ DDS D A, 3555 SUNSET OFFICE DR STE 210 SAINT LOUIS,MO63127	DENTAL SERVICES	2,333,417
JAY F HAUSER DDS PC, PO BOX 503094 SAINT LOUIS,MO63150	DENTAL SERVICES	1,571,815
MICHAEL K PARSONS DDS PC, 17300 OUTER FORTY RD N STE 103 CHESTERFIELD,MO63005	DENTAL SERVICES	1,247,802
DAVID A DURHAM ASSOC DDS PC, 10000 WATSON RD STE A SAINT LOUIS,MO63126	DENTAL SERVICES	1,160,196
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 716

Form 990 (2015)

Page 9

Part VIII

Statement of Revenue

Check if Schedule O contains a response or note to any line in this Part VIII .............

(A)
Total revenue

(B)
Related or
exempt
function
revenue

(D)
Revenue
excluded from
tax under sections
512-514

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		0

			Business Code
2a	DENTAL PREMIUMS	524114	536,864,679	536,864,679
b
c
d
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			536,864,679

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			2,322,803			2,322,803
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		264,523
b	Less: rental expenses		191,264
c	Rental income or (loss)	0	73,259
d	Net rental income or (loss)......			73,259		22,759	50,500
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		248,260
b	Less: cost or other basis and sales expenses
c	Gain or (loss)		248,260
d	Net gain or (loss).....			248,260			248,260
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	MISCELLANEOUS INCOME		900099	227,205			227,205
b	INVESTMENT IN SUBSIDIARY		900003	1,014,289			1,014,289
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			1,241,494
12	Total revenue. See Instructions......			540,750,495	536,864,679	22,759	3,863,057

Form 990 (2015)

Page 10

Part IX

Statement of Functional Expenses

Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ..............

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.		(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	1,196,413	1,196,413
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	485,977,171	485,977,171
5	Compensation of current officers, directors, trustees, and key employees ....	5,004,439	4,103,640	900,799
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	10,505,699	8,614,673	1,891,026
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	2,038,947	1,671,937	367,010
9	Other employee benefits .......	2,495,821	2,046,573	449,248
10	Payroll taxes ...........	918,975	753,560	165,415
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	265,802	217,958	47,844
c	Accounting ...........	453,525	371,890	81,635
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	265,703	217,876	47,827
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	1,909,152	1,565,505	343,647
12	Advertising and promotion ....	1,723,557	1,413,317	310,240
13	Office expenses .......	3,113,529	2,553,094	560,435
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	615,826	504,977	110,849
17	Travel ............	728,867	597,671	131,196
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	144,291	118,319	25,972
20	Interest ...........	127,968	104,934	23,034
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	235,592	193,185	42,407
23	Insurance ...	327,665	268,685	58,980
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	BOARD AND BUREAU DUES	545,332	447,172	98,160
b	SERVICE BUREAU FEES	11,753,805	9,638,120	2,115,685
c	PUBLIC RELATIONS	738,597	605,650	132,947
d	SERVICE AGREEMENTS	290,467	238,183	52,284
e	All other expenses	712,017	583,855	128,162
25	Total functional expenses. Add lines 1 through 24e	532,089,160	524,004,358	8,084,802	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Form 990 (2015)

Page 11

Part X

Balance Sheet

Check if Schedule O contains a response or note to any line in this Part IX ..............

				(A) Beginning of year		(B) End of year

1	Cash–non-interest-bearing ........			0	1	0
2	Savings and temporary cash investments .........			24,305,435	2	14,123,784
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			32,643,748	4	32,640,505
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net ....			0	7	0
8	Inventories for sale or use ........			0	8	0
9	Prepaid expenses and deferred charges ......			253,936	9	251,105
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	13,893,804
b	Less: accumulated depreciation	10b	8,116,709	5,239,912	10c	5,777,095
11	Investments—publicly traded securities .			58,216,135	11	68,885,123
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			23,244,726	13	24,259,016
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			2,875,276	15	2,434,982
16	Total assets. Add lines 1 through 15 (must equal line 34)...			146,779,168	16	148,371,610

17	Accounts payable and accrued expenses .....	12,459,356	17	13,113,155
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	3,123,690	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	36,341,490	25	33,850,176
26	Total liabilities. Add lines 17 through 25..	51,924,536	26	46,963,331

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets		27
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....	0	30	0
31	Paid-in or capital surplus, or land, building or equipment fund ...	0	31	0
32	Retained earnings, endowment, accumulated income, or other funds	94,854,632	32	101,408,279
33	Total net assets or fund balances ...........	94,854,632	33	101,408,279
34	Total liabilities and net assets/fund balances ........	146,779,168	34	148,371,610

Form 990 (2015)

Page 12

Part XI

Reconcilliation of Net Assets

Check if Schedule O contains a response or note to any line in this Part XI ..............

Total revenue (must equal Part VIII, column (A), line 12) ............

540,750,495

Total expenses (must equal Part IX, column (A), line 25) ............

532,089,160

Revenue less expenses. Subtract line 2 from line 1 ..............

8,661,335

Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..

94,854,632

Net unrealized gains (losses) on investments ...............

-2,107,688

Donated services and use of facilities .................

Investment expenses .....................

Prior period adjustments .....................

Other changes in net assets or fund balances (explain in Schedule O) ........

Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))

101,408,279

Part XII

Financial Statements and Reporting

Check if Schedule O contains a response or note to any line in this Part XII .............

Yes

Accounting method used to prepare the Form 990: Cash Accrual Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.

Were the organization’s financial statements compiled or reviewed by an independent accountant?

If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separate basis

Were the organization’s financial statements audited by an independent accountant?

Yes

If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separate basis

If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?

Yes

If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.

As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?

If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.

Form 990 (2015)

Additional Data

Software ID:
Software Version:

Form 990, Special Condition Description:

Special Condition Description

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

DELTA DENTAL OF MISSOURI

Employer identification number

43-0908349

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	1,350,000		1,350,000
b	Buildings	5,954,872	2,617,355	3,337,517
c	Leasehold improvements	1,755,945	1,376,881	379,064
d	Equipment ...	1,596,633	1,549,959	46,674
e	Other ...	3,236,354	2,572,514	663,840
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				5,777,095

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1)INVEST. IN ADVANTICA HLDG CO	24,259,016	C
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	24,259,016

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
INCURRED BUT UNREPORTED CLAIMS	27,953,214
ESTIMATE UNPAID CLAIM PROCESS	930,335
UNEARNED PREMIUMS	4,560,374
EXPERIENCE RATED CREDIT LIAB	83,176
ADVANCE DEPOSITS	323,077
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	33,850,176
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
SCHEDULE D, PART X, TEXT OF FIN 48 FOOTNOTE	FIN 48 FOOTNOTE THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. ADVANTICA HOLDING COMPANY AND ITS WHOLLY-OWNED SUBSIDIARIES ARE SUBJECT TO BOTH FEDERAL AND STATE INCOME TAXES AND ACCOUNT FOR INCOME TAXES IN ACCORDANCE WITH INCOME TAX ACCOUNTING GUIDANCE (ASC 740 INCOME TAXES). THE INCOME TAX ACCOUNTING GUIDANCE RESULTS IN TWO COMPONENTS OF INCOME TAX EXPENSE: CURRENT AND DEFERRED. CURRENT INCOME TAX EXPENSE REFLECTS TAXES TO BE PAID OR REFUNDED FOR THE CURRENT PERIOD BY APPLYING THE PROVISIONS OF THE ENACTED TAX LAW TO THE TAXABLE INCOME OR EXCESS OF DEDUCTIONS OVER REVENUES. THE COMPANY DETERMINES DEFERRED INCOME TAXES USING THE LIABILITY (OR BALANCE SHEET) METHOD. UNDER THIS METHOD, THE NET DEFERRED TAX ASSET OR LIABILITY IS BASED ON THE TAX EFFECTS OF THE DIFFERENCES BETWEEN THE BOOK AND TAX BASES OF ASSETS AND LIABILITIES, AND ENACTED CHANGES IN TAX RATES AND LAWS ARE RECOGNIZED IN THE PERIOD IN WHICH THEY OCCUR. DEFERRED INCOME TAX EXPENSE RESULTS FROM CHANGES IN DEFERRED TAX ASSETS AND LIABILITES BETWEEN PERIODS. DEFERRED TAX ASSETS ARE REDUCED BY A VALUATION ALLOWANCE IF, BASED ON THE WEIGHT OF EVIDENCE AVAILABLE, IT IS MORE LIKELY THAN NOT THAT SOME PORTION OR ALL OF A DEFERRED TAX ASSET WILL NOT BE REALIZED. UNCERTAIN TAX POSITIONS ARE RECOGNIZED IF IT IS MORE LIKELY THAN NOT, BASED ON THE TECHNICAL MERITS, THAT THE TAX POSITION WILL BE REALIZED OR SUSTAINED UPON EXAMINIATION. THE TERM MORE LIKELY THAN NOT MEANS A LIKELIHOOD OF MORE THAN 50 PERCENT; THE TERMS EXAMINED AND UPON EXAMINATION ALSO INCLUDE RESOLUTION OF THE RELATED APPEALS OR LITIGATION PROCESSES, IF ANY. A TAX POSITION THAT MEETS THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD IS INITIALLY AND SUBSEQUENTLY MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT HAS A GREATER THAN 50 PERCENT LIKELIHOOD OF BEING REALIZED UPON SETTLEMENT WITH A TAXING AUTHORITY THAT HAS FULL KNOWLEDGE OF ALL RELEVANT INFORMATION. THE DETERMINATION OF WHETHER OR NOT A TAX POSITION HAS MET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD CONSIDERS THE FACTS, CIRCUMSTANCES AND INFOMRATION AVAILABLE AT THE REPORTING DATE AND IS SUBJECT TO THE MANAGEMENT'S JUDGEMENT. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES ON INCOME TAXES AS A COMPONENT OF INCOME TAX EXPENSE. ON A CONSOLIDATED BASIS, ADVANTICA HOLDING COMPANY AND ITS SUBSIDIARIES HAD AN OPERATING GAIN TOTALING $1,014,292 AND AN OPERATING LOSS TOTALING $4,276,474 AS OF DECEMBER 31, 2015 AND 2014, RESPECTIVELY. AT DECEMBER 31, 2015 AND 2014, ADVANTICA HOLDING COMPANY HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $27,044,000 AND $25,527,000, RESPECTIVELY, WHICH EXPIRE IN YEARS THROUGH 2035. ADVANTICA HOLDING AND ITS SUBSIDIARIES HAD DEFERRED TAX ASSETS OF APPROXIMATELY $8,837,000 AND $9,091,615 AT DECEMBER 31, 2015 AND 2014, RESPECTIVELY, NEARLY ALL OF WHICH ARISE FROM THESE NET OPERATING LOSS CARRYFORWARDS. DUE TO THE REMAINING UNCERTAINTY REGARDING WHETHER THESE WILL BE REALIZED, A FULL VALUATION ALLOWANCE HAS BEEN RECORDED AGAINST THESE DEFERRED TAX ASSETS AT DECEMBER 31, 2015 AND 2014. THE ORGANIZATION AND ITS SUBSIDIARIES ARE CURRENTLY OPEN TO EXAMINIATION UNDER THE STATUE OF LIMITATIONS BY THE INTERNAL REVENUE SERVICE AND STATES IN WHICH IT FILES FOR THE YEARS ENDED DECEMBER 31, 2012 THROUGH 2015.

Return Reference

Explanation

SCHEDULE D, PART X, TEXT OF FIN 48 FOOTNOTE

FIN 48 FOOTNOTE THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. ADVANTICA HOLDING COMPANY AND ITS WHOLLY-OWNED SUBSIDIARIES ARE SUBJECT TO BOTH FEDERAL AND STATE INCOME TAXES AND ACCOUNT FOR INCOME TAXES IN ACCORDANCE WITH INCOME TAX ACCOUNTING GUIDANCE (ASC 740 INCOME TAXES). THE INCOME TAX ACCOUNTING GUIDANCE RESULTS IN TWO COMPONENTS OF INCOME TAX EXPENSE: CURRENT AND DEFERRED. CURRENT INCOME TAX EXPENSE REFLECTS TAXES TO BE PAID OR REFUNDED FOR THE CURRENT PERIOD BY APPLYING THE PROVISIONS OF THE ENACTED TAX LAW TO THE TAXABLE INCOME OR EXCESS OF DEDUCTIONS OVER REVENUES. THE COMPANY DETERMINES DEFERRED INCOME TAXES USING THE LIABILITY (OR BALANCE SHEET) METHOD. UNDER THIS METHOD, THE NET DEFERRED TAX ASSET OR LIABILITY IS BASED ON THE TAX EFFECTS OF THE DIFFERENCES BETWEEN THE BOOK AND TAX BASES OF ASSETS AND LIABILITIES, AND ENACTED CHANGES IN TAX RATES AND LAWS ARE RECOGNIZED IN THE PERIOD IN WHICH THEY OCCUR. DEFERRED INCOME TAX EXPENSE RESULTS FROM CHANGES IN DEFERRED TAX ASSETS AND LIABILITES BETWEEN PERIODS. DEFERRED TAX ASSETS ARE REDUCED BY A VALUATION ALLOWANCE IF, BASED ON THE WEIGHT OF EVIDENCE AVAILABLE, IT IS MORE LIKELY THAN NOT THAT SOME PORTION OR ALL OF A DEFERRED TAX ASSET WILL NOT BE REALIZED. UNCERTAIN TAX POSITIONS ARE RECOGNIZED IF IT IS MORE LIKELY THAN NOT, BASED ON THE TECHNICAL MERITS, THAT THE TAX POSITION WILL BE REALIZED OR SUSTAINED UPON EXAMINIATION. THE TERM MORE LIKELY THAN NOT MEANS A LIKELIHOOD OF MORE THAN 50 PERCENT; THE TERMS EXAMINED AND UPON EXAMINATION ALSO INCLUDE RESOLUTION OF THE RELATED APPEALS OR LITIGATION PROCESSES, IF ANY. A TAX POSITION THAT MEETS THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD IS INITIALLY AND SUBSEQUENTLY MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT HAS A GREATER THAN 50 PERCENT LIKELIHOOD OF BEING REALIZED UPON SETTLEMENT WITH A TAXING AUTHORITY THAT HAS FULL KNOWLEDGE OF ALL RELEVANT INFORMATION. THE DETERMINATION OF WHETHER OR NOT A TAX POSITION HAS MET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD CONSIDERS THE FACTS, CIRCUMSTANCES AND INFOMRATION AVAILABLE AT THE REPORTING DATE AND IS SUBJECT TO THE MANAGEMENT'S JUDGEMENT. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES ON INCOME TAXES AS A COMPONENT OF INCOME TAX EXPENSE. ON A CONSOLIDATED BASIS, ADVANTICA HOLDING COMPANY AND ITS SUBSIDIARIES HAD AN OPERATING GAIN TOTALING $1,014,292 AND AN OPERATING LOSS TOTALING $4,276,474 AS OF DECEMBER 31, 2015 AND 2014, RESPECTIVELY. AT DECEMBER 31, 2015 AND 2014, ADVANTICA HOLDING COMPANY HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $27,044,000 AND $25,527,000, RESPECTIVELY, WHICH EXPIRE IN YEARS THROUGH 2035. ADVANTICA HOLDING AND ITS SUBSIDIARIES HAD DEFERRED TAX ASSETS OF APPROXIMATELY $8,837,000 AND $9,091,615 AT DECEMBER 31, 2015 AND 2014, RESPECTIVELY, NEARLY ALL OF WHICH ARISE FROM THESE NET OPERATING LOSS CARRYFORWARDS. DUE TO THE REMAINING UNCERTAINTY REGARDING WHETHER THESE WILL BE REALIZED, A FULL VALUATION ALLOWANCE HAS BEEN RECORDED AGAINST THESE DEFERRED TAX ASSETS AT DECEMBER 31, 2015 AND 2014. THE ORGANIZATION AND ITS SUBSIDIARIES ARE CURRENTLY OPEN TO EXAMINIATION UNDER THE STATUE OF LIMITATIONS BY THE INTERNAL REVENUE SERVICE AND STATES IN WHICH IT FILES FOR THE YEARS ENDED DECEMBER 31, 2012 THROUGH 2015.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
DELTA DENTAL OF MISSOURI

Employer identification number
43-0908349

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

(1) MISSOURI DENTAL ASSOCIATION FOUNDATION 3340 AMERICAN AVE JEFFERSON CITY,MO65109	44-0535233	501(C)(3)	100,500	GENERAL SUPPORT
(2) DENTAL LIFELINE NETWORK PO BOX 8598 KANSAS CITY,MO64114	90-0293508	501(C)(3)	50,000	GENERAL SUPPORT
(3) SOUTH CAROLINA DENTAL ASSOCIATION 120 STONEMARK LANE COLUMBIA,SC29210	57-0399460	501(C)(3)	50,000	GENERAL SUPPORT
(4) TRUMAN MEDICAL CENTER CHARITABLE FOUNDATION 2330 HOLMES KANSAS CITY,MO64108	43-1194064	501(C)(3)	20,000	GENERAL SUPPORT
(5) THE ELLIS FOUNDATION PO BOX 54 FORT SCOTT,KS66701	48-1093604	501(C)(3)	16,000	GENERAL SUPPORT
(6) RONALD MCDONALD HOUSE CHARITIES 949 E PRIMROSE ST SPRINGFIELD,MO65807	43-0494640	501(C)(3)	15,000	GENERAL SUPPORT
(7) AMERICAN LUNG ASSOCIAITON 55 W WACKER DRIVE CHICAGO,IL60601	13-1632524	501(C)(3)	8,853	GENERAL SUPPORT
(8) ROPER ST FRANCIS FOUNDATION 125 DOUGHTY ST CHARLESTON,SC29403	57-1068509	501(C)(3)	7,500	GENERAL SUPPORT
(9) PALMETTO HEALTH FOUNDATION 1600 MARION ST COLUMBIA,SC29202	57-0725699	501(C)(3)	7,500	GENERAL SUPPORT
(10) GIVE KIDS A SMILE 340 MID RIVERS MALL DR ST PETERS,MO63376	20-1287939	501(C)(3)	6,500	GENERAL SUPPORT
(11) GREENVILLE FREE MEDICAL CLINIC INC 600 ARLINGTON AVE GREENVILLE,SC29601	57-0855205	501(C)(3)	5,400	GENERAL SUPPORT
(12) MISSOURI COALITION FOR ORAL HEALTH 606 E CAPITAL AVE JEFFERSON CITY,MO65101	20-5032836	501(C)(3)	5,100	GENERAL SUPPORT
(13) DENTAL HEALTH THEATRE INC 727 NORTH 1ST ST ST LOUIS,MO63102	75-3018876	501(C)(3)	850,000	COMMUNITY DONATIONS

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of non-cash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of non-cash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference	Explanation
SCHEDULE I, PART I, LINE 2	PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S. Y DELTA DENTAL MAINTAINS RECORDS TO SUBSTANTIATE THE AMOUNT OF ASSISTANCE THAT IT PROVIDES TO THE COMMUNITY ORGANIZATIONS. DELTA DENTAL WORKS WITH THE INDIVIDUAL ORGANIZATIONS TO UNDERSTAND THEIR MISSIONS AND TO DETERMINE THE BENEFITS OF DELTA DENTAL'S PARTICIPATION.

Schedule I (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

DELTA DENTAL OF MISSOURI

Employer identification number

43-0908349

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

Any related organization? .........................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2015

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1GOREN EB ROBPRESIDENT & CEO	(i) (ii)	304,076 ------------- 0	84,000 ------------- 0	22,794 ------------- 0	73,665 ------------- 0	30,035 ------------- 0	514,570 ------------- 0	-------------
2BENTRUP BARBARA CCFO & CORPORATE COUNSEL	(i) (ii)	321,586 ------------- 0	107,509 ------------- 0	31,356 ------------- 0	150,539 ------------- 0	12,023 ------------- 0	623,013 ------------- 0	-------------
3LEES JANICE MVP BOARD RELATIONS	(i) (ii)	112,021 ------------- 0	39,652 ------------- 0	25,662 ------------- 0	67,636 ------------- 0	22,386 ------------- 0	267,357 ------------- 0	-------------
4MARTIN PAMELA ASENIOR VP & COO	(i) (ii)	204,308 ------------- 0	69,815 ------------- 0	47,855 ------------- 0	109,972 ------------- 0	20,167 ------------- 0	452,117 ------------- 0	-------------
5MUDRA KARL ACIO	(i) (ii)	231,293 ------------- 0	79,422 ------------- 0	23,216 ------------- 0	66,006 ------------- 0	27,270 ------------- 0	427,207 ------------- 0	-------------
6PATTAROZZI EDWARD ACHIEF SALES/MARKETING OFFICER	(i) (ii)	311,590 ------------- 0	62,000 ------------- 0	19,629 ------------- 0	107,422 ------------- 0	21,536 ------------- 0	522,177 ------------- 0	-------------
7LAFFITTE HENRY SVP, SALES & ACCOUNT MANAGEMENT	(i) (ii)	206,877 ------------- 0	151,059 ------------- 0	8,308 ------------- 0	39,117 ------------- 0	12,882 ------------- 0	418,243 ------------- 0	-------------
8PYLE LYNNREGIONAL VICE PRESIDENT, SALES	(i) (ii)	78,521 ------------- 0	125,209 ------------- 0	3,184 ------------- 0	31,334 ------------- 0	21,436 ------------- 0	259,684 ------------- 0	-------------
9AUBUCHON JEANNE GVICE PRESIDENT OF SALES	(i) (ii)	92,960 ------------- 0	97,145 ------------- 0	9,879 ------------- 0	29,563 ------------- 0	29,660 ------------- 0	259,207 ------------- 0	-------------
10SAMUELS ELLEN RMANAGER, CORPORATE COMPLIANCE	(i) (ii)	162,736 ------------- 0	44,558 ------------- 0	988 ------------- 0	29,631 ------------- 0	26,576 ------------- 0	264,489 ------------- 0	-------------
11HAYNES DAVID WPRESIDENT & CEO	(i) (ii)	503,674 -------------	203,693 -------------	1,388,567 -------------	39,750 -------------	30,035 -------------	2,165,719 -------------	1,154,456 -------------

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE J, PART I, LINE 1A	INFORMATION REGARDING BENEFITS PROVIDED HEALTH CLUB DUES WERE PAID FOR THE FOLLOWING EMPLOYEES: DAVID HAYNES, KARL MUDRA, AND EDWARD PATTAROZZI. THESE AMOUNTS ARE TREATED AS TAXABLE COMPENSATION.
SCHEDULE J, PART I, LINE 4B	NAMES, AMOUNTS, AND DETAILS OF ARRANGEMENTS THE ORGANIZATION HAS A NONQUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR THE BENEFIT OF CERTAIN EMPLOYEES TO RECEIVE CONTRIBUTIONS IN EXCESS OF THE LIMITATIONS IMPOSED BY THE INTERNAL REVENUE CODE ON STANDARD EMPLOYEE PENSION PLANS. AMOUNTS PAID DURING 2015 FOR THE FOLLOWING INDIVIDUALS WERE: - DAVID HAYNES $ 54,814 - BARBARA BENTRUP $ 18,867 - E. B. ROB GOREN $ 6,208 - KARL MUDRA $ 5,807 - PAMELA MARTIN $ 870 THE ORGANIZATION HAS AN UNFUNDED NONQUALIFIED, DEFINED BENEFIT DEFERRED COMPENSATION PLAN (DBDCP) FOR ITS SENIOR LEVEL EXECUTIVES, WITH VESTING OVER 10 TO 15 YEARS OF SERVICE TO THE ORGANIZATION. THE ACTUARIALLY DETERMINED LIABILITY IS BASED UPON ASSUMPTIONS FOR REMAINING YEARS OF SERVICE UNTIL RETIREMENT, PROJECTED SALARIES FOR THE FINAL THREE YEARS OF SERVICE, AND A PREDETERMINED BENEFIT PERCENTAGE BASED UPON THE PARTICIPANTS POSITION. INDIVIDUALS WHO PARTICIPATED IN THIS PLAN DURING 2015 WERE THE FOLLOWING: DAVID HAYNES, BARBARA BENTRUP, E. B. ROB GOREN, JANICE LEES, PAMELA MARTIN, EDWARD PATTAROZZI, AND KARL MUDRA. ALL INCREASES IN THE PROJECTED BENEFIT ACCRUALS FOR THIS DBDCP ARE REPORTED ANNUALLY IN THE FORM 990 FOR EACH PARTICIPANT. IT IS IMPORTANT TO NOTE THAT SEVERAL PARTICIPANTS IN THIS PROGRAM ARE NOT YET VESTED, YET THE INCREASE IN THE VALUE OF THE COMPANYS ACCRUAL HAS TO BE REPORTED ANNUALLY AS COMPENSATION IN THE FORM 990 FOR EACH OF THE PARTICIPANTS WHEN THERE WAS NO BENEFIT VALUE TO THEM PERSONALLY IF PARTICIPANTS LEAVE THE COMPANY PRIOR TO MEETING THE AGE AND SERVICE REQUIREMENTS, THERE IS NO BENEFIT PAYABLE. SCHEDULE J, PART II, COLUMN C INCLUDES THESES AMOUNTS FOR THE INCREASES IN THE COMPANYS ACCRUAL. THE AMOUNTS PER PARTICIPANT ARE: - BARBARA BENTRUP $ 110,789 - E. B. ROB GOREN $ 34,455 - PAMELA MARTIN $ 70,222 - KARL MUDRA $ 26,256 - JANICE LEES $ 44,185 - EDWARD PATTAROZZI $ 67,672 AMOUNTS PAID UNDER THE PLAN IN 2015 PER PARTICIPANT WERE: -DAVID HAYNES $ 1,316,225 -PAMELA MARTIN $ 12,344 -JANICE LEES $ 4,759

Return Reference

Explanation

SCHEDULE J, PART I, LINE 1A

INFORMATION REGARDING BENEFITS PROVIDED HEALTH CLUB DUES WERE PAID FOR THE FOLLOWING EMPLOYEES: DAVID HAYNES, KARL MUDRA, AND EDWARD PATTAROZZI. THESE AMOUNTS ARE TREATED AS TAXABLE COMPENSATION.

SCHEDULE J, PART I, LINE 4B

NAMES, AMOUNTS, AND DETAILS OF ARRANGEMENTS THE ORGANIZATION HAS A NONQUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR THE BENEFIT OF CERTAIN EMPLOYEES TO RECEIVE CONTRIBUTIONS IN EXCESS OF THE LIMITATIONS IMPOSED BY THE INTERNAL REVENUE CODE ON STANDARD EMPLOYEE PENSION PLANS. AMOUNTS PAID DURING 2015 FOR THE FOLLOWING INDIVIDUALS WERE: - DAVID HAYNES $ 54,814 - BARBARA BENTRUP $ 18,867 - E. B. ROB GOREN $ 6,208 - KARL MUDRA $ 5,807 - PAMELA MARTIN $ 870 THE ORGANIZATION HAS AN UNFUNDED NONQUALIFIED, DEFINED BENEFIT DEFERRED COMPENSATION PLAN (DBDCP) FOR ITS SENIOR LEVEL EXECUTIVES, WITH VESTING OVER 10 TO 15 YEARS OF SERVICE TO THE ORGANIZATION. THE ACTUARIALLY DETERMINED LIABILITY IS BASED UPON ASSUMPTIONS FOR REMAINING YEARS OF SERVICE UNTIL RETIREMENT, PROJECTED SALARIES FOR THE FINAL THREE YEARS OF SERVICE, AND A PREDETERMINED BENEFIT PERCENTAGE BASED UPON THE PARTICIPANTS POSITION. INDIVIDUALS WHO PARTICIPATED IN THIS PLAN DURING 2015 WERE THE FOLLOWING: DAVID HAYNES, BARBARA BENTRUP, E. B. ROB GOREN, JANICE LEES, PAMELA MARTIN, EDWARD PATTAROZZI, AND KARL MUDRA. ALL INCREASES IN THE PROJECTED BENEFIT ACCRUALS FOR THIS DBDCP ARE REPORTED ANNUALLY IN THE FORM 990 FOR EACH PARTICIPANT. IT IS IMPORTANT TO NOTE THAT SEVERAL PARTICIPANTS IN THIS PROGRAM ARE NOT YET VESTED, YET THE INCREASE IN THE VALUE OF THE COMPANYS ACCRUAL HAS TO BE REPORTED ANNUALLY AS COMPENSATION IN THE FORM 990 FOR EACH OF THE PARTICIPANTS WHEN THERE WAS NO BENEFIT VALUE TO THEM PERSONALLY IF PARTICIPANTS LEAVE THE COMPANY PRIOR TO MEETING THE AGE AND SERVICE REQUIREMENTS, THERE IS NO BENEFIT PAYABLE. SCHEDULE J, PART II, COLUMN C INCLUDES THESES AMOUNTS FOR THE INCREASES IN THE COMPANYS ACCRUAL. THE AMOUNTS PER PARTICIPANT ARE: - BARBARA BENTRUP $ 110,789 - E. B. ROB GOREN $ 34,455 - PAMELA MARTIN $ 70,222 - KARL MUDRA $ 26,256 - JANICE LEES $ 44,185 - EDWARD PATTAROZZI $ 67,672 AMOUNTS PAID UNDER THE PLAN IN 2015 PER PARTICIPANT WERE: -DAVID HAYNES $ 1,316,225 -PAMELA MARTIN $ 12,344 -JANICE LEES $ 4,759

Schedule J (Form 990) 2015

Additional Data

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- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

DELTA DENTAL OF MISSOURI

Employer identification number

43-0908349

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No










Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2015

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) JAMES W RHEA DDS PC	BOARD MEMBER AS OWNER	206,977	DENTAL SERVICES PROVIDED		No
(2) FINNANE-ROBISON DENTAL LLC	BOARD MEMBER AS OWNER	166,636	DENTAL SERVICES PROVIDED		No
(3) CURRY TAYLOR DDS LLC	BOARD MEMBER AS OWNER	183,159	DENTAL SERVICES PROVIDED		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
PART IV, LINE 1	BUSINESS TRANSACTIONS BOARD MEMBER JAMES W. RHEA DDS HAS A REPORTABLE INTEREST IN JAMES W RHEA DDS PC WHICH PROVIDES DENTAL SERVICES TO SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION. BOARD MEMBER EDWARD ROBISON DDS HAS A REPORTABLE INTEREST IN FINNANE-ROBISON DENTAL LLC WHICH PROVIDES DENTAL SERVICES TO SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION. BOARD MEMBER TIMOTHY TAYLOR HAS A REPORTABLE INTEREST IN CURRY TAYLOR DDS LLC WHICH PROVIDES DENTAL SERVICES TO SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION.

Return Reference

Explanation

PART IV, LINE 1

BUSINESS TRANSACTIONS BOARD MEMBER JAMES W. RHEA DDS HAS A REPORTABLE INTEREST IN JAMES W RHEA DDS PC WHICH PROVIDES DENTAL SERVICES TO SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION. BOARD MEMBER EDWARD ROBISON DDS HAS A REPORTABLE INTEREST IN FINNANE-ROBISON DENTAL LLC WHICH PROVIDES DENTAL SERVICES TO SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION. BOARD MEMBER TIMOTHY TAYLOR HAS A REPORTABLE INTEREST IN CURRY TAYLOR DDS LLC WHICH PROVIDES DENTAL SERVICES TO SUBSCRIBERS AND DEPENDENTS OF BENEFIT PLANS INSURED OR ADMINISTERED BY THE ORGANIZATION.

Schedule L (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

DELTA DENTAL OF MISSOURI

Employer identification number

43-0908349

Return Reference	Explanation
FORM 990, PART III, LINE 4B	DESCRIPTION OF OTHER PROGRAM SERVICES DELTA DENTAL HEALTH THEATRE CO-SPONSORS/COALITIONS INVOLVED: ST. LOUIS DENTAL SOCIETY AND VARIOUS CHARITABLE CORPORATE DONORS (E.G., CARDINALS CARE, MISSOURI FOUNDATION FOR HEALTH, AND OTHERS). PROGRAM DESCRIPTION: THE DELTA DENTAL HEALTH THEATRE (PREVIOUSLY NAMED DENTAL HEALTH THEATRE) HAS BEEN PROVIDING ORAL HEALTH EDUCATION AND ENTERTAINMENT TO YOUNG CHILDREN IN THE ST. LOUIS METROPOLITAN AREA FOR MORE THAN 30 YEARS, SINCE ITS INCEPTION IN 1977. APPROXIMATELY 20,000 VISITORS, PRIMARILY FROM SCHOOL FIELD TRIPS, VISITED THE THEATRE IN 2015. IN 2002 DELTA DENTAL OF MISSOURI BECAME THE PRIMARY SPONSOR OF THE DELTA DENTAL HEALTH THEATRE, AND WE BEGAN WORKING WITH THE THEATRE'S BOARD OF DIRECTORS TO MAKE PROGRAM AND FACILITY IMPROVEMENTS. A FEATURE PRESENTATION NOW INCLUDES A VIDEO OF DDMO'S AWARD-WINNING LAND OF SMILES PROGRAM, A PUPPET VIDEO OF A VISIT TO "HEALTHY HOLLOW" INTRODUCING A CAST OF FANTASY CHARACTERS WHO EACH TEACH SOMETHING ABOUT GOOD ORAL HEALTH AND A HEALTHY LIFESTYLE, AND AN ANIMATRONIC TOUCAN THAT LEADS DISCUSSIONS OF CONFIDENCE THROUGH A "YOU CAN" THEME. A MAJOR RECONSTRUCTION IN 2011 ENHANCED THE LEARNING EXPERIENCE BY OPENING UP SPACE, CREATING ATTRACTIVE MURALS AND ADDING INTERACTIVE EXHIBITS. WE WILL CONTINUE TO EXPAND THE PROGRAMMING TO INTEGRATE EDUCATION ON OVERALL HEALTH AND WELLNESS, FITNESS AND NUTRITION ALONG WITH ORAL HEALTH INFORMATION TO RAISE AWARENESS FOR THE IMPORTANCE OF ORAL HEALTH AND OF THE LINK BETWEEN ORAL HEALTH AND OVERALL HEALTH. THE THEATRE IS ALSO EXPANDING OUTREACH BY PARTICIPATING IN CIVIC EVENTS AND HEALTH FAIRS, SUCH AS WINTER ZOO AND BOO AT THE ZOO AT THE ST. LOUIS ZOO; BABY KIDS EXPO, WHERE THE THEATRE PROVIDES EDUCATIONAL PROGRAMS, PAMPHLETS, AND DENTAL CARE SUPPLIES; AND THE DDHT CANDY EXCHANGE WHERE THE THEATRE ACCEPTS EXCESS HALLOWEEN CANDY IN EXCHANGE FOR A CARNIVAL FOR THE KIDS. LONGEVITY: THE THEATRE HAS BEEN OPERATING SINCE 1977. DELTA DENTAL HAS BEEN A PRIMARY SPONSOR SINCE 2002.
FORM 990, PART III, LINE 4C	DESCRIPTION OF OTHER PROGRAM SERVICES LAND OF SMILES TOURING THEATRICAL EDUCATION PROGRAM DESCRIPTION: LAND OF SMILES IS A TOURING, THEATRICAL PROGRAM THAT FEATURES TOOTH WIZARD, LITTLE SISTER TOOTH FAIRY AND THEIR ARCH ENEMY PLAQUEMAN. THE SHOW TRAVELED TO 400 SCHOOLS (K-3RD GRADE CLASSROOMS) THROUGHOUT THE STATES OF MISSOURI AND SOUTH CAROLINA IN 2015, TEACHING CHILDREN THE IMPORTANCE OF ORAL HEALTH. AN ASSEMBLY-STYLE LIVE PERFORMANCE WITH AUDIENCE PARTICIPATION, THE PROGRAM CAPTURES EACH STUDENT'S ATTENTION THROUGH FUN, KID-FOCUSED ENTERTAINMENT. THE THREE CHARACTERS EXPLAIN PROPER BRUSHING TECHNIQUES, HOW TO FLOSS, GOOD AND BAD FOODS FOR THE TEETH AND WHY IT IS IMPORTANT TO VISIT THE DENTIST TWICE A YEAR. EACH CHILD IS GIVEN A TAKE-HOME "SMILE BAG" FILLED WITH A TOOTHBRUSH, TOOTHPASTE, FLOSS, A COLORING SHEET, AND A REMINDER DECAL. STUDENTS WHO COMPLETE THE PROGRAM ALSO EARN HEALTHY SMILE "CERTOOTHICATES." TO REINFORCE THE MESSAGES OF THE PROGRAM AFTER THE PERFORMANCE, DDMO DISTRIBUTES A CURRICULUM KIT THAT INCLUDES A DVD, A LARGE MODEL OF A MOUTH, A LARGE TOOTHBRUSH, AND AUDIO VISUAL EDUCATIONAL TOOLS FOR USE IN THE CLASSROOM, AS WELL AS BOOKS FOR THE LIBRARY. A KIDS' WEBSITE, WWW.LANDOFSMILESVIDEO.COM, PROVIDES ANOTHER SOURCE TO VIEW THE DVD ONLINE. THIS PROGRAM REACHES OVER 90,000 CHILDREN EACH YEAR. TEACHERS AND SCHOOL NURSES CONSISTENTLY RATE THE PROGRAM AS EXCELLENT, AND TYPICALLY FOLLOW UP EACH SHOW WITH A REQUEST TO BE ADDED TO THE LIST IN THE TWO-YEAR CYCLE. IN ADDITION TO THE SCHOOL TOUR, THE LAND OF SMILES PROGRAM IS PERFORMED AT THE GIVE KIDS A SMILE CLINICS IN ST. LOUIS AND AT MORE THAN 20 AREA HEALTH FAIRS, WITH NEARLY 50,000 KIDS AND FAMILIES ATTENDING THROUGH THE YEAR. LONGEVITY: THIS PROGRAM HAS BEEN IN PLACE SINCE 2002.
FORM 990, PART III, LINE 4D	DESCRIPTION OF OTHER PROGRAM SERVICES GIVE KIDS A SMILE ("GKAS") IN ST. LOUIS CO-SPONSORS/COALITIONS INVOLVED: GREATER ST. LOUIS DENTAL SOCIETY (GSLDS) AND GREATER KANSAS CITY DENTAL SOCIETY. PROGRAM DESCRIPTION: ONE OF OUR MOST SUCCESSFUL OUTREACH INITIATIVES, GKAS WAS LAUNCHED IN ST. LOUIS, MISSOURI, IN FEBRUARY OF 2002 IN PARTNERSHIP WITH GSLDS. IN 2015, GKAS IN ST. LOUIS PROVIDED 4,000 CHILDREN WITH MORE THAN $1 MILLION WORTH OF FREE DENTAL CARE AND ORAL HEALTH EDUCATION AT ITS TWO CLINICS AND OTHER COMMUNITY PROGRAMS. AT THE TWO-DAY CLINICS, SEVERAL HUNDRED LOCAL DENTISTS, HYGIENISTS AND ASSISTANTS, SUPPORTED BY LAY VOLUNTEERS AND SPONSORS, SUCH AS DELTA DENTAL, PROVIDE CHILDREN WITH FREE, COMPREHENSIVE DENTAL CARE, INCLUDING EXAMS, SEALANTS, X-RAYS, PROFESSIONAL CLEANINGS, FLUORIDE TREATMENTS, RESTORATIONS AND MORE. ON-SITE ENTERTAINMENT SUCH AS FACE PAINTING,STORYTELLING, BALLOONISTS, DELTA DENTAL'S TOOTH WIZARD, P.A.N.D.A. AND TOOTH FAIRY CHARACTERS, EDUCATIONAL VIDEOS, DENTAL CARE KITS, FREE TOYS AND BOOKS AND SACK LUNCHES ENSURE THAT THE CHILDREN'S VISIT TO THE DENTIST IS ASSOCIATED WITH A FUN AND EDUCATIONAL EXPERIENCE. FOR EACH CLINIC, DELTA DENTAL OF MISSOURI PROVIDES BUS TRANSPORTATION FOR GROUPS OF CHILDREN AND FUNDS ALL PUBLIC RELATIONS AND MARKETING ACTIVITIES, FACILITY LIABILITY COVERAGE, VOLUNTEER T-SHIRTS, EVENT SIGNAGE, DECORATIONS, GIVEAWAYS, AND ENTERTAINERS. IN 2003, GKAS WAS ADOPTED BY THE AMERICAN DENTAL ASSOCIATION AS A NATIONAL CAMPAIGN. IN 2006, GKAS WAS RECOGNIZED BY CONGRESS AS AN EXEMPLARY GRASSROOTS EFFORT. THE GKAS PROGRAM WAS EXPANDED TO THE GREATER KANSAS CITY AREA IN 2013. LONGEVITY: THIS PROGRAM HAS BEEN IN PLACE SINCE 2002.
FORM 990, PART VI, SECTION A, LINE 4	CHANGES TO BY-LAWS ART. I, SEC. 2 UPDATES REFERENCE TO THE "MISSOURI NONPROFIT CORPORATION ACT" ART. II, SEC. 3 EXPANDS THE ABILITY TO CALL SPECIAL MEETINGS BY THE MEMBERS FOR ANY OF THE PURPOSES PERMITTED UNDER MISOURI LAW ART. II, SEC. 4 EXPANDS VOTING BY WRITTEN BALLOT ART. II, SEC. 5; ART. XI, SEC. 1, ART. III, SEC. 3 EXPANDS MATTERS WHICH MAY BE VOTED ON BY MEMBERS TO INCLUDE PROPOSED AMENDMENTS TO THE BYLAWS IN ACCORDANCE WITH MISSOURI LAW ART. II, SEC. 6 INCREASES THE NOTICE PERIOD FOR THE ANNUAL MEETING TO BETWEEN 30 AND 60 DAYS (WAS 30 AND 45 DAYS) ART. III, SEC. 1 CHANGES THE NOMINATION DEADLINE TO 30 DAYS PRIOR TO THE ELECTION DATE TO ALLOW MORE TIME TO SEND OUT, PROCESS, AND COUNT ALL BALLOTS BY THE ELECTION DATE (WAS 15 DAYS) ART. VI, SEC. 1.D. INCREASES THE TIMEFRAME TO PROVIDE NOTICE OF THE GOVERNANCE & NOMINATING COMMITTEE NOMINEES TO BETWEEN 30 AND 60 DAYS (WAS 30 AND 45 DAYS) ART. III, SEC. 6 CHANGES THE NUMBER OF DAYS WITHIN WHICH THE ANNUAL MEETING OF THE DIRECTORS WILL OCCUR AFTER THE ANNUAL MEETING OF THE MEMBERS FROM CURRENTLY 30 DAYS TO 60 DAYS ART. IX CHANGES THE RULES OF ORDER FROM ROBERTS RULES OF ORDER TO THE STANDARD CODE OF PARLIAMENTARY PROCEDURE ART. VI, SEC. 1 CLARIFIES THE IDENTITY OF THE PERSONS THAT CAN SIT ON COMMITTEES; REMOVES OVERSIGHT OF THE PENSION PLAN FROM THE FINANCE & AUDIT COMMITTEE AS THE TRUSTEES OF THE PENSION PLAN PROVIDE OVERSIGHT; AND ADDS THAT AT LEAST 3 PERSONS ON THE DENTAL STANDARDS AND DENTAL HEALTH EDUCATION COMMITTEE MUST BE MEMBERS OF THE CORPORATION ART. III, SEC. 2 SPECIFIES THAT DIRECTOR TERMS COMMENCE UPON THE ANNOUNCEMENT OF THE RESULTS OF THE ANNUAL ELECTION ART. V, SEC. 5; ART. III, SEC. 1 ELIMINATES THE PRESIDENT/CEO AS A VOTING MEMBER OF THE BOARD OF DIRECTORS; THE PRESIDENT/CEO NOW SERVES AS AN EX-OFFICIO, NONVOTING MEMBER OF THE BOARD OF DIRECTORS. ART. III, SEC. 1 CLARIFIES THE REQUIREMENTS TO QUALIFY TO SERVE AS A DIRECTOR
FORM 990, PART VI, SECTION A, LINE 6	CLASSES OF MEMBERS OR STOCKHOLDERS THE MEMBERS OF THE ORGANIZATION ARE COMPRISED OF LICENSED DENTISTS IN THE STATES OF MISSOURI AND SOUTH CAROLINA WHO HAVE SIGNED A PARTICIPATING DENTIST AGREEMENT WITH THE ORGANIZATION. THE MEMBERS MEET ANNUALLY.
FORM 990, PART VI, SECTION A, LINE 7A	MEMBERS OR STOCKHOLDRS WHO CAN ELECT MEMBERS OF THE GOVERNING BODY THE ORGANIZATION HAS MEMBERS WHO ELECT THE INDIVIDUALS TO SERVE ON THE ORGANIZATION'S BOARD OF DIRECTORS. THE MEMBERS OF THE ORGANIZATION ARE COMPRISED OF LICENSED DENTISTS IN THE STATES OF MISSOURI AND SOUTH CAROLINA WHO HAVE SIGNED A PARTICIPATING DENTIST AGREEMENT WITH THE ORGANIZATION. THE MEMBERS MEET ANNUALLY.
FORM 990, PART VI, SECTION A, LINE 7B	GOVERNANCE DECISIONS RECOMMENDED CHANGES TO THE CORPORATE BYLAWS BY THE BOARD ARE SUBJECT TO APPROVAL BY THE MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11B	PROCESS TO REVIEW THE FORM 990 THE FORM 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. THE FORM 990 IS THEN REVIEWED IN DETAIL BY THE ORGANIZATION'S CFO AND PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE ELECTRONIC FILING OF THE FROM 990 WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY DELTA DENTAL OF MISSOURI REGULARLY REQUIRES ITS OFFICERS, DIRECTORS, AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST STATEMENT. THE REVIEW OF THE STATEMENTS IS PART OF THE FINANCE AND AUDIT COMMITTEE'S RESPONSIBILITIES.
PART VI, QUESTION 15A & 15B	COMPENSATION APPROVAL PROCESS DELTA DENTAL OF MISSOURI HAS ESTABLISHED A COMPENSATION COMMITTEE (A SUBSET OF THE BOARD OF DIRECTORS) COMPOSED ENTIRELY OF PERSONS WITH NO CONFLICT OF INTEREST THAT REVIEWS AND SETS OFFICER COMPENSATION IN ACCORDANCE WITH THE PROCESS OUTLINED IN TREASURY REGULATION SECTION 53.4958-6 FOR ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS OF THE COMPENSATION OF THE CEO AND ALL OTHER OFFICERS. THIS PROCESS INCLUDES EMPLOYING INDEPENDENT COMPENSATION CONSULTANTS, UTILIZING RELEVANT COMPENSATION SURVEYS AND STUDIES, CONTEMPORANEOUSLY DOCUMENTING AND RECORDING THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT, AND SEEKING APPROVAL ON FINALIZED COMPENSATION PROPOSALS BY THE COMMITTEE AND BOARD OF DIRECTORS.
PART VI, LINE 19	DISCLOSURE THE ORGANIZATION'S CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

DELTA DENTAL OF MISSOURI

Employer identification number

43-0908349

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) ADVANTICA HOLDING COMPANY 12399 GRAVOIS ROAD ST LOUIS,MO63127 26-1323283	HOLDING COMPANY	MO	NA	C-CORP	66,591,076	30,741,127	100.000 %	Yes

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) ADVANTICA HOLDING COMPANY	L	698,904	ALLOCATIONS
(2) ADVANTICA HOLDING COMPANY	M	9,334,191	EXPENSE BASED

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:
Software Version: