Form990
Click to see attachment
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)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
A For the 2020 calendar year, or tax year beginning 01-01-2020 , and ending 12-31-2020
BCheck if applicable:
CName of organization
DELTA DENTAL OF KENTUCKY INC
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
10100 LINN STATION ROAD NO 700
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LOUISVILLE, KY40223
D Employer identification number

61-0659432
E Telephone number

G Gross receipts $ 182,814,969
F Name and address of principal officer:
J JUDE THOMPSON
10100 LINN STATION ROAD NO 700
LOUISVILLE,KY40223
I
Tax-exempt status: ( 4 ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.DELTADENTALKY.COM
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1966
M State of legal domicile: KY
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: DELTA DENTAL OF KENTUCKY'S MISSION HAS ALWAYS BEEN TO BE THE LEADER IN THE MARKETS WE SERVE, TO DELIVER UNMATCHED QUALITY AND VALUE IN OUR PROGRAMS AND SERVICES, AND TO VIGOROUSLY PROMOTE THE IMPORTANCE OF ORAL HEALTH AS AN ESSENTIAL PART OF OVERALL HEALTH. ITS OVERARCHING MISSION IS TO BE THE DENTAL BENEFITS COMPANY OF CHOICE IN THE MARKETS WE SERVE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 9
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 7
5 Total number of individuals employed in calendar year 2020 (Part V, line 2a) ...... 5 86
6 Total number of volunteers (estimate if necessary) ............. 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 2,481,326
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 146,696,663 156,745,570
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,359,948 2,058,349
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) -883,222 -708,248
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 147,173,389 158,095,671
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,665,998 3,651,243
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 116,397,006 107,279,363
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 10,086,152 10,703,950
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 16,100,242 19,333,421
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 144,249,398 140,967,977
19 Revenue less expenses. Subtract line 18 from line 12....... 2,923,991 17,127,694
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 102,860,273 127,336,348
21 Total liabilities (Part X, line 26)............. 16,078,508 19,540,235
22 Net assets or fund balances. Subtract line 21 from line 20..... 86,781,765 107,796,113
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
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
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) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2020)
Form 990 (2020)
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..............
1
Briefly describe the organization’s mission: SEE SCHEDULE ODELTA DENTAL OF KENTUCKY'S MISSION HAS ALWAYS BEEN TO BE THE LEADER IN THE MARKETS WE SERVE, TO DELIVER UNMATCHED QUALITY AND VALUE IN OUR PROGRAMS AND SERVICES, AND TO VIGOROUSLY PROMOTE THE IMPORTANCE OF ORAL HEALTH AS AN ESSENTIAL PART OF OVERALL HEALTH. ITS OVERARCHING MISSION IS TO BE THE DENTAL BENEFITS COMPANY OF CHOICE IN THE MARKETS WE SERVE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
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 $ 136,733,651 including grants of $ 3,651,243 ) (Revenue $ 154,264,244 )
DELTA DENTAL OF KENTUCKY IS THE LARGEST AND OLDEST DENTAL BENEFIT ADMINISTRATOR IN KENTUCKY. AS A NOT-FOR-PROFIT ORGANIZATION, OUR CORE MISSION IS THAT EVERYONE DESERVES A HAPPY AND HEALTHY SMILE. WE ARE COMMITTED TO FULFILLING THIS MISSION THROUGH OUR DENTAL, VISION AND LIFE BENEFIT PROGRAMS AS WELL AS OUR CORPORATE PHILANTHROPIC INITIATIVES. DELTA DENTAL OF KENTUCKY INSURES NEARLY 800,000 SMILES IN THE COMMONWEALTH OF KENTUCKY THROUGH GROUP AND INDIVIDUAL PLANS. SEE SCHEDULE O FOR CONTINUATIONFOR CLOSE TO SIX DECADES, DELTA DENTAL OF KENTUCKY HAS HELPED PROMOTE HEALTHY SMILES FOR OUR MEMBERS BY DESIGNING AND ADMINISTERING INNOVATIVE, COST-EFFECTIVE DENTAL BENEFIT PROGRAMS. THESE PLANS MEET OUR MEMBERS' COST-OBJECTIVES WHILE IMPROVING AND MAINTAINING THEIR ORAL HEALTH. DELTA DENTAL OF KENTUCKY IS DEDICATED TO OUR MEMBERS AND ENSURING WE PROVIDE SUPERIOR CUSTOMER SERVICE, AS EVIDENCED BY NEARLY 90% OF CALLS ANSWERED IN LESS THAN 15 SECONDS. OUR AWARD WINNING CUSTOMER SERVICE HAS A 95% SATISFACTION RATE.DELTA DENTAL OF KENTUCKY OPERATES THE LARGEST DENTAL NETWORKS WITH 89% OF PARTICIPATION AMONG KENTUCKY DENTISTS. OUR TWO LARGE NETWORKS GIVE DELTA DENTAL MEMBERS ADDED PROTECTION BECAUSE THEY GUARANTEE THAT PARTICIPATING DENTISTS WILL ACCEPT THEIR PAYMENT FOR COVERED SERVICES AND THAT NO CHARGES, OTHER THAN CO-PAYMENTS AND DEDUCTIBLES ARE BILLED. OUR DENTIST-CREDENTIALING PROGRAM, COST MANAGEMENT POLICIES AND FEE REDUCTION AGREEMENTS WITH PARTICIPATING DENTISTS HELP MEMBERS RECEIVE QUALITY DENTISTRY AND BEST DENTAL OUTCOMES. IN 2019, DELTA DENTAL EXPANDED PRODUCT OFFERINGS TO INCLUDE VISION INSURANCE FOR GROUPS AND INDIVIDUALS. IN EARLY 2020, DELTA DENTAL AGAIN EXPANDED INTO MORE ANCILLARY LINES OFFERING LIFE AND DISABILITY COVERAGE. ENSURING OUR MISSION OF HAPPY AND HEALTHY SMILES IS A CORE COMPONENT OF DELTA DENTAL OF KENTUCKY, A SEPARATE ACCOUNT WAS ESTABLISHED AT THE COMMUNITY FOUNDATION OF LOUISVILLE IN 2003 WHICH IS FUNDED ANNUALLY FOR GIVING PURPOSES. SINCE THE INCEPTION OF THE COMMUNITY FOUNDATION OF LOUISVILLE ACCOUNT IN 2003, THE CORPORATE PHILANTHROPIC GIVING HAS PROVIDED OVER $17 MILLION IN GRANTS TO OVER 160 ORGANIZATIONS. IN 2020, DONATIONS TOTALED $1.5 MILLION TO THE COMMUNITY FOUNDATION ACCOUNT THAT SUPPORTED 80 ORGANIZATIONS THROUGHOUT THE ENTIRE STATE. THESE DONATIONS FUNDED 22 DENTAL CLINICS ACROSS THE COMMONWEALTH AND 70% OF DOLLARS WERE DIRECTED TO ORGANIZATIONS PROVIDING DENTAL CARE AND ORAL HEALTH EDUCATION TO VULNERABLE POPULATIONS. IN 2020, ADDITIONAL DONATIONS OF $1.7 MILLION WERE FUNDED THROUGH THE COMMUNITY FOUNDATION OF LOUISVILLE ACCOUNT AND SUPPORTED 265 ORGANIZATIONS ACROSS THE COMMONWEALTH THROUGH A COVID-19 RELIEF FUNDING PROGRAM.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet136,733,651
Form 990 (2020)
Form 990 (2020)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A.....................
1
 
No
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...
2
 
No
3
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.............
3
 
No
4
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.........
4
 
 
5
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..
5
 
No
6
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 IClick to see attachment.........................
6
 
No
7
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 IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part IIIClick to see attachment..............
8
 
No
9
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 IVClick to see attachment..............
9
 
No
10
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......
10
 
No
11
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.
a
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
 
b
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 VIIClick to see attachment.......
11b
Yes
 
c
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 VIIIClick to see attachment.......
11c
 
No
d
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 IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
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 XClick to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XIIClick to see attachment......................
12a
 
No
b
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
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
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
 
No
15
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.....
15
 
No
16
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...
16
 
No
17
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) ....
17
 
No
18
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............
18
 
No
19
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...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
21
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
21
Yes
 
Form 990 (2020)
Form 990 (2020)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
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
22
 
No
23
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
23
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
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
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
 
 
d
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 ....
25a
 
No
b
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.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
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
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
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
33
Yes
 
34
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
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
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
 
36
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.............
36
 
 
37
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 VIClick to see attachment
37
 
No
38
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. ............
38
Yes
 
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
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
19,956
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2020)
Form 990 (2020)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
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 ..................
2a
86
b
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)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
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)? ..
4a
 
No
b
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).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
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? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
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? ....................
7a
 
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
 
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
 
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
 
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
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? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
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
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
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
 
 
b
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
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2020)
Form 990 (2020)
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
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
9
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.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
7
2
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? .................
2
 
No
3
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? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
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? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
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.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
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
 
b
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
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
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
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
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?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
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
Yes
 
b
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
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A 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.
19
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.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletCHRISTOPHER W GREEN CFO10100 LINN STATION ROAD STE 700   LOUISVILLE,KY40223 (502) 736-5000
Form 990 (2020)
Form 990 (2020)
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.

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

RoundBullet 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.

RoundBullet 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.

See instructions for the order in which to list the persons above.
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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) J JUDE THOMPSON......................................................................
PRESIDENT, CEO
 40.00
.................
0.00 		X   X       867,857 0 163,791
(2) BRIAN D HART......................................................................
VP/CRO
 40.00
.................
0.00 		    X       605,630 0 129,891
(3) ANGELA J NENNI......................................................................
VP/CAO
 40.00
.................
0.00 		    X       569,959 0 112,104
(4) CHRISTOPHER W GREEN......................................................................
VP/CFO
 40.00
.................
0.00 		    X       447,560 0 98,995
(5) JEFFREY D DUES......................................................................
DIRECTOR, ACCOUNT MGMT
 40.00
.................
0.00 		        X   247,149 0 48,472
(6) TAUNYA L ESHENBAUGH......................................................................
DIRECTOR, SALES
 40.00
.................
0.00 		        X   221,774 0 38,238
(7) LAURA F WINCE......................................................................
DIRECTOR, MARKETING
 40.00
.................
0.00 		        X   192,578 0 40,508
(8) DANIELLE JACKSON......................................................................
CORPORATE COUNSEL
 40.00
.................
0.00 		        X   132,122 0 40,427
(9) TAMMY W CANNON......................................................................
MANAGER, UNDERWRITING
 40.00
.................
0.00 		        X   136,424 0 29,985
(10) RONALD E STORY......................................................................
FORMER VP/CIO (THRU 8/2019)
 0.00
.................
0.00 		          X 134,894 0 0
(11) MICHAEL CHILDERS DMD......................................................................
DIRECTOR
 4.00
.................
5.00 		X           31,550 24,996 0
(12) J DAVID SMITH......................................................................
CHAIR
 2.00
.................
0.00 		X   X       34,300 0 0
(13) STEVE S REED......................................................................
DIRECTOR
 2.00
.................
0.00 		X           27,550 0 0
(14) DIANE CORNWELL......................................................................
DIRECTOR
 4.00
.................
0.00 		X           24,550 0 0
(15) RODNEY A JACKSON DMD......................................................................
VICE CHAIR
 2.00
.................
0.00 		X   X       21,800 0 0
(16) OLIVIA F KIRTLEY......................................................................
DIRECTOR
 4.00
.................
0.00 		X           1,200 0 19,500
(17) RANDALL F DYER JR......................................................................
DIRECTOR
 2.00
.................
0.00 		X           18,800 0 0
Form 990 (2020)
Form 990 (2020)
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) 		(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) JOHNNA REEDER KLEYMEYER........................................................................
DIRECTOR
 2.00
.......................0.00 		X           18,550 0 0
























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 3,734,247 24,996 721,911
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet17
Yes
No
3
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 ..............
3
Yes
 
4
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...........................
4
Yes
 
5
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 ........
5
 
No
Section B. Independent Contractors
1
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
DELTA DENTAL PLAN OF MICHIGAN

PO BOX 30416
LANSING,MI48909 		ADMINISTRATIVE SERVICES 4,147,148
MCGRIFF INSURANCE SERVICES INC

3605 GLENWOOD AVENUE STE 201
RALEIGH,NC27612 		BENEFITS CONSULTING 1,084,784
ASSURED PARTNERS NL LLC

2305 RIVER ROAD
LOUISVILLE,KY40206 		BENEFITS CONSULTING 942,569
HOUCHENS INSURANCE GROUP INC

1750 SCOTTSVILLE ROAD STE 4
BOWLING GREEN,KY42104 		BENEFITS CONSULTING 670,907
SKYGEN

N92 W14612 ANTHONY AVENUE
MENOMONEE FALLS,WI53051 		SOFTWARE & CONSULTING 477,500
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet29
Form 990 (2020)
Form 990 (2020)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet  
Program Service RevenueAmt Business Code
2a DENTAL CARE REVENUE 524114 154,256,366 154,256,366    
b VISION INSURANCE REVENUE 524114 2,481,326   2,481,326  
c OTHER FEES 900099 7,878 7,878    
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 156,745,570
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 1,231,653     1,231,653
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   695,912 6a
b Less: rental expenses   1,404,160 6b
c Rental income or (loss)   -708,248 6c
d Net rental income or (loss).......MediumBullet -708,248     -708,248
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   24,141,834 7a
b Less: cost or other basis and sales expenses   23,315,138 7b
c Gain or (loss)   826,696 7c
d Net gain or (loss).........MediumBullet 826,696     826,696
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet  
12 Total revenue. See instructions.....MediumBullet 158,095,671 154,264,244 2,481,326 1,350,101
Form 990 (2020)
Form 990 (2020)
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 .... 3,651,243 3,651,243
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members ....... 107,279,363 107,279,363
5 Compensation of current officers, directors, trustees, and key employees ........... 2,995,788 809,684 2,186,104  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........ 5,549,123 5,549,123    
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 566,081 566,081    
9 Other employee benefits ....... 1,124,614 1,124,614    
10 Payroll taxes ........... 468,344 360,625 107,719  
11 Fees for services (non-employees):        
a Management ...... 323,423   323,423  
b Legal ......... 119,548   119,548  
c Accounting ........... 41,679   41,679  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 148,847   148,847  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)        
12 Advertising and promotion .... 681,351 613,216 68,135  
13 Office expenses ....... 1,316,164 855,507 460,657  
14 Information technology ...... 741,645 741,645    
15 Royalties ..        
16 Occupancy ........... 328,281 285,604 42,677  
17 Travel ............ 1,115,156 557,578 557,578  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 26,402 15,841 10,561  
20 Interest ........... 1,316 1,316    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 134,006 120,605 13,401  
23 Insurance ... 149,655   149,655  
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 BROKER COMMISSIONS 8,760,817 8,760,817    
b PROCESSING FEES 3,548,553 3,548,553    
c FEDERAL HEALTHCARE TAX 1,006,863 1,006,863    
d POSTAGE & SHIPPING 434,217 429,875 4,342  
e All other expenses 455,498 455,498    
25 Total functional expenses. Add lines 1 through 24e 140,967,977 136,733,651 4,234,326 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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2020)
Form 990 (2020)
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
Assets 1 Cash–non-interest-bearing ........ 10,695,270 1 3,659,484
2 Savings and temporary cash investments ......... 412,681 2 20,937,811
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 20,933,603 4 14,258,771
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ...........   7  
8 Inventories for sale or use ............   8  
9 Prepaid expenses and deferred charges ...... 46,909 9 96,347
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 16,881,559
b Less: accumulated depreciation 10b 7,414,985 9,231,387 10c 9,466,574
11 Investments—publicly traded securities . 23,477,283 11 27,303,330
12 Investments—other securities. See Part IV, line 11 ..... 29,830,439 12 39,889,519
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 8,232,701 15 11,724,512
16 Total assets. Add lines 1 through 15 (must equal line 33)... 102,860,273 16 127,336,348
Liabilities 17 Accounts payable and accrued expenses ..... 1,711,153 17 4,922,626
18 Grants payable ...   18  
19 Deferred revenue ......... 1,999,508 19 2,094,136
20 Tax-exempt bond liabilities .........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
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 12,367,847 25 12,523,473
26 Total liabilities. Add lines 17 through 25.. 16,078,508 26 19,540,235
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 86,781,765 27 107,796,113
28 Net assets with donor restrictions ...........   28  
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 86,781,765 32 107,796,113
33 Total liabilities and net assets/fund balances ........ 102,860,273 33 127,336,348
Form 990 (2020)
Form 990 (2020)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
158,095,671
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
140,967,977
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
17,127,694
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
86,781,765
5
Net unrealized gains (losses) on investments ...............
5
5,367,863
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-1,481,209
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
107,796,113
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
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:
b
Were the organization’s financial statements audited by an independent accountant?
2b
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:
c
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?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
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?
3a
 
No
b
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.
3b
 
 
Form 990 (2020)
Form 990 (2020)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
DELTA DENTAL OF KENTUCKY INC
 
Employer identification number

61-0659432
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .............................
9
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.
1a
If the organization elected, as permitted under FASB 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.
b
If the organization elected, as permitted under FASB 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 $  
2
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 FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2020

Schedule D (Form 990) 2020
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?...
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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 ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .......................
3a(i)
 
 
(ii) Related organizations .......................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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 .....   830,000 830,000
b Buildings ....   11,727,036 4,775,451 6,951,585
c Leasehold improvements   1,582,626 1,129,978 452,648
d Equipment ....   1,438,516 1,062,845 375,671
e Other .....   1,303,381 446,711 856,670
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 9,466,574
Schedule D (Form 990) 2020

Schedule D (Form 990) 2020
Page 3
Part VII
Investments - Other 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........ 31,539,070 F
(3) Other
(A) INVESTMENT - DENTAL CHOICE, INC.		 8,350,449 F
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 39,889,519
Part VIII
Investments - Program 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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
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)ACCRUED INVESTMENT INCOME 135,445
(2)457(B) PLAN 691,823
(3)INVESTMENT - RHC 10,897,244
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 11,724,512
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  
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 12,523,473
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) 2020

Schedule D (Form 990) 2020
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Schedule D (Form 990) 2020


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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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
DELTA DENTAL OF KENTUCKY INC
 
Employer identification number
61-0659432
Part I
General Information on Grants and Assistance
1
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? ........................
2
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
noncash assistance		 (h) Purpose of grant
or assistance
(1) COMMUNITY FOUNDATION OF LOUISVILLE
325 WEST MAIN STREET SUITE 1110
LOUISVILLE,KY40202 		31-0997017 501(C)(3) 2,900,000   CASH   GENERAL DONATION
(2) LEADERSHIP KENTUCKY FOUNDATION
464 CHENAULT RD
FRANKFORT,KY406019260 		31-1096215 501(C)(3) 5,000   CASH   GENERAL DONATION
(3) HOME OF THE INNOCENTS
1100 EAST MARKET STREET
LOUISVILLE,KY40206 		61-0445834 501(C)(3) 5,000   CASH   GENERAL DONATION
(4) SMILEFAITH FOUNDATION
9775 HIGHWAY 805
JENKINS,KY41537 		80-0453938 501(C)(3) 5,000   CASH   GENERAL DONATION
(5) UNIVERSITY OF KENTUCKY ATHLETICS
338 LEXINGTON AVENUE
LEXINGTON,KY405060604 		GOVT 525,000   CASH   SUPPORT GENERAL MISSION
(6) ACTORS THEATRE OF LOUISVILLE
316 W MAIN STREET
LOUISVILLE,KY40202 		61-0645030 501(C)(3) 9,000   CASH   SUPPORT GENERAL MISSION
(7) AMERICAN HEART ASSOCIATION
7272 GREENVILLE AVENUE
DALLAS,TX75231 		13-5613797 501(C)(3) 8,800   CASH   SUPPORT GENERAL MISSION
(8) FRIENDS OF THE LOUISVILLE ZOO
PO BOX 37250
LOUISVILLE,KY402337250 		61-0721682 501(C)(3) 7,000   CASH   SUPPORT GENERAL MISSION
(9) LIFE LEARNING CENTER
20 W 18TH ST
COVINGTON,KY410113329 		20-3454261 501(C)(3) 10,000   CASH   SUPPORT GENERAL MISSION
(10) LOUISVILLE BALLET
315 EAST MAIN STREET
LOUISVILLE,KY40202 		61-6033779 501(C)(3) 5,000   CASH   SUPPORT GENERAL MISSION
(11) FREEDOM LAKE INC
2005 ASCENDER CT
LOUISVILLE,KY402453403 		81-2739074 501(C)(3) 10,000   CASH   SUPPORT GENERAL MISSION
(12) NORTON CHILDREN'S HOSPITAL FOUNDATION
224 E BROADWAY
LOUISVILLE,KY40202 		61-6027530 501(C)(3) 5,000   CASH   SUPPORT GENERAL MISSION
(13) UNBRIDLED CHARITABLE FOUNDATION INC
PO BOX 7331
LOUISVILLE,KY402570331 		46-2090072 501(C)(3) 7,500   CASH   SUPPORT GENERAL MISSION
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
13
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2020

Schedule I (Form 990) 2020
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
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash 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
PART I, LINE 2: GRANTS ARE MADE AND MONITORED UNDER A BOARD APPROVED CORPORATE POLICY WHICH SETS OUT THE GRANT CRITERIA, INCLUDING PROCESSES FOR APPROVAL, DISTRIBUTION, AND MONITORING. THE GRANT REVIEW AND APPROVAL COMMITTEE CONSISTS OF MEMBERS OF THE BOARD AND COMPANY EXECUTIVES. GRANTS MUST BE SUBMITTED ON SPECIFIED FORMS WHICH REQUIRE INFORMATION ABOUT THE GRANTEE ORGANIZATION AND HOW THE GRANTS WILL BE USED. GRANTEE ORGANIZATIONS MUST PERIODICALLY REPORT ON HOW THE FUNDS HAVE BEEN UTILIZED AND CERTIFY THAT FUNDS ARE DISBURSED IN ACCORDANCE WITH THE APPROVED GRANT APPLICATION. THESE REPORTS ARE REGULARLY REVIEWED BY COMPANY STAFF AND SUMMARIZED FOR THE GRANT COMMITTEE. THE COMMITTEE REVIEWS THE REPORTS AT LEAST QUARTERLY AND COMMUNICATES QUESTIONS OR CONCERNS BACK TO THE GRANTEE ORGANIZATION.
Schedule I (Form 990) 2020



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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Graphic Arrow Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Graphic Arrow Attach to Form 990.
Graphic Arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
DELTA DENTAL OF KENTUCKY INC
 
Employer identification number

61-0659432
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
If any of the boxes on 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 .....
1b
Yes
 
2
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 on Line 1a? ....
2
 
No
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2020

Schedule J (Form 990) 2020
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
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1J JUDE THOMPSON
PRESIDENT, CEO 		(i)

(ii)		 498,107
-------------
0 		369,750
-------------
0 		0
-------------
0 		122,384
-------------
0 		41,407
-------------
0 		1,031,648
-------------
0 		0
-------------
0
2BRIAN D HART
VP/CRO 		(i)

(ii)		 396,830
-------------
0 		208,800
-------------
0 		0
-------------
0 		91,125
-------------
0 		38,766
-------------
0 		735,521
-------------
0 		0
-------------
0
3ANGELA J NENNI
VP/CAO 		(i)

(ii)		 361,159
-------------
0 		208,800
-------------
0 		0
-------------
0 		81,613
-------------
0 		30,491
-------------
0 		682,063
-------------
0 		0
-------------
0
4CHRISTOPHER W GREEN
VP/CFO 		(i)

(ii)		 335,560
-------------
0 		112,000
-------------
0 		0
-------------
0 		74,545
-------------
0 		24,450
-------------
0 		546,555
-------------
0 		0
-------------
0
5JEFFREY D DUES
DIRECTOR, ACCOUNT MGMT 		(i)

(ii)		 86,899
-------------
0 		160,250
-------------
0 		0
-------------
0 		15,921
-------------
0 		32,551
-------------
0 		295,621
-------------
0 		0
-------------
0
6TAUNYA L ESHENBAUGH
DIRECTOR, SALES 		(i)

(ii)		 75,914
-------------
0 		145,860
-------------
0 		0
-------------
0 		19,304
-------------
0 		18,934
-------------
0 		260,012
-------------
0 		0
-------------
0
7LAURA F WINCE
DIRECTOR, MARKETING 		(i)

(ii)		 119,770
-------------
0 		72,808
-------------
0 		0
-------------
0 		10,649
-------------
0 		29,859
-------------
0 		233,086
-------------
0 		0
-------------
0
8DANIELLE JACKSON
CORPORATE COUNSEL 		(i)

(ii)		 96,160
-------------
0 		35,962
-------------
0 		0
-------------
0 		8,757
-------------
0 		31,670
-------------
0 		172,549
-------------
0 		0
-------------
0
9TAMMY W CANNON
MANAGER, UNDERWRITING 		(i)

(ii)		 108,303
-------------
0 		28,121
-------------
0 		0
-------------
0 		9,702
-------------
0 		20,283
-------------
0 		166,409
-------------
0 		0
-------------
0
10RONALD E STORY
FORMER VP/CIO (THRU 8/2019) 		(i)

(ii)		 0
-------------
0 		0
-------------
0 		134,894
-------------
0 		0
-------------
0 		0
-------------
0 		134,894
-------------
0 		0
-------------
0
Schedule J (Form 990) 2020

Schedule J (Form 990) 2020
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
PART I, LINE 1A BOARD MEMBERS ARE ALLOWED A TRAVEL COMPANION FOR THE ANNUAL RHSC CONFERENCE. THE COMPANION TRAVEL IS TAXABLE TO THE BOARD MEMBER. SINCE THERE WAS NO CONFERENCE IN 2020, NO BOARD MEMBER RECEIVED THIS BENEFIT IN 2020.
PART I, LINES 4A-B PART I, LINE 4A: DURING 2020, RONALD E. STORY, THE FORMER CIO, RECEIVED SEVERANCE PAYMENTS IN THE AMOUNT OF $134,894. PART I, LINE 4B: DELTA DENTAL OF KENTUCKY, INC. MAINTAINS A RETENTION BONUS AGREEMENT WITH A SELECT GROUP OF EXECUTIVES OF THE ORGANIZATION. THE BONUS AGREEMENT IS A NONQUALIFIED DEFERRED COMPENSATION PLAN THAT IS INTENDED TO COMPLY WITH SECTION 457(F) OF THE INTERNAL REVENUE CODE. BENEFITS UNDER THIS AGREEMENT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE AND ARE TAXABLE TO THE PARTICIPATING EXECUTIVES WHEN SUCH AMOUNTS ARE VESTED. THE FOLLOWING EXECUTIVES PARTICIPATE IN THE RETENTION BONUS AGREEMENT: J. JUDE THOMPSON BRIAN D. HART ANGELA J. NENNI CHRISTOPHER W. GREEN NO AMOUNTS WERE PAID OUT OR VESTED UNDER THIS AGREEMENT DURING 2020.
PART I, LINE 7 AS INDICATED IN SCHEDULE J, PART II, TOP MANAGEMENT OFFICIALS RECEIVED A BONUS BASED UPON EMPLOYEE PERFORMANCE AND THE FINANCIAL RESULTS OF THE ORGANIZATION AS COMPARED TO BUDGET. THIS BONUS WAS APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD.
Schedule J (Form 990) 2020

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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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
DELTA DENTAL OF KENTUCKY INC
 
Employer identification number

61-0659432
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 6 EFFECTIVE JULY 1, 2009 RENAISSANCE HEALTH SERVICE CORPORATION BECAME THE SOLE CORPORATE MEMBER OF DELTA DENTAL OF KENTUCKY.
FORM 990, PART VI, SECTION A, LINE 7A RHSC IS THE SOLE VOTING MEMBER OF DDKY. HOWEVER, UNDER THE TERMS OF THE AFFILIATION AGREEMENT THE PARTIES AGREED THAT THE DELTA DENTAL OF KENTUCKY (DDKY) BOARD SELECTS DIRECTOR CANDIDATES AND SUBMITS THEM TO RENAISSANCE HEALTH SERVICE CORP (RHSC). RHSC THEN APPROVES THE CANDIDATES. RHSC CAN REJECT PROPOSED CANDIDATES ONLY FOR "JUST CAUSE" AS DEFINED IN THE AGREEMENT. OTHERWISE, RHSC MUST APPROVE ALL THE CANDIDATES PROPOSED BY THE DDKY BOARD. RHSC HAS THE RIGHT TO ELECT A NUMBER OF DIRECTORS TO THE DDKY BOARD PROPORTIONAL TO THE NUMBER OF DIRECTORS THAT DDKY MAY NOMINATE TO THE RHSC BOARD. AS OF 12/31/2020, RHSC APPOINTED ONE MEMBER OF THE 9 MEMBER DDKY BOARD.
FORM 990, PART VI, SECTION A, LINE 7B THE RIGHTS OF THE DDKY BOARD ARE TO APPROVE THE ANNUAL BUDGETS FOR OPERATIONS, ELECT OFFICERS OF THE DDKY BOARD OF DIRECTORS, APPROVE THE TRANSFER OF ANY OF ITS ASSETS, APPROVE THE INCURRENCE OR GUARANTY OF DEBT AND APPROVE THE MANAGEMENT OF ITS INVESTMENTS. RHSC MUST APPROVE ANY TRANSFER OF ASSETS, INVESTMENTS, LOANS, GUARANTIES OR EXPENDITURES WHICH EXCEEDS TEN PERCENT OF DDKY'S NET ASSETS. RHSC MUST APPROVE THE FOLLOWING CHANGES TO THE DDKY BYLAWS: THE IDENTITY, QUALIFICATION OR RIGHTS OF DDKY'S VOTING MEMBER, THE QUALIFICATIONS, CLASSIFICATIONS, TERMS OF OFFICE OR PERMISSIBLE NUMBER OF DIRECTORS ON DDKY'S BOARD OR ANY LIMITATION ON THE RIGHTS OR AUTHORITY OF THE DDKY BOARD CONTAINED IN DDKY'S ORGANIZATIONAL DOCUMENTS.
FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS FIRST REVIEWED INTERNALLY BY THE VICE PRESIDENT AND CFO, CORPORATE COUNSEL AND CEO. A DRAFT IS THEN PROVIDED TO THE AUDIT AND FINANCE COMMITTEE FOR REVIEW. PRIOR TO FILING, A COPY OF THE FINAL FORM 990 IS DISTRIBUTED TO THE ENTIRE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS AND KEY EMPLOYEES MUST COMPLETE AND SUBMIT A CONFLICT OF INTEREST DISCLOSURE ANNUALLY. THESE FORMS ARE REVIEWED BY THE CEO, THE CORPORATE COMPLIANCE OFFICER, AND A REPORT IS MADE TO THE AUDIT AND FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. THE AUDIT COMMITTEE REVIEWS ALL POTENTIAL CONFLICTS TO DETERMINE IF THE CONFLICTS REPRESENT MATERIAL FINANCIAL RISK TO THE COMPANY AND TAKES ANY ACTION NECESSARY TO RESOLVE OR MITIGATE THE EFFECT OF THE CONFLICTS. WHEN A CONFLICT EXISTS AMONG THE VOTING BOARD MEMBERS, THAT BOARD MEMBER WILL ABSTAIN FROM VOTING ON THE CONFLICTED ISSUE. ALL EMPLOYEES AND DIRECTORS ARE ADVISED ANNUALLY OF THE REQUIREMENT TO REPORT ANY POTENTIAL CONFLICTS OF INTEREST AS THEY OCCUR. EMPLOYEES AND DIRECTORS MAY ALSO MAKE ANONYMOUS REPORTS OF ANY VIOLATIONS OF CORPORATE POLICIES THROUGH A DEDICATED WHISTLEBLOWER SYSTEM ADMINISTERED BY A THIRD PARTY.
FORM 990, PART VI, SECTION B, LINE 15 CEO AND OTHER OFFICERS COMPENSATION ARE REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS IS PERFORMED, AT A MINIMUM, ANNUALLY. COMPENSATION WAS LAST REVIEWED BY DELTA DENTAL OF KENTUCKY'S COMPENSATION COMMITTEE IN THE FIRST QUARTER OF 2020. THE COMMITTEE IS MADE UP OF BOARD MEMBERS. THE COMMITTEE UTILIZES CERTAIN COMPENSATION SURVEYS AND OUTSIDE CONSULTANTS ARE ENGAGED AS NEEDED.
FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE FILED WITH THE KENTUCKY DEPARTMENT OF INSURANCE AND ARE AVAILABLE FOR INSPECTION BY THE PUBLIC THROUGH THAT AGENCY. ADDITIONALLY, THE COMPANY MAKES ORGANIZATIONAL DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS AVAILABLE AT NO COST UPON RECEIPT OF A WRITTEN REQUEST.
FORM 990, PART VII CERTAIN EMPLOYEES ARE OFFICERS OF MULTIPLE COMPANIES WITHIN THE LARGER ORGANIZATION. THE AVERAGE HOURS WORKED REFLECTS APPROXIMATE TIME SPENT IN EACH OF THOSE INDIVIDUAL COMPANIES. WHILE THE HOURS ARE ALLOCATED TO INDIVIDUAL COMPANIES, MUCH OF THE OFFICERS' TIME IS SPENT WORKING ON ISSUES THAT IMPACT THE ENTIRE ORGANIZATION, NOT JUST ONE COMPANY. COMPENSATION IS REPORTED IN FULL TO AGREE TO THE EMPLOYEE'S W-2 AS REQUIRED BY IRS INSTRUCTIONS. ANY ALLOCATION OF COMPENSATION IS INCLUDED ON SCHEDULE R.
FORM 990, PART XI, LINE 9: EQUITY IN SUBSIDIARY -1,481,209.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2020


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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
DELTA DENTAL OF KENTUCKY INC
 
Employer identification number

61-0659432
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
(1) DENTAL CHOICE PROPERTIES LLC
10100 LINN STATION RD SUITE
LOUISVILLE,KY40223
61-0659432 		NO BUSINESS ACTIVITY KY 0 0 DELTA DENTAL OF KENTUCKY
 










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?
Yes No
(1)RENAISSANCE HEALTH SERVICE CORPORATION
PO BOX 30416

LANSING,MI489097916
38-1675667 		PROMOTING DENTAL CARE MI 501(C)(4) N/A N/A
 
No
(2)DELTA DENTAL PLAN OF MICHIGAN INC
4100 OKEMOS ROAD

OKEMOS,MI48864
38-1791480 		PROVIDE DENTAL SERVICE PLANS MI 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION
 
 
No
(3)DELTA DENTAL OF TENNESSEE INC
240 VENTURE CIRCLE

NASHVILLE,TN37228
62-0812197 		PROVIDE DENTAL SERVICE PLANS TN 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION
 
 
No
(4)DELTA DENTAL PLAN OF NEW MEXICO INC
2500 LOUISIANA BLVD NE

ALBUQUERQUE,NM87110
85-0224562 		PROVIDE DENTAL SERVICE PLANS NM 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION
 
 
No
(5)DELTA DENTAL OF NORTH CAROLINA
4242 SIX FORKS ROAD

RALEIGH,NC27609
56-1018068 		PROVIDE DENTAL SERVICE PLANS NC 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION
 
 
No
(6)DELTA DENTAL PLAN OF OHIO INC
PO BOX 30416

LANSING,MI489097916
31-0685339 		PROVIDE DENTAL SERVICE PLANS OH 501(C)(4) N/A DELTA DENTAL PLAN OF MICHIGAN INC
 
 
No
(7)DELTA DENTAL PLAN OF INDIANA INC
PO BOX 30416

LANSING,MI489097916
35-1545647 		PROVIDE DENTAL SERVICE PLANS IN 501(C)(4) N/A DELTA DENTAL PLAN OF MICHIGAN INC
 
 
No
(8)DELTA DENTAL FUND
PO BOX 30416

LANSING,MI489097916
38-2337000 		SUPPORT DENTAL EDUCATION AND RESEARCH PROGRAMS MI 501(C)(3) LINE 12A, I DELTA DENTAL PLAN OF MICHIGAN INC
 
 
No
(9)DELTA DENTAL PLAN OF ARKANSAS INC
1513 COUNTRY CLUB RD

SHERWOOD,AR72120
71-0561140 		PROVIDE DENTAL SERVICE PLANS AR 501(C)(4) NA RENAISSANCE HEALTH SERVICE CORPORATION
 
 
No
(10)DELTA DENTAL OF ARKANSAS FOUNDATION INC
1513 COUNTRY CLUB RD

SHERWOOD,AR72120
26-1569324 		PROVIDE DENTAL SERVICE PLANS AR 501(C)(3) PF RENAISSANCE HEALTH SERVICE CORPORATION
 
 
No
(11)RENAISSANCE FAMILY FOUNDATION INC
4100 OKEMOS ROAD

OKEMOS,MI48864
46-1376165 		EMPHASIZE DENTAL HEALTH IN COMMUNITIES IN 501(C)(3) PF RENAISSANCE HOLDING COMPANY
 
 
No
(12)SMILE 180 FOUNDATION
240 VENTURE CIRCLE

NASHVILLE,TN37228
47-1654054 		EMPHASIZE DENTAL HEALTH IN COMMUNITIES TN 501(C)(3) LINE 12A, I DELTA DENTAL OF TENNESSEE INC
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(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?



 		(k)
Percentage
ownership
Yes No Yes No
(1) CHESME LLC

124 N BRIDGE ST
DEWITT,MI48820
20-0061957 		CAPITAL MANAGEMENT MI N/A
         No     No  
(2) RED CEDAR INVESTMENT MANAGEMENT LLC

333 BRIDGE STREET NW SUITE 601
GRAND RAPIDS,MI49546
46-2667997 		CAPITAL MANAGEMENT MI N/A
         No     No  
(3) DH LOGIX LLC

1000 SOUTH MIAMI TRAIL
SARASOTA,FL34236
81-5265121 		CAPITAL MANAGEMENT DE N/A
         No     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?
Yes No
(1) DENTAL CHOICE INC

10100 LINN STATION RD SUITE 700
LOUISVILLE,KY40223
61-1105118 		PROVIDE DENTAL SERVICE PLANS KY DELTA DENTAL OF KENTUCKY
  		C -4,087,843 9,497,007 100.000 % Yes  
(2) DENTAL CHOICE AGENCY INC

10100 LINN STATION RD SUITE 700
LOUISVILLE,KY40223
61-1336003 		PRIMARY GENERAL AGENCY FOR DDKY & DENTAL CHOICE KY DELTA DENTAL OF KENTUCKY
  		C -600   100.000 % Yes  
(3) RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF NEW YORK

PO BOX 30381
LANSING,MI48909
13-4098096 		INSURANCE NY RENAISSANCE HOLDING COMPANY
  		C 60,279 891,208 5.900 %   No
(4) RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA

PO BOX 30381
LANSING,MI48909
47-0397286 		INSURANCE IN RENAISSANCE HOLDING COMPANY
  		C 468,197 8,072,984 5.900 %   No
(5) RENAISSANCE HOLDING COMPANY

PO BOX 30381
LANSING,MI48909
41-2177193 		HOLDING COMPANY MI DELTA DENTAL OF MICHIGAN
  		C 1,781,535 5,369,298 5.900 %   No
(6) DEWPOINT INC

300 S WASHIGNTON SQUARE
LANSING,MI48933
38-3300595 		COMPUTER CONSULTING MI N/A
 C         No
(7) FORE HOLDING CORPORATION

240 VENTURE CIRCLE
NASHVILLE,TN37228
20-4116122 		EMPLOYEE BENEFITS TN N/A
 C         No
(8) OMEGA ADMINISTRATORS INC

1513 COUNTRY CLUB ROAD
SHERWOOD,AR72120
04-3740469 		PROVIDE THIRD-PARTY ADMINISTRATIVE SERVICES AR N/A
 C         No
(9) THE 4100 GROUP

4100 OKEMOS ROAD
OKEMOS,MI48864
47-2557772 		INVESTMENT IN SUBSIDIARIES MI N/A
 C         No
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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
No
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 .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
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) DELTA DENTAL PLAN OF MICHIGAN INC

 M 2,771,629 ACTUAL COST
(2) DENTAL CHOICE INC

 L 356,243 ACTUAL COST
(3) DENTAL CHOICE INC

 B 9,060,000 ACTUAL COST



Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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) 2020

Additional Data


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