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 Rhode Island

% GEORGE BEDARD

Doing business as

Number and street (or P.O. box if mail is not delivered to street address)
10 Charles Street

Room/suite

City or town, state or province, country, and ZIP or foreign postal code
Providence, RI02904

D Employer identification number

05-0296998

E Telephone number

G Gross receipts $ 233,078,487

F Name and address of principal officer:
JOSEPH NAGLE
10 Charles Street
Providence,RI02904

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

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

Website:

www.deltadentalri.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: 1959

M State of legal domicile: RI

Part I

Summary

1	Briefly describe the organization’s mission or most significant activities: to provide cost effective group dental insurance to the rhode island business communities.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	14
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	58
6	Total number of volunteers (estimate if necessary) .............	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	192,230,670	196,524,961
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	2,324,689	3,147,829
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	167,584	169,621
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	194,722,943	199,842,411
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,547,361	545,271
14	Benefits paid to or for members (Part IX, column (A), line 4).....	168,200,203	177,440,293
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	10,407,455	11,724,651
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)....	10,159,375	9,070,969
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	190,314,394	198,781,184
19	Revenue less expenses. Subtract line 18 from line 12.......	4,408,549	1,061,227
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	110,755,768	107,812,958
21	Total liabilities (Part X, line 26).............	18,706,502	18,698,122
22	Net assets or fund balances. Subtract line 21 from line 20.....	92,049,266	89,114,836

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: Our mission is to deliver impeccable service, quality and innovation that exceeds expectations. As experts in oral health care, we are committed to accessible, affordable care that drives improved health outcomes.

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 $ 177,985,564 including grants of $ ) (Revenue $ 196,374,807 )
	Dental Benefits for 579,866 members under 276,483 contracts. The Company offers a broad range of prepaid dental care coverage options and administrative services to organizations providing such benefits to their employees on a contributory or a noncontributory basis.

4b	(Code: ) (Expenses $ 9,128,318 including grants of $ ) (Revenue $ 161,224 )
	Operations Expense Incurred To Administer The Payment of Dental Benefits.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses187,113,882

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

Yes

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

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 ..

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

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?...

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

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)? ..

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

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? ...........................

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

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

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

GEORGE BEDARD10 CHARLES STREET Providence,RI02904 (401) 752-6240

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) William A Mekrut...................................................................... CHAIR	1.0 ................. 1.0	X	X	14,700	0	0
(2) Fred K Butler...................................................................... Vice Chair	1.0 ................. 1.0	X	X	8,500	0	0
(3) A Thomas Correia DDS...................................................................... Dir. (THRU 2/15) & dental dir.	1.0 ................. 1.0	X		54,363	0	0
(4) Julie G Duffy...................................................................... Director	1.0 ................. 1.0	X		6,000	0	0
(5) Francis J Flynn...................................................................... Director	1.0 ................. 1.0	X		6,500	0	0
(6) William G Foulkes...................................................................... Director	1.0 ................. 1.0	X		1,000	0	0
(7) Almon C Hall...................................................................... Director	1.0 ................. 1.0	X		7,500	0	0
(8) Edward O Handy III...................................................................... Director	1.0 ................. 1.0	X		7,500	0	0
(9) Steven J Issa...................................................................... Director	1.0 ................. 1.0	X		9,200	0	0
(10) Joseph J Marcaurele...................................................................... Director	1.0 ................. 1.0	X		7,000	0	0
(11) Linda R McGoldrick...................................................................... Director	1.0 ................. 1.0	X		7,500	0	0
(12) James F McManus DDS...................................................................... Director	1.0 ................. 1.0	X		7,500	0	0
(13) Cynthia S Reed...................................................................... Director	1.0 ................. 1.0	X		8,500	0	0
(14) John T Ruggieri...................................................................... Director	1.0 ................. 1.0	X		8,000	0	0
(15) Edwin J Santos...................................................................... Director	1.0 ................. 1.0	X		10,400	0	0
(16) Vanessa Toledo-Vickers...................................................................... Director	40.0 ................. 1.0	X		6,500	0	0
(17) Joseph Nagle...................................................................... President & CEO	40.0 ................. 1.0		X	792,565	0	136,351

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) Richard A Fritz........................................................................ VP Finance, CFO & TREASURER	40.0 .......................1.0	X			309,201	0	57,786
(19) Kerrie L Bennett........................................................................ VP Marketing & Secretary	40.0 .......................1.0	X			210,838	0	28,554
(20) George J Bedard........................................................................ Controller & Asst. Treasurer	40.0 .......................1.0	X			142,507	0	34,700
(21) Melissa A Gennari........................................................................ Director Compliance & Asst Sec	40.0 .......................1.0	X			129,110	0	13,690
(22) Thomas D Chase........................................................................ VP Technology & CIO	40.0 .......................1.0		X		0	341,563	57,847
(23) Joseph R Perroni........................................................................ VP Sales-Dental & Altus Dental	40.0 .......................1.0		X		297,726	0	49,398
(24) Blaine R Carroll........................................................................ VP Strategic Initiatives	40.0 .......................1.0		X		251,086	0	47,762
(25) Angelo Pezzullo........................................................................ VP Sales	40.0 .......................1.0			X	177,049	0	39,913
(26) Ellen M Hendrix........................................................................ AVP Underwriting	40.0 .......................1.0			X	156,600	0	38,325
(27) Timothy Fitzgibbons........................................................................ Sr. Director Actuarial	40.0 .......................1.0			X	158,361	0	32,239
(28) Keith Whitt........................................................................ Director of Sales	40.0 .......................1.0			X	148,969	0	35,133
(29) Duane S Easter........................................................................ Director of Corp Reporting	40.0 .......................1.0			X	132,601	0	34,999

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,077,276	341,563	606,697

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
NETCENERGY LLC, 231 ELM STREET WARWICK,RI02888	IT CONSULTING	905,120
DUFFY SHANLEY Inc, 10 CHARLES STREET PROVIDENCE,RI02904	MARKETING SERVICES	754,816
Cathedral Corporation, Griffin Technology Park ROME,NY13441	PROCESSING SERVICES	466,423
EDGEWATER TECHNOLOGY INC, PO BOX 845183 BOSTON,MA022845183	Product Development	453,720
GRANT THORNTON LLP, 90 State House Square 10th Floor HARTFORD,CT06103	AUDIT/TAX SERVICES	267,386
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 25

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	PREMIUMS	524114	196,524,961	196,524,961
b
c
d
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			196,524,961

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			1,879,542			1,879,542
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss)......			0
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		34,504,363
b	Less: cost or other basis and sales expenses		33,236,076
c	Gain or (loss)		1,268,287
d	Net gain or (loss).....			1,268,287			1,268,287
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	INCOME FROM SUBSIDIARY		900099	158,551			158,551
b	OTHER INCOME		900099	11,070	11,070
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			169,621
12	Total revenue. See Instructions......			199,842,411	196,536,031		3,306,380

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	545,271	545,271
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	177,440,293	177,440,293
5	Compensation of current officers, directors, trustees, and key employees ....	2,671,937		2,671,937
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	7,639,927	5,304,582	2,335,345
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	376,897	310,710	66,187
9	Other employee benefits .......	341,685	217,704	123,981
10	Payroll taxes ...........	694,205	335,628	358,577
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	223,176		223,176
c	Accounting ...........	284,634		284,634
d	Lobbying ...........	60,000	60,000
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	831,462		831,462
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	2,292,914	605,662	1,687,252
12	Advertising and promotion ....	443,528		443,528
13	Office expenses .......	955,069	721,915	233,154
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	793,473	414,587	378,886
17	Travel ............	105,170	5,556	99,614
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	13,893		13,893
20	Interest ...........	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	1,023,470		1,023,470
23	Insurance ...	142,193		142,193
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	EQUIPMENT RENTAL & MAINT	1,141,325	1,141,325
b	ASSOCIATION FEES	412,188	9,174	403,014
c	TELEPHONE	293,486		293,486
d	LICENSES & FEES	22,931		22,931
e	All other expenses	32,057	1,475	30,582
25	Total functional expenses. Add lines 1 through 24e	198,781,184	187,113,882	11,667,302	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 ........			250	1	250
2	Savings and temporary cash investments .........			6,872,444	2	-1,358,237
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			10,623,329	4	11,805,775
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 ......			587,705	9	2,714,640
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	11,290,466
b	Less: accumulated depreciation	10b	9,723,954	1,865,069	10c	1,566,512
11	Investments—publicly traded securities .			80,294,046	11	80,960,681
12	Investments—other securities. See Part IV, line 11 .....			9,871,073	12	10,344,305
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			641,852	15	1,779,032
16	Total assets. Add lines 1 through 15 (must equal line 34)...			110,755,768	16	107,812,958

17	Accounts payable and accrued expenses .....	12,389,841	17	11,594,232
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 ..	0	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	6,316,661	25	7,103,890
26	Total liabilities. Add lines 17 through 25..	18,706,502	26	18,698,122

	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	92,049,266	32	89,114,836
33	Total net assets or fund balances ...........	92,049,266	33	89,114,836
34	Total liabilities and net assets/fund balances ........	110,755,768	34	107,812,958

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) ............

199,842,411

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

198,781,184

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

1,061,227

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

92,049,266

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

-1,325,866

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

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

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

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

-2,669,791

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

89,114,836

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 Rhode Island

Employer identification number

05-0296998

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 ...
b	Buildings
c	Leasehold improvements	2,689,561	2,328,789	360,773
d	Equipment ...	5,691,304	4,660,762	1,030,541
e	Other ...	2,909,601	2,734,403	175,198
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,566,512

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) SUBSIDIARIES	7,965,026	C
(B) INVESTMENT-OTHER	2,379,279	F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	10,344,305

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)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

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
CLAIMS INCURRED BUT UNPAID	4,872,000
ADVANCED SUBSCRIBER PREMIUMS	1,392,506
ACCRUED CLAIMS ADJUSTMENT EXPENSE	430,738
ADVANCED DEPOSITS	408,646
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	7,103,890
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
ASC 470	SCHEDULE D, PART X Delta Dental of Rhode Island is a not-for-profit corporation pursuant to Section 501(c)(4) of the Internal Revenue Code (IRC) and is generally exempt from federal income taxes on related income under Section 501(a) of the IRC and, accordingly, no provision for income taxes relative to Delta Dental of Rhode Island has been made in the accompanying consolidated financial statements. The Company evaluates its uncertain tax positions with a two-step process in accordance with GAAP. First, the Company determines whether it is more likely than not that an uncertain tax position will be sustained upon examination based on the technical merits of the position. Second, an uncertain tax position that meets the more likely than not threshold is measured to determine the amount of benefit to recognize in the financial statements. The position is measured at the largest amount of benefit that is greater than 50% likely of being realized upon ultimate settlement. Uncertain tax positions that previously failed to meet the more likely than not recognition threshold are recognized in the first subsequent reporting period in which the threshold is met. Previously recognized uncertain tax positions that no longer meet the more likely than not recognition threshold are derecognized in the first subsequent reporting period in which the threshold is no longer met. Should interest or penalties be assessed, such expenses would be reflected in selling, general and administrative expenses. As of December 31, 2015 and 2014, the Company had no uncertain tax positions.

Return Reference

Explanation

ASC 470

SCHEDULE D, PART X Delta Dental of Rhode Island is a not-for-profit corporation pursuant to Section 501(c)(4) of the Internal Revenue Code (IRC) and is generally exempt from federal income taxes on related income under Section 501(a) of the IRC and, accordingly, no provision for income taxes relative to Delta Dental of Rhode Island has been made in the accompanying consolidated financial statements. The Company evaluates its uncertain tax positions with a two-step process in accordance with GAAP. First, the Company determines whether it is more likely than not that an uncertain tax position will be sustained upon examination based on the technical merits of the position. Second, an uncertain tax position that meets the more likely than not threshold is measured to determine the amount of benefit to recognize in the financial statements. The position is measured at the largest amount of benefit that is greater than 50% likely of being realized upon ultimate settlement. Uncertain tax positions that previously failed to meet the more likely than not recognition threshold are recognized in the first subsequent reporting period in which the threshold is met. Previously recognized uncertain tax positions that no longer meet the more likely than not recognition threshold are derecognized in the first subsequent reporting period in which the threshold is no longer met. Should interest or penalties be assessed, such expenses would be reflected in selling, general and administrative expenses. As of December 31, 2015 and 2014, the Company had no uncertain tax positions.

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 Rhode Island

Employer identification number
05-0296998

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) UNITED WAY OF RHODE ISLAND 50 VALLEY STREET PROVIDENCE,RI02909	05-0276059	501(C)(3)	28,728	PROGRAM SUPPORT
(2) CVS CHARITY CLASSIC INC ONE CVS DRIVE WOONSOCKET,RI02895	05-0508742	501(C)(3)	26,500	PROGRAM SUPPORT
(3) AMOS HOUSE 413 FRIENDSHIP STREET PROVIDENCE,RI02907	05-0387218	501(C)(3)	25,250	PROGRAM SUPPORT
(4) MAKE A WISH MASSACHUSETTS ONE BULFINCH PLACE SUITE 201 BOSTON,MA02114	22-2867371	501(C)(3)	25,000	PROGRAM SUPPORT
(5) SAN MIGUEL SCHOOL 525 BRANCH AVENUE PROVIDENCE,RI02904	22-3232973	501(C)(3)	21,500	PROGRAM SUPPORT
(6) PROVIDENCE COLLEGE 1 CUNNING SQUARE PROVIDENCE,RI02908	05-0258932	501(C)(3)	25,750	PROGRAM SUPPORT
(7) SALVE REGINA UNIVERSITY 100 OCHRE POINT AVENUE NEWPORT,RI02840	05-0259080	501(C)(3)	16,750	PROGRAM SUPPORT
(8) CROSSROADS RHODE ISLAND 160 BROAD STREET PROVIDENCE,RI02903	05-0259094	501(C)(3)	15,500	PROGRAM SUPPORT
(9) MCAULEY MINISTRIES 622 ELMWOOD AVENUE PROVIDENCE,RI02907	05-0440470	501(C)(3)	12,250	PROGRAM SUPPORT
(10) RHODE ISLAND FOUNDATION - CIVIC LEADERSHIP FUND ONE UNION STATION PROVIDENCE,RI02914	22-2604963	501(C)(3)	11,000	PROGRAM SUPPORT
(11) AMY GALLAGHER FOUNDATION 180 EAST SHORE ROAD JAMESTOWN,RI02835	47-5609593	501(C)(3)	10,000	PROGRAM SUPPORT
(12) CITY YEAR INC 77 EDDY ST 2ND FLOOR PROVIDENCE,RI02903	22-2882549	501(C)(3)	10,000	PROGRAM SUPPORT
(13) FIRST WORKS 270 WESTMINSTER STREET PROVIDENCE,RI02903	22-2597014	501(C)(3)	10,000	PROGRAM SUPPORT
(14) LEARNING COMMUNITY 21 LINCOLN AVENUE CENTRAL FALL,RI02863	47-0942849	501(C)(3)	10,000	PROGRAM SUPPORT
(15) RHODE ISLAND COMMUNITY FOOD BANK 200 NIANTIC AVENUE PROVIDENCE,RI02907	05-0395601	501(C)(3)	10,000	PROGRAM SUPPORT
(16) STATION FIRE MEMORIAL FOUNDATION 20 HALL STREET EAST GREENWICH,RI02818	56-2382562	501(C)(3)	10,000	PROGRAM SUPPORT
(17) FAMILY SERVICE OF RHODE ISLAND 55 HOPE STREET PROVIDENCE,RI029046688	05-0258858	501(C)(3)	9,000	PROGRAM SUPPORT
(18) JOHNSON & WALES UNIVERSITY 8 ABBOT PARK PLACE PROVIDENCE,RI02903	05-0306206	501(C)(3)	8,500	PROGRAM SUPPORT
(19) JEFFREY OSBORNE CELEBRITY CLASSIC PO BOX 27815 PROVIDENCE,RI02907	05-0510492	501(C)(3)	7,500	PROGRAM SUPPORT
(20) JUNIOR ACHIEVEMENT 120 WATERMAN STREET PROVIDENCE,RI02906	05-0263443	501(C)(3)	7,500	PROGRAM SUPPORT
(21) RHODE ISLAND HOSPITAL FOUNDATION PO BOX H PROVIDENCE,RI02901	05-0468736	501(C)(3)	7,500	PROGRAM SUPPORT
(22) SPECIAL OLYMPICS RHODE ISLAND 370 G WASHINGTON HWY SMITHFIELD,RI02917	05-0377867	501(C)(3)	7,000	PROGRAM SUPPORT
(23) ROCKY HILL SCHOOL 530 IVES ROAD EAST GREENWICH,RI02818	05-0277258	501(C)(3)	6,065	PROGRAM SUPPORT
(24) BRYANT UNIVERSITY 1150 DOUGLAS TURNPIKE SIMTHFIELD,RI02908	05-0258810	501(C)(3)	6,000	PROGRAM SUPPORT
(25) OCEAN STATE JOB LOT CHARITABLE 375 COMMERCE PARK ROAD KINGSTOWN,RI02852	20-0959438	501(C)(3)	6,000	PROGRAM SUPPORT
(26) LITTLE SISTERS OF THE POOR 964 MAIN STREET PAWTUCKET,RI02860	05-0283791	501(C)(3)	5,350	PROGRAM SUPPORT
(27) TOMORROW FUND 593 EDDY STREET PROVIDENCE,RI02903	05-0450569	501(C)(3)	5,100	PROGRAM SUPPORT

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	The Company does not issue specific grants, however, as part of THE corporate responsibility program, DELTA DENTAL OF RHODE ISLAND supports local charitable organizations.

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 Rhode Island

Employer identification number

05-0296998

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?

Yes

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?

Yes

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)
1Joseph NaglePresident & CEO	(i) (ii)	578,186 ------------- 0	140,285 ------------- 0	74,094 ------------- 0	115,986 ------------- 0	20,365 ------------- 0	928,916 ------------- 0	0 ------------- 0
2Richard A FritzVP Finance, CFO & TREASURER	(i) (ii)	284,307 ------------- 0	22,136 ------------- 0	2,758 ------------- 0	38,413 ------------- 0	19,373 ------------- 0	366,987 ------------- 0	0 ------------- 0
3Kerrie L BennettVP Marketing & Secretary	(i) (ii)	201,764 ------------- 0	8,640 ------------- 0	434 ------------- 0	19,613 ------------- 0	8,941 ------------- 0	239,392 ------------- 0	0 ------------- 0
4George J BedardController & Asst. Treasurer	(i) (ii)	129,635 ------------- 0	11,738 ------------- 0	1,134 ------------- 0	16,364 ------------- 0	18,336 ------------- 0	177,207 ------------- 0	0 ------------- 0
5Thomas D ChaseVP Technology & CIO	(i) (ii)	0 ------------- 311,071	0 ------------- 28,877	0 ------------- 1,615	0 ------------- 40,034	0 ------------- 17,813	0 ------------- 399,410	0 ------------- 0
6Joseph R PerroniVP Sales-Dental & Altus Dental	(i) (ii)	254,902 ------------- 0	35,976 ------------- 0	6,848 ------------- 0	31,585 ------------- 0	17,813 ------------- 0	347,124 ------------- 0	0 ------------- 0
7Blaine R CarrollVP Strategic Initiatives	(i) (ii)	219,463 ------------- 0	30,513 ------------- 0	1,110 ------------- 0	27,264 ------------- 0	20,498 ------------- 0	298,848 ------------- 0	0 ------------- 0
8Angelo PezzulloVP Sales	(i) (ii)	145,491 ------------- 0	24,242 ------------- 0	7,316 ------------- 0	22,516 ------------- 0	17,397 ------------- 0	216,962 ------------- 0	0 ------------- 0
9Ellen M HendrixAVP Underwriting	(i) (ii)	140,989 ------------- 0	14,935 ------------- 0	676 ------------- 0	18,429 ------------- 0	19,896 ------------- 0	194,925 ------------- 0	0 ------------- 0
10Timothy FitzgibbonsSr. Director Actuarial	(i) (ii)	152,290 ------------- 0	5,597 ------------- 0	474 ------------- 0	14,423 ------------- 0	17,816 ------------- 0	190,600 ------------- 0	0 ------------- 0
11Keith WhittDirector of Sales	(i) (ii)	135,917 ------------- 0	6,225 ------------- 0	6,827 ------------- 0	14,097 ------------- 0	21,036 ------------- 0	184,102 ------------- 0	0 ------------- 0
12Duane S EasterDirector of Corp Reporting	(i) (ii)	118,299 ------------- 0	13,940 ------------- 0	362 ------------- 0	14,633 ------------- 0	20,366 ------------- 0	167,600 ------------- 0	0 ------------- 0

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
Gross-Up Payments	Schedule J, Part I, Line 1a The CEO's employment agreement contains provisions for him to receive payments so that he can personally procure certain fringe benefits such as life insurance and long term disability policies that are otherwise available to all other employees. This additional income is grossed up to account for the tax impact of these payments and the gross-up is included in reportable compensation on Schedule J Part II Column (B)(iii).
Health or Social Club Dues	Schedule J, Part I, Line 1a The CEO is a member of a local business club. Reimbursement for use of this is exclusively for offsite employee meetings as well as business related meetings with individuals outside the company. The company maintains strict policies regarding substantiation and documentation for all business related expenses incurred. This benefit is NOT reported as taxable compensation.
Supplemental nonqualified retirement plan	Schedule J, Part I, Line 4b The CEO participates in a 457(F) deferred compensation plan but has not met the vesting criteria and therefore no payments have been made to the CEO to date. Contributions of $62,886 made to the plan during 2015 have been reported on Schedule J Part II Column (C).
Compensation contingent on revenues of related organizations	Schedule J, Part I, Line 5b The CEO has an incentive bonus opportunity for up to 15% of his base pay should certain goals be attained. Goals are established annually and for the tax year 2015, one of these goals is based on the revenues of a wholly-owned subsidiary of the company. This particular goal has a weighting of 10% of the total incentive bonus opportunity. The percentage of the bonus reported on Schedule J, Part II, Column (B)(ii) contingent on the revenues of the wholly-owned subsidiary is equal to 1.5% of the CEO's base pay.
Compensation contingent on net earnings of the organization	Schedule J, Part I, Line 6a The company maintains an annual incentive program that is allocated to all applicable employees, including all individuals listed on Form 990, if the company meets certain board approved corporate financial goals, including meeting enrollment levels, control of operating expenses, and overall profitability.

Schedule J (Form 990) 2015

Additional Data

Software ID:
Software Version:

- 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 Rhode Island

Employer identification number

05-0296998

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) A Thomas Correia DDS Inc	Correia - Board Member	542,817	Payment to Dental Practice		No
(2) MCMANUS PRATT	McManus - Board Member	903,027	Payment to Dental Practice		No

Part V

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

Return Reference	Explanation
Business Transactions Involving Interested Persons	Part IV The organization engages in transactions with dental practices of whom the board members identified in Schedule L Part IV have a controlling interest. The transactions are entered into in the ordinary course of business and at fair market value. Transactions with these entities are subject to the same procedures and review as all dental practices.

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 Rhode Island

Employer identification number

05-0296998

Return Reference	Explanation
MEMBERS OF THE ORGANIZATION	FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS 73 CORPORATE MEMBERS.
MEMBERS THAT MAY ELECT THE GOVERNING BODY	Form 990, Part VI, section a, LINE 7a The corporate members meet annually to approve any by-law changes and to elect individuals to the 15 member board of directors which is the organization's governing body. All 15 members of the board of directors also serve as representatives of the corporate members.
DECISIONS OF THE GOVERNING BODY SUBJECT TO APPROVAL BY MEMBERS	Form 990, Part VI, section a, LINE 7b The members of the corporation, at the annual meeting, shall elect directors of the corporation that have been proposed by the board of directors and shall approve amendments or alterations of the by-laws proposed by the board of directors.
FORM 990 REVIEW PROCESS	Form 990, Part VI, Section B, Line 11 THE ANNUAL FORM 990 IS PREPARED BY GRANT THORNTON LLP, THE COMPANY'S TAX ADVISOR AND INDEPENDENT AUDITOR, USING INFORMATION PROVIDED BY DELTA DENTAL OF RHODE ISLAND. AFTER PREPARATION AND REVIEW OF THE RETURN BY GRANT THORNTON, THE DRAFT is REVIEWED BY Delta Dental's FINANCE DEPARTMENT AND MANAGEMENT, INCLUDING THE CONTROLLER, CFO, AND CEO AS NECESSARY. THE COMPLETE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
CONFLICT OF INTEREST POLICY	Form 990, Part VI, section b, LINE 12c All W-2 employees, interns, temps, dental consultants, and board members complete an annual conflict of interest questionnaire. The review process for complete questionnaires containing disclosures is as follows: For W-2 employees, interns, and temps, disclosures are reviewed by the director of compliance and CFO. Disclosed potential conflicts are discussed and may be elevated in the review process to the CEO and external legal counsel for advice. Any required actions are immediately implemented in accordance with the company's documented conflict of interest policies. For the CEO and CFO, disclosures are reviewed by external legal counsel. Legal counsel advises of any required actions which are immediately implemented in accordance with the company's documented standards of conduct and business ethics and conflict of interest policies. For dental consultants, disclosures are reviewed by the director of compliance, the VP-CFO, the director of program integrity and network management, and the VP-CIO. All conflicts are discussed and may be elevated to external legal counsel for advice. Any required actions are immediately implemented in accordance with the company's documented conflict of interest policies. For board members, disclosures are reviewed by external legal counsel. Legal counsel prepares a written memorandum for presentation to board members with the results of the review. All conflicts are discussed and any required actions are immediately implemented in accordance with the company's documented conflict of interest policies. In the case of a conflict, immediate and appropriate action is taken in accordance with the company's policies. Persons with a conflict are recused from discussions and do not vote on resolutions that pertain directly to their conflict.
COMPENSATION POLICY	Form 990, Part VI, SECTION B, LINE 15 The board of directors elects independent members to serve on its compensation committee which is responsible for setting the CEO's compensation and approving pay ranges for the various job tracks within the company as well as approving any fringe benefits. The company and the committee annually contract with independent compensation consultants to help determine appropriate pay ranges and fringe benefits such as health and other insurances and retirement and other benefits. Comparable data is used to determine whether compensation is consistent with similar organizations. Recommendations for the CEO's compensation are made by the compensation committee to the board of directors for review and approval. The review and approval process is contemporaneously documented in the minutes of both the compensation committee and the board of directors.
PUBLIC DISCLOSURE	Form 990, Part VI, SECTION C, LINE 19 The company's governing documents, such as bylaws and corporate charter, are available upon request from the company and can also be obtained from the secretary of state's office within the state of Rhode Island. The company's conflict of interest policy, as well as the company's audited financial statements, are also available upon request at the company's headquarters. Additionally, all statutory filings completed by the company are available through the insurance division within the Rhode Island department of business regulation. The company's Form 990 is also posted on www.guidestar.org. Director COMPENSATION Form 990, Part VII, Section A A. Thomas Correia, DDS, served on the Board of Directors for Delta Dental of Rhode Island until February 13, 2015 when he was hired as an employee. Reportable compensation reported on 990 Part VII column D properly reflects reasonable compensation for services rendered as a Director of $4,000 and compensation as an employee of $50,363.
OTHER CHANGES IN NET ASSETS	FORM 990, PART XI, LINE 9 ALTUS VENTURES, INC. WAS SETUP and capitalized IN JUNE OF 2014. The company transferred an additional $3,000,000 of capital to Altus Ventures, Inc. in 2015. Also included in line 9 is an adjustment of ($330,209) for overaccrued expenses related to a joint venture with other delta dental plans. TOTAL OTHER CHANGES IN NET ASSETS EQUAL ($2,669,791).

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 Rhode Island

Employer identification number

05-0296998

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
(1)Altus Realty Company 10 Charles Street Providence,RI029042208 03-0396397	Holding Co.	RI	501(C)(2)	N/A	DDRI	Yes

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) The Altus Group Inc 10 Charles Street Providence,RI02904 05-0502610	Insurance	RI	DDRI	C Corp	0	0	100.000 %	Yes
(2) ALTUS DENTAL INC 10 CHARLES STREET PROVIDENCE,RI02904 05-0502612	INSURANCE	RI	ALTUS GROUP INC	C CORP	0	0	100.000 %	Yes
(3) ALTUS VENTURES INC 10 CHARLES STREET PROVIDENCE,RI02904 46-5627174	VENTURE CAPITAL	RI	ALTUS GROUP INC	C CORP	0	0	100.000 %	Yes
(4) ALTUS DENTAL INSURANCE CO INC 10 CHARLES STREET PROVIDENCE,RI02904 05-0513223	INSURANCE	RI	ALTUS GROUP INC	C CORP	0	0	100.000 %	Yes
(5) ALTUS SYSTEMS INC 10 CHARLES STREET PROVIDENCE,RI02904 05-0502611	INSURANCE	RI	ALTUS GROUP INC	C CORP	0	0	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 .....................

Yes

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

Yes

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

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

Yes

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) ......................

Yes

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) ...................

Yes

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

Yes

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) Altus Dental Insurance Co Inc	A(IV)	308,550	FMV
(2) Altus Dental Inc	A(I)	89,041	FMV
(3) Altus Realty Inc	A(I)	67,373	FMV
(4) Altus Ventures Inc	B	3,000,000	FMV
(5) Altus Realty Inc	D	3,060,978	FMV
(6) Altus Realty Inc	K	793,474	FMV
(7) Altus Systems Inc	L	5,397,619	FMV
(8) Altus Dental Insurance Co Inc	M	925,651	FMV
(9) Altus Dental Insurance Co Inc	o	969,730	fmv

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

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