Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 01-01-2022 , and ending 12-31-2022
BCheck if applicable:
CName of organization
DELTA DENTAL OF MINNESOTA
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
500 WASHINGTON AVE S 2060
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MINNEAPOLIS, MN55415
D Employer identification number

41-0952670
E Telephone number

G Gross receipts $ 476,093,561
F Name and address of principal officer:
RODNEY A YOUNG
500 WASHINGTON AVE S 2060
MINNEAPOLIS,MN55415
I
Tax-exempt status: ( 4 ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.DELTADENTALMN.ORG
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: 1969
M State of legal domicile: MN
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: DELTA DENTAL OF MINNESOTA PROVIDES DENTAL INSURANCE SERVICE PLANS TO MAKE DENTAL CARE AVAILABLE IN THE COMMUNITIES IT SERVES AS A NOT FOR PROFIT ORGANIZATION.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 16
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 12
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 0
6 Total number of volunteers (estimate if necessary) ............. 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 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) ......... 345,783,075 402,576,157
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 8,424,542 3,502,303
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,172,759 332,215
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 355,380,376 406,410,675
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 632,842 478,028
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 23,701,878 25,589,290
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).... 331,256,131 379,450,599
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 355,590,851 405,517,917
19 Revenue less expenses. Subtract line 18 from line 12....... -210,475 892,758
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 129,264,360 127,242,974
21 Total liabilities (Part X, line 26)............. 40,842,081 52,389,473
22 Net assets or fund balances. Subtract line 21 from line 20..... 88,422,279 74,853,501
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 (2021)
Form 990 (2021)
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: DELTA DENTAL OF MINNESOTA OPERATES A NONPROFIT HEALTH SERVICE PLAN TO MAKE DENTAL CARE AVAILABLE THAT ADVANCES ORAL HEALTH IN THE COMMUNITIES 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 $ 385,852,117 including grants of $ 478,028 ) (Revenue $ 402,576,157 )
DELTA DENTAL OF MINNESOTA'S PRINCIPAL PURPOSE IS TO IMPROVE ORAL HEALTH BY PROVIDING WIDESPREAD AND TIMELY AVAILABILITY OF ECONOMICAL DENTAL SERVICES FOR THE COMMUNITIES IN WHICH IT SERVES. THE COMPANY PROVIDES ADMINISTRATIVE SERVICES FOR PUBLIC PROGRAMS IN MINNESOTA THROUGH ARRANGEMENTS WITH MULTIPLE HEALTH PLANS AS PART OF ITS SOCIAL WELFARE MISSION.
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 expensesMediumBullet385,852,117
Form 990 (2021)
Form 990 (2021)
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 Rev. Proc. 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
List of Attached Documents:
// Content
.........................
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
List of Attached Documents:
// Content
....
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
List of Attached Documents:
// Content
..............
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
List of Attached Documents:
// Content
..............
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
List of Attached Documents:
// Content
...................
11a
 
No
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
List of Attached Documents:
// Content
.......
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
List of Attached Documents:
// Content
.......
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
List of Attached Documents:
// Content
............
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
11f
Yes
 
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
List of Attached Documents:
// Content
......................
12a
Yes
 
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
21
Yes
 
Form 990 (2021)
Form 990 (2021)
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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 the 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 line 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
List of Attached Documents:
// Content
33
 
No
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
List of Attached Documents:
// Content
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
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 ...
35b
 
 
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
List of Attached Documents:
// Content
37
 
No
38
Did the organization complete Schedule O and provide explanations on 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
7,901
b
Enter the number of Forms W-2G included on 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 (2021)
Form 990 (2021)
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
0
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
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
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
 
 
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 the 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
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
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
16
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
12
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 on 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 on 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 on 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
 
No
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
 
 
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 (1024 or 1024-A, if applicable), 990, and 990-T (section 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:
MediumBulletCAROL M HOUGHTBY WATSON500 WASHINGTON AVE S 2060   MINNEAPOLIS,MN55415 (612) 224-3173
Form 990 (2021)
Form 990 (2021)
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 the 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, Form 1099-MISC, and/or box 1 of Form 1099-NEC) 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 the 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/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(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) RODNEY A YOUNG......................................................................
CEO & DIRECTOR
 22.00
.................
28.00 		X   X       0 2,155,976 49,641
(2) TAMERA K ROBINSON......................................................................
PRESIDENT & DIRECTOR
 20.50
.................
29.50 		X   X       0 1,059,289 24,154
(3) BRUCE TEMPLETON DMD......................................................................
DIRECTOR
 1.20
.................
32.70 		X           0 364,000 2,882
(4) MICHAEL W HOWE......................................................................
VICE CHAIR
 1.00
.................
5.10 		X   X       0 116,750 842
(5) KIMBERLY F PRICE......................................................................
TREASURER
 0.50
.................
3.90 		X   X       0 84,000 842
(6) ANGELA M RILEY......................................................................
CO-CHAIR
 0.70
.................
2.60 		X   X       0 81,000 842
(7) DEB S KNUTSON......................................................................
CO-CHAIR
 0.70
.................
3.40 		X   X       0 81,000 842
(8) JOHN D SOMROCK......................................................................
DIRECTOR
 0.50
.................
3.60 		X           0 73,000 842
(9) SIMA L GRIFFITH......................................................................
DIRECTOR
 0.50
.................
2.70 		X           0 66,000 0
(10) MICHAEL ZAKULA DDS......................................................................
SECRETARY
 1.40
.................
2.20 		X   X       0 48,000 842
(11) LAURA J GILLUND......................................................................
DIRECTOR
 0.50
.................
2.00 		X           0 43,000 1,363
(12) JOHN W BLUFORD......................................................................
DIRECTOR
 0.50
.................
2.50 		X           0 41,000 842
(13) JAMES R SWANSTROM DDS......................................................................
DIRECTOR
 1.20
.................
1.90 		X           0 40,000 842
(14) LYNDSAY BATES DDS......................................................................
DIRECTOR
 1.20
.................
1.80 		X           0 39,000 1,363
(15) PAUL CARLSON......................................................................
DIRECTOR
 1.20
.................
0.90 		X           0 36,000 0
(16) KATE MORTENSON......................................................................
DIRECTOR
 0.50
.................
1.90 		X           0 36,000 0
(17) SUSAN C ANDERSON......................................................................
DIRECTOR
 1.20
.................
0.90 		X           0 36,000 842
Form 990 (2021)
Form 990 (2021)
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/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(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) STEPHANIE A ALBERT........................................................................
EVP & CHIEF LEGAL OFFICER
 15.70
.......................34.30 		    X       0 717,051 49,586
(19) CAROL M HOUGHTBY WATSON........................................................................
CFO, ASSIST. TREASURER
 27.90
.......................22.10 		    X       0 434,418 36,525
(20) NADIA MARTYN........................................................................
VP, ASST. SECRETARY (INS. DIV.)
 28.20
.......................21.80 		    X       0 314,124 58,222
(21) TIMOTHY R QUINN........................................................................
CHIEF MARKETING OFFICER
 24.90
.......................25.10 		      X     0 641,522 29,701
(22) THOMAS J BELLAMY........................................................................
CHIEF SALES OFFICER
 24.00
.......................16.00 		      X     0 429,057 35,968
(23) KATHLEEN J EILAND-MADISON........................................................................
VP OF HR, DEI
 25.00
.......................25.00 		      X     0 425,706 28,195
(24) JOSEPH P LALLY EXEC DIR........................................................................
VP GOVERN. RELAT. (TO 9/2022)
 0.00
.......................50.00 		        X   0 638,775 31,349
(25) KEVIN R DAVIDSON CHIEF........................................................................
CORP. DEV. OFFICER (TO 10/2022)
 1.00
.......................39.00 		        X   0 455,704 35,460
(26) NIRMALA J PRABHU........................................................................
CHIEF DENTAL OFFICER
 24.00
.......................16.00 		        X   0 406,801 57,230
(27) FORREST M FLINT........................................................................
VP STRAT & INNO (TO 12/2022)
 20.50
.......................14.50 		        X   0 414,823 40,860
(28) PETER I VLADIMIROV........................................................................
VP, IT & DATA ENGINEERING
 24.00
.......................16.00 		        X   0 408,167 33,608
(29) MICHAEL J MCGUIRE........................................................................
FORMER COO (TO 11/2021)
 0.00
.......................0.00 		          X 0 508,915 0


1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 0 10,195,078 523,685
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 MediumBullet0
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
COMMUNITY DENTAL CARE

1670 BEAM AVE STE 204
MAPLEWOOD,MN55109 		DENTAL CLAIMS 13,842,878
APPLE TREE DENTAL

2442 MOUNDS VIEW BLVD
MOUNDS VIEW,MN55112 		DENTAL CLAIMS 11,722,052
PDG PA

2200 COUNTY RD C WEST SUITE 2210
ROSEVILLE,MN55113 		DENTAL CLAIMS 8,039,313
MINNESOTA ORTHODONTICS AND DENTOFACIAL

2019 JEFFERSON RD STE C
NORTHFIELD,MN55057 		DENTAL CLAIMS 7,350,464
FAMILY AND COSMETIC GENTLE DENTISTRY

4100 SHORELINE DR STE 4
SPRING PARK,MN55384 		DENTAL CLAIMS 7,138,663
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet524
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet  
Program Service RevenueAmt Business Code
2a SUBSCRIPTION REVENUE: 624100 215,868,675 215,868,675    
b SUBSCRIPTION REVENUE: 624100 186,707,482 186,707,482    
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 402,576,157
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 2,891,227     2,891,227
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents     6a
b Less: rental expenses     6b
c Rental income or (loss)     6c
d Net rental income or (loss).......MediumBullet        
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 12,217 70,281,745 7a
b Less: cost or other basis and sales expenses 0 69,682,886 7b
c Gain or (loss) 12,217 598,859 7c
d Net gain or (loss).........MediumBullet 611,076     611,076
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 OTHER REVENUE 900999 332,215     332,215
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 332,215
12 Total revenue. See instructions.....MediumBullet 406,410,675 402,576,157 0 3,834,518
Form 990 (2021)
Form 990 (2021)
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 .... 478,028 478,028
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 .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 3,297,664 3,066,827 230,837  
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........ 16,021,907 14,900,373 1,121,534  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 454,845 423,005 31,840  
9 Other employee benefits ....... 5,179,081 4,816,547 362,534  
10 Payroll taxes ........... 635,793 591,287 44,506  
11 Fees for services (non-employees):        
a Management ...... 17,514,155 2,977,406 14,536,749  
b Legal ......... 454,210   454,210  
c Accounting ........... 161,825   161,825  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 418,393   418,393  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 2,550,164 433,520 2,116,644  
12 Advertising and promotion .... 384,391 311,357 73,034  
13 Office expenses ....... 2,724,843 544,868 2,179,975  
14 Information technology ...... 2,087,054 417,334 1,669,720  
15 Royalties ..        
16 Occupancy ........... 1,586,105 1,586,105    
17 Travel ............ 81,376 3,255 78,121  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 15,822 15,822    
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 2,433,435   2,433,435  
23 Insurance ... 950,582   950,582  
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 CLAIMS EXPENSE 342,510,365 342,510,365    
b COMMISSIONS EXPENSE 11,845,270 11,845,270    
c BUSINESS TAXES 2,017,014 201,701 1,815,313  
d BANK CHARGES 1,012,324 30,370 981,954  
e All other expenses -9,296,729 698,677 -9,995,406  
25 Total functional expenses. Add lines 1 through 24e 405,517,917 385,852,117 19,665,800 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 (2021)
Form 990 (2021)
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 ........   1  
2 Savings and temporary cash investments ......... 11,836,034 2 14,870,633
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 8,194,800 4 9,922,777
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 ........... 2,620,695 7 2,577,045
8 Inventories for sale or use ............   8  
9 Prepaid expenses and deferred charges ......   9  
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a  
b Less: accumulated depreciation 10b     10c  
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 ..... 106,320,925 12 86,325,796
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 291,906 15 13,546,723
16 Total assets. Add lines 1 through 15 (must equal line 33)... 129,264,360 16 127,242,974
Liabilities 17 Accounts payable and accrued expenses ..... 18,002,074 17 21,844,043
18 Grants payable ...   18  
19 Deferred revenue ......... 3,309,902 19 2,813,762
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 19,530,105 25 27,731,668
26 Total liabilities. Add lines 17 through 25.. 40,842,081 26 52,389,473
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 ..........   27  
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 ..... 0 29 0
30 Paid-in or capital surplus, or land, building or equipment fund ... 0 30 0
31 Retained earnings, endowment, accumulated income, or other funds 88,422,279 31 74,853,501
32 Total net assets or fund balances ........... 88,422,279 32 74,853,501
33 Total liabilities and net assets/fund balances ........ 129,264,360 33 127,242,974
Form 990 (2021)
Form 990 (2021)
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
406,410,675
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
405,517,917
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
892,758
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
88,422,279
5
Net unrealized gains (losses) on investments ...............
5
-6,018,327
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
-8,443,209
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
74,853,501
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 on
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 (2021)
Form 990 (2021)
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
2021
Open to Public Inspection
Name of the organization
DELTA DENTAL OF MINNESOTA
 
Employer identification number

41-0952670
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) 2021

Schedule D (Form 990) 2021
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 .....      
b Buildings ....        
c Leasehold improvements        
d Equipment ....        
e Other .....        
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 0
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
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........    
(3) Other
(A) AVAILABLE-FOR-SALE SECURITIES		 67,146,898 F

(B) TRADING SECURITIES		 19,178,898 F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 86,325,796
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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
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)INVESTMENT RECEIVABLE 491,422
(2)RIGHT OF USE ASSET 13,055,301
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 13,546,723
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 27,731,668
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) 2021

Schedule D (Form 990) 2021
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 ....... 1 388,128,685
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a -6,018,327
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 -6,018,327
3 Subtract line 2e from line 1.................. 3 394,147,012
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 418,393
b Other (Describe in Part XIII.) ........... 4b 11,845,270
c Add lines 4a and 4b.................... 4c 12,263,663
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 406,410,675
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 ........... 1 393,254,254
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 0
3 Subtract line 2e from line 1................... 3 393,254,254
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 418,393
b Other (Describe in Part XIII.) ............ 4b 11,845,270
c Add lines 4a and 4b..................... 4c 12,263,663
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 405,517,917
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
PART X, LINE 2: DELTA DENTAL OF MINNESOTA (DDMN) IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(4), THOUGH IT IS SUBJECT TO TAX ON INCOME UNRELATED TO ITS EXEMPT PURPOSE, UNLESS THAT INCOME IS OTHERWISE EXCLUDED BY THE IRC. DDMN HAS PROCESSES IN PLACE TO ENSURE THE MAINTENANCE OF THE TAX-EXEMPT STATUS FOR THE ORGANIZATION, TO IDENTIFY AND REPORT UNRELATED INCOME, TO DETERMINE ITS FILING AND TAX OBLIGATIONS IN JURISDICTIONS FOR WHICH IT HAS NEXUS, AND TO IDENTIFY AND EVALUATE OTHER MATTERS THAT MAY BE CONSIDERED TAX POSITIONS. DDMN FILES TAX RETURNS IN THE U.S. FEDERAL AND APPLICABLE STATE JURISDICTION. THE TAX YEARS ENDING DECEMBER 31, 2018 AND THEREAFTER ARE STILL OPEN TO AUDIT FOR FEDERAL OR STATE PURPOSES. DDMN HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN TAX YEARS AND HAS CONCLUDED THAT IT DOES NOT MEET THE THRESHOLD FOR FINANCIAL STATEMENT RECOGNITION OF AN UNCERTAIN INCOME TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN.
PART XI, LINE 4B - OTHER ADJUSTMENTS: COMMISSIONS EXPENSE REPORTED AS PART OF REVENUE ON AUDIT 11,845,270.
PART XII, LINE 4B - OTHER ADJUSTMENTS: COMMISSIONS EXPENSE REPORTED AS PART OF REVENUE ON AUDIT 11,845,270.
Schedule D (Form 990) 2021


Additional Data


Software ID:  
Software Version:  





Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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
2022
Open to Public
Inspection
Name of the organization
DELTA DENTAL OF MINNESOTA
 
Employer identification number
41-0952670
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) ACCESSPOINT DENTAL LLC
1590 S ROBERT STREET SUITE 120
WEST ST PAUL,MN55118 		46-5282727 NON TAX EXEMPT 21,512 0     INCREASING ORAL HEALTH ACCESS PARTNERSHIP
(2) AMERICAN RED CROSS MINNESOTA & DAKOTAS REGION
1201 WEST RIVER PARKWAY
MINNEAPOLIS,MN55454 		53-0196605 501(C)(3) 5,091 0     DISASTER RELIEF AND HUMANITARIAN AID
(3) BOYS & GIRLS CLUB OF ROCHESTER
1026 E CENTER ST
ROCHESTER,MN55904 		41-1945875 501(C)(3) 12,500 0     YOUTH DEVELOPMENT POSITIVE ACTION PROGRAM
(4) BOYS AND GIRLS CLUB OF THE BEMIDJI AREA
1600 MINNESOTA AVENUE NW PO BOX 191
BEMIDJI,MN56619 		81-0599601 501(C)(3) 12,500 0     PROJECT RESTART: SUPPORT, STRENGTHEN & SURROUND YOUTH AND FAMILIES
(5) COMMUNITY DENTAL CARE
1670 BEAM AVE STE 204
MAPLEWOOD,MN55109 		04-3692982 501(C)(3) 25,000 0     PROGRAM TO IMPROVE COMMUNITY ORAL HEALTH OUTREACH
(6) GREATER BEMIDJI INC
102 1ST W SUITE 101
BEMIDJI,MN56601 		36-3367707 501(C)(3) 17,500 0     GREATER BEMIDJI INVESTMENT PARTNER CONTRIBUTION 2022
(7) GREATER MINNEAPOLIS CRISIS NURSERY INC
4544 FOURTH AVE S
MINNEAPOLIS,MN55419 		41-1379021 501(C)(3) 15,000 0     PEDIATRIC ASSESSMENT AND MEDICAL MANAGEMENT PROGRAM
(8) HENNEPIN HEALTHCARE FOUNDATION
HENNEPIN HEALTHCARE MAIL CENTER
HENNEPIN HEALTHCARE FOUNDATION - S6
MINNEAPOLIS,MN55415 		41-0845733 501(C)(3) 7,500 0     PATHWAYS TO SUCCESS ORAL HEALTH INTERNSHIPS AND BLACK WOMEN WITH STETHOSCOPES
(9) INTERCULTURAL MUTUAL ASSISTANCE ASSOCIATION INC
2500 VALLEYHIGH DR NW
ROCHESTER,MN55901 		41-1497753 501(C)(3) 10,000 0     ORAL HEALTH PREVENTION OUTREACH AND EDUCATION 2022
(10) KEYSTONE COMMUNITY SERVICES
2000 ST ANTHONY AVE
SAINT PAUL,MN55104 		41-0693924 501(C)(3) 7,500 0     KEYSTONE TOOTH TUTOR
(11) MANKATO YOUTH PLACE INC
709 S BROAD STREET
MANKATO,MN56001 		84-2745924 501(C)(3) 10,000 0     HEALTHY LIFESTYLES PROGRAM
(12) MENTAL HEALTH RESOURCES INC
762 TRANSFER ROAD SUITE 21
SAINT PAUL,MN55114 		41-1273885 501(C)(3) 25,000 0     COMPREHENSIVE DENTAL HEALTH INITIATIVE
(13) MIGIZI COMMUNICATIONS INC
1845 EAST LAKE STREET
MINNEAPOLIS,MN55407 		41-1379114 501(C)(3) 12,500 0     CULTURAL LEADERSHIP ACADEMIC WELL-BEING (CLAW)
(14) MILL CITY FARMERS MARKET CHARITABLE FUND
704 SOUTH 2ND STREET
MINNEAPOLIS,MN55401 		81-4420781 501(C)(3) 7,500 0     GREENS FOR GOOD PROGRAM 2022
(15) MINNESOTA DENTAL FOUNDATION INC
1335 INDUSTRIAL BLVD 200
MINNEAPOLIS,MN55413 		41-1927049 501(C)(3) 15,000 0     FUND-A-SMILE
(16) MINNESOTA SPORTS AND EVENTS
2131 LINDAU LANE S STE 420
BLOOMINGTON,MN55425 		85-1580569 501(C)(3) 25,000 0     BIG TEN CONFERENCE TOURNAMENT IN MINNESOTA SPONSORSHIP
(17) MINNESOTA SPORTS AND EVENTS
2131 LINDAU LANE S STE 420
BLOOMINGTON,MN55425 		85-1580569 501(C)(3) 12,500 0     CHAMPIONS COUNCIL MEMBERSHIP
(18) MINNESOTA SPORTS AND EVENTS
2131 LINDAU LANE S STE 420
BLOOMINGTON,MN55425 		85-1580569 501(C)(3) 62,500 0     NCAA WOMEN'S FINAL FOUR AND 50TH ANNIVERSARY OF TITLE IX
(19) OASIS FOR YOUTH
2200 W OLD SHAKOPEE RD
BLOOMINGTON,MN55431 		45-3683785 501(C)(3) 12,500 0     MOBILE OASIS PROGRAM
(20) SAHAN JOURNAL
370 WABASHA ST N SUITE 500
ST PAUL,MN55102 		83-2745995 501(C)(3) 7,500 0     INCLUSIVE HEALTH REPORTING AT SAHAN JOURNAL
(21) SECOND HARVEST HEARTLAND
7101 WINNETKA AVENUE NORTH
BROOKLYN PARK,MN55428 		23-7417654 501(C)(3) 12,500 0     24-HOUR HARVEST GIVING DAY 2022
(22) ST CATHERINE UNIVERSITY
2004 RANDOLPH AVE
SAINT PAUL,MN55105 		41-0695509 501(C)(3) 25,000 0     FAMILY-CENTERED ORAL HEALTH EDUCATION
(23) ST MARY'S HEALTH CLINICS
1884 RANDOLPH AVE
ST PAUL,MN55105 		41-1760632 501(C)(3) 12,500 0     ORAL HEALTH SERVICES PROGRAM
(24) THE BRIDGE FOR YOUTH
1111 WEST 22ND STREET
MINNEAPOLIS,MN55405 		40-0983062 501(C)(3) 7,500 0     FOSTERING HEALTHY CONNECTIONS FOR YOUTH
(25) UNCF MINNEAPOLIS
1201 MARQUETTE AVE SUITE 300
MINNEAPOLIS,MN55403 		13-1624241 501(C)(3) 7,500 0     ANNUAL MLK HOLIDAY BREAKFAST IN MINNEAPOLIS 2022
(26) UNIVERSITY OF MINNESOTA FOUNDATION
200 SE OAK ST SUITE 500
MINNEAPOLIS,MN554552010 		41-6042488 501(C)(3) 12,500 0     DONATION TO TUCKER CENTER TUCKER CENTER FOR RESEARCH ON GIRLS & WOMEN IN SPORT
(27) WELCH CENTER INC DBA VALLEY YOUTH CENTER
720 N CENTRAL AVE
DULUTH,MN55807 		41-0850223 501(C)(3) 12,500 0     ROUTINES FOR ACHIEVING HEALTHIER LIVES
(28) YOUNG WOMEN'S CHRISTIAN ASSOCIATION OF ST PAUL
375 SELBY AVE
ST PAUL,MN55102 		41-0693892 501(C)(3) 12,500 0     ADVANCING HEALTH EQUITY INITIATIVE FOR TRANSITIONAL HOUSING PROGRAM YOUTH
(29) YWCA MINNEAPOLIS
1130 NICOLLET MALL
MINNEAPOLIS,MN55403 		41-0693891 501(C)(3) 12,500 0     STRONG FAST FIT PROGRAM
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
28
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2022

Schedule I (Form 990) 2022
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: THE ORGANIZATION'S TEAM MEMBERS WORK WITH EACH OF THE GRANTEES TO DETERMINE HOW THE FUNDS HAVE BEEN USED, VERIFY THAT THE USE OF THE FUNDS MATCHES THE PURPOSE OF THE GRANT AND TO GET REPORTS REGARDING THE IMPACT SUCH AS NUMBER OF INDIVIDUALS THAT RECEIVED CARE, IMPACT OF THE CARE RECEIVED TO THE INDIVIDUAL'S HEALTH, ETC. THIS INFORMATION IS REPORTED TO THE BOARD OF DIRECTORS THROUGH THE SOCIAL RESPONSIBILITY COMMITTEE.
Schedule I (Form 990) 2022



Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
DELTA DENTAL OF MINNESOTA
 
Employer identification number

41-0952670
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
 
 
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
 
 
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
 
No
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
Yes
 
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
Yes
 
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
 
No
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) 2022

Schedule J (Form 990) 2022
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, 1099-MISC compensation, and/or 1099-NEC (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
1RODNEY A YOUNG
CEO & DIRECTOR 		(i)

(ii)		 0
-------------
1,034,794 		0
-------------
1,100,682 		0
-------------
20,500 		0
-------------
18,300 		0
-------------
31,341 		0
-------------
2,205,617 		0
-------------
0
2TAMERA K ROBINSON
PRESIDENT & DIRECTOR 		(i)

(ii)		 0
-------------
653,101 		0
-------------
385,688 		0
-------------
20,500 		0
-------------
18,300 		0
-------------
5,854 		0
-------------
1,083,443 		0
-------------
0
3STEPHANIE A ALBERT
EVP & CHIEF LEGAL OFFICER 		(i)

(ii)		 0
-------------
443,991 		0
-------------
251,975 		0
-------------
21,085 		0
-------------
18,300 		0
-------------
31,286 		0
-------------
766,637 		0
-------------
0
4TIMOTHY R QUINN
CHIEF MARKETING OFFICER 		(i)

(ii)		 0
-------------
412,469 		0
-------------
202,053 		0
-------------
27,000 		0
-------------
18,300 		0
-------------
11,401 		0
-------------
671,223 		0
-------------
0
5JOSEPH P LALLY EXEC DIR
VP GOVERN. RELAT. (TO 9/2022) 		(i)

(ii)		 0
-------------
167,153 		0
-------------
176,714 		0
-------------
294,908 		0
-------------
18,300 		0
-------------
13,049 		0
-------------
670,124 		0
-------------
0
6MICHAEL J MCGUIRE
FORMER COO (TO 11/2021) 		(i)

(ii)		 0
-------------
0 		0
-------------
0 		0
-------------
508,915 		0
-------------
0 		0
-------------
0 		0
-------------
508,915 		0
-------------
0
7KEVIN R DAVIDSON CHIEF
CORP. DEV. OFFICER (TO 10/2022) 		(i)

(ii)		 0
-------------
274,572 		0
-------------
154,204 		0
-------------
26,928 		0
-------------
18,300 		0
-------------
17,160 		0
-------------
491,164 		0
-------------
0
8CAROL M HOUGHTBY WATSON
CFO, ASSIST. TREASURER 		(i)

(ii)		 0
-------------
292,142 		0
-------------
108,276 		0
-------------
34,000 		0
-------------
18,300 		0
-------------
18,225 		0
-------------
470,943 		0
-------------
0
9THOMAS J BELLAMY
CHIEF SALES OFFICER 		(i)

(ii)		 0
-------------
322,970 		0
-------------
79,487 		0
-------------
26,600 		0
-------------
18,300 		0
-------------
17,668 		0
-------------
465,025 		0
-------------
0
10NIRMALA J PRABHU
CHIEF DENTAL OFFICER 		(i)

(ii)		 0
-------------
269,233 		0
-------------
110,568 		0
-------------
27,000 		0
-------------
18,300 		0
-------------
38,930 		0
-------------
464,031 		0
-------------
0
11FORREST M FLINT
VP STRAT & INNO (TO 12/2022) 		(i)

(ii)		 0
-------------
239,649 		0
-------------
127,674 		0
-------------
47,500 		0
-------------
18,300 		0
-------------
22,560 		0
-------------
455,683 		0
-------------
0
12KATHLEEN J EILAND-MADISON
VP OF HR, DEI 		(i)

(ii)		 0
-------------
279,484 		0
-------------
124,779 		0
-------------
21,443 		0
-------------
13,194 		0
-------------
15,001 		0
-------------
453,901 		0
-------------
0
13PETER I VLADIMIROV
VP, IT & DATA ENGINEERING 		(i)

(ii)		 0
-------------
301,269 		0
-------------
86,398 		0
-------------
20,500 		0
-------------
18,300 		0
-------------
15,308 		0
-------------
441,775 		0
-------------
0
14NADIA MARTYN
VP, ASST. SECRETARY (INS. DIV.) 		(i)

(ii)		 0
-------------
209,658 		0
-------------
68,899 		0
-------------
35,567 		0
-------------
18,300 		0
-------------
39,922 		0
-------------
372,346 		0
-------------
0
15BRUCE TEMPLETON DMD
DIRECTOR 		(i)

(ii)		 0
-------------
364,000 		0
-------------
0 		0
-------------
0 		0
-------------
0 		0
-------------
2,882 		0
-------------
366,882 		0
-------------
0
Schedule J (Form 990) 2022

Schedule J (Form 990) 2022
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 3 ALL COMPENSATION TO THE CEO IS PAID BY STRATACOR, A RELATED ORGANIZATION. STRATACOR USES THE FOLLOWING TO ESTABLISH COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4A SOME EMPLOYEES RECEIVED A SEVERANCE PAYMENT DURING THE CALENDER YEAR. THE TERMS AND CONDITIONS OF THE CONFIDENTIAL SEVERANCE AGREEMENT ARE AVAILABLE TO THE INTERNAL REVENUE SERVICE UPON REQUEST.
PART I, LINE 5 ALL ELIGIBLE EMPLOYEES MAY PARTICIPATE IN THE EMPLOYEE INCENTIVE PLAN WHICH IS APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE BOARD. THE 2022 PLAN ALLOWS FOR AN INCENTIVE PLAN PAYOUT BASED ON THREE COMPONENTS: THE RELATED COMPANY'S FINANCIAL PERFORMANCE, CUSTOMER AND EMPLOYEE EXPERIENCE, AND INDIVIDUAL GOALS. WITHIN THE CALCULATION OF THE RELATED COMPANY'S FINANCIAL PERFORMANCE, THERE IS A COMPONENT BASED ON REVENUE AND A COMPONENT BASED ON OPERATING EARNINGS. THE INCENTIVE AMOUNT IS BASED ON THE MATHEMATICAL CALCULATION OF THE RESULTS FOR EACH COMPONENT. FOR 2022, EACH EMPLOYEE'S AMOUNT WAS CALCULATED WITH 75% WEIGHT BASED ON THE RELATED COMPANY PERFORMANCE AND 25% WEIGHT BASED ON THEIR INDIVIDUAL PERFORMANCE
PART I, LINE 6 ALL ELIGIBLE EMPLOYEES MAY PARTICIPATE IN THE EMPLOYEE INCENTIVE PLAN WHICH IS APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE BOARD. THE 2022 PLAN ALLOWS FOR AN INCENTIVE PLAN PAYOUT BASED ON THREE COMPONENTS: THE RELATED COMPANY'S FINANCIAL PERFORMANCE, CUSTOMER AND EMPLOYEE EXPERIENCE, AND INDIVIDUAL GOALS. WITHIN THE CALCULATION OF THE RELATED COMPANY'S FINANCIAL PERFORMANCE, THERE IS A COMPONENT BASED ON REVENUE AND A COMPONENT BASED ON OPERATING EARNINGS. THE INCENTIVE AMOUNT IS BASED ON THE MATHEMATICAL CALCULATION OF THE RESULTS FOR EACH COMPONENT. FOR 2022, EACH EMPLOYEE'S AMOUNT WAS CALCULATED WITH 75% WEIGHT BASED ON THE RELATED COMPANY PERFORMANCE AND 25% WEIGHT BASED ON THEIR INDIVIDUAL PERFORMANCE
Schedule J (Form 990) 2022

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990)

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
2021
Open to Public
Inspection
Name of the organization
DELTA DENTAL OF MINNESOTA
 
Employer identification number

41-0952670
Return Reference Explanation
FORM 990, PART V, LINES 2A AND 2B: ALL EMPLOYEES ARE LEGAL EMPLOYEES OF STRATACOR (FEIN: 41-1852523) OR ABOVA TALENT (FEIN: 85-3884782), BOTH FILE ALL REQUIRED FEDERAL EMPLOYMENT FORMS EACH YEAR.
FORM 990, PART VI, SECTION A, LINE 6 STRATACOR IS THE SOLE MEMBER OF DELTA DENTAL OF MINNESOTA.
FORM 990, PART VI, SECTION A, LINE 7A STRATACOR IS THE SOLE MEMBER OF DELTA DENTAL OF MINNESOTA AND HAS THE AUTHORITY TO APPOINT MEMBERS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7B STRATACOR, AS THE SOLE MEMBER OF DELTA DENTAL OF MINNESOTA, HAS RIGHTS TO APPROVE CERTAIN ACTIONS OF THE BOARD OF DIRECTORS, AS OUTLINED IN THE ORGANIZATION'S BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11B TAX FORM 990 WAS PREPARED, REVIEWED AND FILED BY BAKER TILLY US, LLP, THE EXTERNAL AUDITORS OF STRATACOR. THE COMPANY PROVIDED ALL INFORMATION TO BAKER TILLY US, LLP, INCLUDING OFFICER AND DIRECTOR COMPENSATION DISCLOSURES. COMPANY MANAGEMENT ALSO REVIEWED THE RETURN. A FULL COPY OF THE RETURN WITH COMPENSATION PAGES WAS MADE AVAILABLE TO THE BOARD PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, ALL DIRECTORS AND OFFICERS MUST COMPLETE AND SIGN A CONFLICT OF INTEREST POLICY AND DISCLOSURE. THESE DISCLOSURES ARE SUBMITTED TO LEGAL COUNSEL FOR REVIEW. LEGAL COUNSEL REPORTS THE RESULTS OF THEIR REVIEW TO THE AUDIT COMMITTEE AT A MEETING OF THE FULL AUDIT COMMITTEE.
FORM 990, PART VI, SECTION B, LINE 15 OFFICERS OF THE FILING ORGANIZATION ARE NOT COMPENSATED BY THE FILING ORGANIZATION. INDIVIDUALS SERVING AS OFFICERS OF THE FILING ORGANIZATION SERVE IN THE SAME OR SIMILAR CAPACITY FOR A RELATED 501 (C)(4) ORGANIZATION, STRATACOR. ALL COMPENSATION RECEIVED BY OFFICERS OF THE FILING ORGANIZATION (IN THEIR CAPACITIES AS EMPLOYEES OF STRATACOR) IS PAID BY STRATACOR, AND STRATACOR IS RESPONSIBLE FOR COMPENSATION SETTING POLICY AND PROCEDURE.
FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST. STATUTORY FINANCIAL STATEMENTS ARE FILED WITH THE MINNESOTA DEPARTMENT OF COMMERCE AND THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS AS A MATTER OF PUBLIC RECORD. GAAP BASIS FINANCIALS ARE AVAILABLE UPON REQUEST. FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D).
FORM 990, PART XI, LINE 9: CHANGE IN GAIN ON AVAILABLE -FOR-SALE BONDS -8,443,209.
FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSEEING THE AUDIT AND SELECTING THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED SINCE PRIOR YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


Additional Data


Software ID:  
Software Version:  
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
2021
Open to Public Inspection
Name of the organization
DELTA DENTAL OF MINNESOTA
 
Employer identification number

41-0952670
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)DELTA DENTAL OF MINNESOTA FOUNDATION
500 WASHINGTON AVENUE S SUITE 2060

MINNEAPOLIS,MN55415
26-4482509 		FOUNDATION MN 501 (C)(3) LINE 12B, II STRATACOR
 
 
No
(2)STRATACOR
500 WASHINGTON AVENUE S SUITE 2060

MINNEAPOLIS,MN55415
41-1852523 		HOLDING COMPANY MN 501 (C)(4) N/A N/A
 
No
(3)DELTA DENTAL OF NEBRASKA
1299 FARNAM STREET SUITE 300

OMAHA,NE68105
47-0685003 		DENTAL SERVICE PLANS NE 501 (C)(4) N/A STRATACOR
 
 
No








For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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












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) HEALTH VENTURES NETWORK

500 WASHINGTON AVENUE S SUITE 2060
MINNEAPOLIS,MN55415
41-1539439 		VISION COVERAGE MN N/A
 C         No
(2) ABOVA INC

500 WASHINGTON AVENUE S SUITE 2060
MINNEAPOLIS,MN55415
81-4457588 		SALE OF DENTAL PRODUCTS AND CONSULTING DE N/A
 C         No
(3) TRASKA INC

500 WASHINGTON AVENUE S SUITE 2060
MINNEAPOLIS,MN55415
83-1531907 		BEMIDJI BUILDING HOLDING CO DE N/A
 C         No








Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
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
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
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





Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) 2021
Schedule R (Form 990) 2021
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) 2021

Additional Data


Software ID:  
Software Version: