Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
Do not enter social security numbers on this form as it may be made public.
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public Inspection
A For the 2023 calendar year, or tax year beginning 01-01-2023 , and ending 12-31-2023
BCheck if applicable:
CName of organization
DELTA DENTAL OF IDAHO
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
555 E PARKCENTER BLVD
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
BOISE, ID83706
D Employer identification number

82-0299431
E Telephone number

G Gross receipts $ 91,840,026
F Name and address of principal officer:
GREG DONACA
555 E PARKCENTER BLVD
BOISE,ID83706
I
Tax-exempt status: ( 4 ) (insert no.) or
J
Website:
WWW.DELTADENTALID.COM
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number  
K Form of organization:  
L Year of formation: 1971
M State of legal domicile: ID
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: DELTA DENTAL PLAN OF IDAHO, INC. WAS INCORPORATED IN 1971 AS A NON-PROFIT SERVICE (SEE SCHEDULE O) ORGANIZATION. DELTA DENTAL PLAN OF IDAHO, INC. PROVIDES PREPAYMENT DENTAL SERVICE PROGRAMS TO SUBSCRIBERS, THEIR ELIGIBLE DEPENDENTS, AND OTHER BENEFICIARES AS WELL AS PUBLIC BENEFIT PROGRAMS TO PROMOTE ORAL HEALTH.
2 Check this box
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 13
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 8
5 Total number of individuals employed in calendar year 2023 (Part V, line 2a) ...... 5 125
6 Total number of volunteers (estimate if necessary) ............. 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 675,567
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) ......... 78,904,073 83,432,063
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,722,501 1,403,997
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 80,626,574 84,836,060
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 780,626 783,884
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) 8,995,066 9,973,689
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) 0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 69,793,909 72,281,683
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 79,569,601 83,039,256
19 Revenue less expenses. Subtract line 18 from line 12....... 1,056,973 1,796,804
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 77,033,140 85,966,501
21 Total liabilities (Part X, line 26)............. 24,400,411 25,091,052
22 Net assets or fund balances. Subtract line 21 from line 20..... 52,632,729 60,875,449
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
Signature of officer Date
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name

Firm's EIN
Firm's address



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 (2023)
Form 990 (2023)
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 PLAN OF IDAHO, INC.'S MISSION IS "WE ARE THE TRUSTED LEADER THAT PROVIDES QUALITY DENTAL BENEFITS AND SERVICES." DELTA DENTAL PLAN OF IDAHO, INC. WAS INCORPORATED IN 1971 AS A NON-PROFIT SERVICE ORGANIZATION TO IMPROVE THE DENTAL HEALTH OF ALL IDAHOANS.
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 $ 59,825,448 including grants of $   ) (Revenue $ 82,756,496 )
DENTAL HEALTH SERVICES: DENTAL HEALTH COVERAGE AND ADMINISTRATIVE SERVICES INCLUDING EXTERNAL COMMISSIONS PAID, PROVIDED FOR 445,063 MEMBERS.
4b (Code:   ) (Expenses $ 1,126,443 including grants of $ 268,818 ) (Revenue $   )
DENTAL SEALANT CLINICS: IN 2023, WE SAW 8,953 CHILDREN IN FREE SCHOOLBASED PREVENTIVE CLINICS AND AN ADDITIONAL 1,318 AT COORDINATED EVENTS WITH COMMUNITY PARTNERS. WE ALSO EDUCATED 18,624 CHILDREN ON THE IMPORTANCE OF GOOD ORAL HYGIENE THROUGH IN PERSON CLINICS AND 10,477 VIRTUALLY THROUGH THE LAND OF SMILES PROGRAM, AND 185 THROUGH THE GIRL SCOUTS PATCH PROGRAM.
4c (Code:   ) (Expenses $ 674,340 including grants of $ 515,066 ) (Revenue $   )
COMMUNITY GRANTS: WE PARTIALLY FUNDED A FULL TIME COMMUNITY DENTAL HEALTH COORDINATOR AT TERRY REILLY DENTAL HEALTH CENTER WHO PROVIDED PREVENTION/EDUCATION SERVICE TO 546 PATIENTS AND DENTAL TREATMENT TO AN ADDITIONAL 759 PATIENTS.
(Code:   ) (Expenses $ 596,255 including grants of $   ) (Revenue $   )
DENTAL SENIOR PLANS: WE PROVIDED 245 SENIORS AND 15 ADULTS AGES 26 - 34 WITH FREE SERVICES UP TO $1,850 PER PERSON AND MAINTAINED OVER 98 SENIORS ON A PREVENTIVE BENEFIT PLAN. WE PROVIDED 109 CHILDREN, UP TO AGE 18, WITH FREE SERVICES UP TO $2,000 PER CHILD. WE ALSO PARTNERED WITH VARIOUS ORGANIZATIONS TO PROVIDE 15 ORAL HEALTH SCHOLARSHIPS AND DONATED 117,673 DENTAL CARE KITS AND ORAL HEALTH EDUCATIONAL MATERIALS FOR IDAHOANS.
4d Other program services (Describe in Schedule O.)
(Expenses $ 596,255 including grants of $   ) (Revenue $   )
4e Total program service expenses62,222,486
Form 990 (2023)
Form 990 (2023)
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
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment
List of Attached Documents:
// Content
.......
11b
 
No
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
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
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 (2023)
Form 990 (2023)
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
Yes
 
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 .... Click to see attachment
List of Attached Documents:
// Content
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.......................Click to see attachment
List of Attached Documents:
// Content
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 IIClick to see attachment
List of Attached Documents:
// Content
...........
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 IIIClick to see attachment
List of Attached Documents:
// Content
.........................
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......................Click to see attachment
List of Attached Documents:
// Content
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
List of Attached Documents:
// Content
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
Yes
 
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
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
List of Attached Documents:
// Content
34
 
No
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
15,841
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 (2023)
Form 990 (2023)
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
125
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country:
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, or any disqualified or other person 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 (2023)
Form 990 (2023)
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
13
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
8
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 filed
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:
GREG DONACA555 E PARKCENTER BLVD   BOISE,ID83706 (208) 489-3580
Form 990 (2023)
Form 990 (2023)
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, box 6 of 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) GREG DONACA......................................................................
PRESIDENT AND CEO
 40.00
.................
  		X   X       502,361 0 72,647
(2) ANNETTE HERMAN......................................................................
CHAIR
 5.00
.................
  		X   X       42,726 0 0
(3) KYLE SIEMEN DMD......................................................................
IMMEDIATE PAST CHAIR
 4.00
.................
  		X   X       25,665 0 0
(4) MICHAEL FERY......................................................................
SECRETARY
 4.00
.................
  		X   X       25,500 0 0
(5) JIM PIERCE DDS......................................................................
BOARD MEMBER
 4.00
.................
  		X           27,312 0 0
(6) JONATHAN L JUREVIC......................................................................
BOARD MEMBER
 4.00
.................
  		X           28,408 0 0
(7) MARK ALEXANDER DMD......................................................................
BOARD MEMBER
 4.00
.................
  		X           27,610 0 0
(8) KURT PETELLIN DDS......................................................................
BOARD MEMBER
 4.00
.................
  		X           26,199 0 0
(9) MIKE MOONEY......................................................................
CHAIR-ELECT
 4.00
.................
  		X   X       26,150 0 0
(10) JACK LINCKS DDS......................................................................
BOARD MEMBER
 4.00
.................
  		X           28,150 0 0
(11) CHRISTINE NEUHOFF......................................................................
BOARD MEMBER
 4.00
.................
  		X           27,150 0 0
(12) NANCY BRIGGS......................................................................
BOARD MEMBER
 4.00
.................
  		X           25,050 0 0
(13) JOHN ECK MD......................................................................
BOARD MEMBER
 4.00
.................
  		X           23,550 0 0
(14) PARK PRICE......................................................................
BOARD MEMBER
 4.00
.................
  		X           23,991 0 0
(15) BILL SHRUM......................................................................
SVP, FINANCE AND ACCOUNTING
 40.00
.................
  		    X       188,469 0 41,123
(16) CORY VAUGHN THROUGH 112023......................................................................
VP OF IT AND OPERATIONS
 40.00
.................
  		      X     328,063 0 45,618
(17) DONALD MURRAY SVP SALES......................................................................
ACCT MANAGEMENT AND GOVN'T RELATIONS
 40.00
.................
  		      X     228,509 0 46,944
Form 990 (2023)
Form 990 (2023)
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) CHRIS FERGUSON........................................................................
DIRECTOR, ENTERPRISE APPLICATIONS
 40.00
.......................   		        X   183,434 0 28,044
(19) JOANNA RAMER........................................................................
STRATEGIC SALES ACCOUNT EXECUTIVE
 40.00
.......................   		        X   186,989 0 19,510
(20) JODY DIPALMA........................................................................
SENIOR ACCOUNT EXECUTIVE
 40.00
.......................   		        X   174,728 0 18,146
(21) HEATHER BROWN........................................................................
SR. DIR., COM. OUTREACH & ORAL HEALTH
 40.00
.......................   		        X   139,877 0 19,249
(22) JAMES PAULL........................................................................
MANAGER, SOFTWARE DEVELOPMENT
 40.00
.......................   		        X   150,512 0 17,234
















1b Sub-Total..............
c Total from continuation sheets to Part VII, Section A..
d Total (add lines 1b and 1c)......... 2,440,403 0 308,515
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 28
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
 
No
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
SUMMIT DENTAL GROUP

782 SOUTH AMERICANA BLVD
BOISE,ID83702 		CLAIMS 1,110,140
RIVERSTONE DENTAL CARE PLLC

2344 N MERRITT CREEK LOOP
COEUR D ALENE,ID83814 		CLAIMS 852,957
S W GRANT PC

2275 SOUTH EAGLE RD STE 140
MERIDIAN,ID83642 		CLAIMS 787,460
EASTERN IDAHO ENDODONTICS PLLC

3335 S HOLMES AVE
IDAHO FALLS,ID83404 		CLAIMS 731,504
DFS PLLC

651 E PARKCENTER BLVD
BOISE,ID83706 		CLAIMS 730,306
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 390
Form 990 (2023)
Form 990 (2023)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......  
Program Service RevenueAmt Business Code
2a DENTAL PREMIUMS 524114 77,483,606 77,483,606    
b ADMINISTRATION FEES 524114 5,272,890 5,272,890    
c IT SERVICE REVENUE 541519 675,567   675,567  
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f ..... 83,432,063
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ...... 1,320,624     1,320,624
4 Income from investment of tax-exempt bond proceeds        
5 Royalties...........        
(i) Real (ii) Personal
6a Gross rents 6a    
b Less: rental expenses 6b    
c Rental income or (loss) 6c    
d Net rental income or (loss).......        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 7a 7,087,339  
b Less: cost or other basis and sales expenses 7b 7,003,966  
c Gain or (loss) 7c 83,373  
d Net gain or (loss)......... 83,373     83,373
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..      
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..        
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..        
OtherRevenueMiscAmt
Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......  
12 Total revenue. See instructions..... 84,836,060 82,756,496 675,567 1,403,997
Form 990 (2023)
Form 990 (2023)
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 .... 515,066 515,066
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 268,818 268,818
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 ........... 1,811,197   1,811,197  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........ 5,706,889   5,706,889  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 995,305   995,305  
9 Other employee benefits ....... 895,081   895,081  
10 Payroll taxes ........... 565,217   565,217  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 436,471   436,471  
c Accounting ........... 171,904   171,904  
d Lobbying ........... 67,671   67,671  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 282,082   282,082  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 1,546,241   1,546,241  
12 Advertising and promotion .... 640,366   640,366  
13 Office expenses ....... 107,273   107,273  
14 Information technology ...... 442,740   442,740  
15 Royalties ..        
16 Occupancy ........... 165,875   165,875  
17 Travel ............ 199,977   199,977  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 131,081   131,081  
21 Payments to affiliates ....... 295,208   295,208  
22 Depreciation, depletion, and amortization .. 503,040   503,040  
23 Insurance ... 278,623   278,623  
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 59,825,445 59,825,445    
b EXTERNAL COMMISSIONS 4,014,685   4,014,685  
c COMMUNITY PROGRAMS 1,613,157 1,613,157    
d
e All other expenses 1,559,844   1,559,844  
25 Total functional expenses. Add lines 1 through 24e 83,039,256 62,222,486 20,816,770 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).        
Form 990 (2023)
Form 990 (2023)
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 ........ 201,741 1 127,884
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 2,956,703 4 3,282,717
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ...........   7  
8 Inventories for sale or use ............   8  
9 Prepaid expenses and deferred charges ...... 402,096 9 406,195
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 14,690,354
b Less: accumulated depreciation 10b 4,765,387 10,058,242 10c 9,924,967
11 Investments—publicly traded securities . 54,580,282 11 62,187,404
12 Investments—other securities. See Part IV, line 11 ..... 44,489 12 0
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 8,789,587 15 10,037,334
16 Total assets. Add lines 1 through 15 (must equal line 33)... 77,033,140 16 85,966,501
Liabilities 17 Accounts payable and accrued expenses ..... 4,578,748 17 3,674,387
18 Grants payable ...   18  
19 Deferred revenue .........   19  
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 .. 4,029,875 23 3,915,959
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 15,791,788 25 17,500,706
26 Total liabilities. Add lines 17 through 25.. 24,400,411 26 25,091,052
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 52,582,729 27 60,825,449
28 Net assets with donor restrictions ........... 50,000 28 50,000
Organizations that do not follow FASB ASC 958, check here right arrow and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 52,632,729 32 60,875,449
33 Total liabilities and net assets/fund balances ........ 77,033,140 33 85,966,501
Form 990 (2023)
Form 990 (2023)
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
84,836,060
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
83,039,256
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
1,796,804
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
52,632,729
5
Net unrealized gains (losses) on investments ...............
5
6,445,916
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
0
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
60,875,449
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 Uniform Guidance, 2 C.F.R. Part 200, Subpart F?
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 (2023)
Form 990 (2023)
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
right arrow 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.
right arrow Attach to Form 990.
right arrow 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 IDAHO
 
Employer identification number

82-0299431
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 July 25, 2006, 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 right arrow  
4
Number of states where property subject to conservation easement is located right arrow  
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
right arrow  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow $  
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 .........................right arrow $  
(ii)
Assets included in Form 990, Part X ...............................right arrow $  
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 ..........................right arrow $  
b
Assets included in Form 990, Part X ...............................right arrow $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2022

Schedule D (Form 990) 2022
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 right arrow  
b
Permanent endowment right arrow  
c
Term endowment right arrow  
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 .....   1,177,645 1,177,645
b Buildings ....   8,405,851 1,378,246 7,027,605
c Leasehold improvements        
d Equipment ....   4,163,142 3,387,141 776,001
e Other .....   943,716   943,716
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..right arrow 9,924,967
Schedule D (Form 990) 2022

Schedule D (Form 990) 2022
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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)right arrow  
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.)right arrow  
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)DEFERRED COMPENSATION 10,037,334
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........right arrow 10,037,334
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  
DEFERRED COMPENSATION 10,037,334
ACCRUED DENTAL CLAIMS 4,145,000
UNEARNED PREMIUMS 1,847,934
ADVANCE DEPOSITS 814,899
RETENTION ACCOUNT 363,539
PROVISION FOR CLAIMS PROCESSINGS 292,000



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)right arrow 17,500,706
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) 2022

Schedule D (Form 990) 2022
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 90,999,894
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a 6,445,916
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 6,445,916
3 Subtract line 2e from line 1.................. 3 84,553,978
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 282,082
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c 282,082
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 84,836,060
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 82,757,174
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 82,757,174
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 282,082
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b..................... 4c 282,082
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 83,039,256
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 PLAN OF IDAHO, INC. BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. DELTA DENTAL PLAN OF IDAHO, INC. WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED.
Schedule D (Form 990) 2022


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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2023
Open to Public
Inspection
Name of the organization
DELTA DENTAL OF IDAHO
 
Employer identification number
82-0299431
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) COMMUNITY HEALTH CLINICS INC DBA TERRY REILLY HEALTH SERVICES
STREET ADDRESS
NAMPA,ID83653 		82-0300537 501(C)(3) 50,000 0     PARTIALLY FUND FULL TIME COMMUNITY DENTAL HEALTH COORDINATOR
(2) IDAHO STATE UNIVERSITY FOUNDATION
PO BOX 9
POCATELLO,ID83209 		82-6013543 501(C)(3) 8,230 0     DENTAL HYGIENE SCHOLARSHIP
(3) IDAHO ORAL HEALTH ALLIANCE
921 S 8TH AVE STOP 8050
BOISE,ID83701 		20-0454949 501(C)(3) 20,000 0     1ST OF 3 YEAR SPONSORSHIP FOR INFRASTRUCTURE
(4) GENESIS COMMUNITY HEALTH
PO BOX 2309
BOISE,ID83714 		82-0505073 501(C)(3) 50,000 0     FUNDS TO EMPLOYEE DENTAL HYGIENIST
(5) COLLEGE OF SOUTHERN IDAHO FOUNDATION INC
215 W 35TH ST
TWIN FALLS,ID83303 		82-0388193 501(C)(3) 15,760 0     2 DA SCHOLARSHIPS
(6) NORTH IDAHO COLLEGE FOUNDATION
PO BOX 1238
COUER D ALENE,ID83814 		82-0337334 501(C)(3) 7,640 0     2 DH SCHOLARSHIPS
(7) COLLEGE OF EASTERN IDAHO
8169 W VICOTRY ROAD
IDAHO FALLS,ID83404 		94-3160729 501(C)(3) 75,000 0     ORAL HEALTH GRANT
(8) COMMUNITY COUNCIL OF IDAHO
1600 S 25TH E
CALDWELL,ID83607 		82-0299736 501(C)(3) 50,000 0     ORAL HEALTH GRANT
(9) GENESIS COMMUNITY HEALTH
317 HAPPY DAY BLV SUITE 250
BOISE,ID83714 		82-0505073 501(C)(3) 205,000 0     DONATION TO FUND DENTAL EQUIPMENT AND SUPPLIES
(10) PANHANDLE HEALTH DISTRICT
8500 N ATLAS ROAD
HAYDEN,ID83835 		82-0537262 GOVERNMENTAL ENTITY 8,436 0     FUNDS TO RUN NORTH IDAHO SCHOOL SEALANT CLINICS ON OUR BEHALF.
(11) BOISE PUBLIC SCHOOLS EDUCATION FOUNDATION INC
8169 W VICOTRY ROAD
BOISE,ID83702 		82-0400689 501(C)(3) 25,000 0     ORAL HEALTH GRANT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
10
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) 2023

Schedule I (Form 990) 2023
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) SCHOLARSHIPS 15 47,426      
(2) GRANTS TO INDIVIDUALS FOR CONFERENCES 8 6,392      
(3) COMMUNITY OUTREACH - DENTAL KITS 117673 0 215,000 FMV DENTAL KITS
(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 ENDEAVORS TO MONITOR ITS GRANTS AND DONATIONS TO ENSURE THAT THE FUNDS ARE USED FOR THEIR PROPER PURPOSES AND NOT OTHERWISE DIVERTED FROM THEIR INTENDED USE. THIS IS ACCOMPLISHED BY REQUESTING RECIPIENT ENTITIES TO AFFIRM THAT FUNDS MUST BE USED SOLELY IN ACCORDANCE WITH THE GRANT REQUEST AND BUDGET ON WHICH THE GRANT WAS BASED AND THAT FUNDS NOT EXPENDED FOR THE STATED PURPOSE ARE TO BE RETURNED TO THE ORGANIZATION. REPORT ARE REQUESTED FROM TIME TO TIME AS IS DEEMED APPROPRIATE. THE SCHOLARSHIP RECIPIENTS ARE DETERMINED BY THE SCHOOL IN LINE WITH CRITERIA THAT ARE SET IN OUR SCHOLARSHIP AGREEMENT. THE SCHOOL'S FOUNDATION RECEIVES THE FUNDS FROM THE ORGANIZATION AND WORKS WITH THE SCHOOL'S FINANCIAL AID OFFICE TO APPLY THE FUNDS TO RECIPIENTS' TUITION. SCHOOLS PROVIDE ANNUAL REPORTS AND/OR THANK YOU LETTERS STATING OUR FUNDS HAVE BEEN USED.
Schedule I (Form 990) 2023



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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic Attach to Form 990.
medium right arrow graphic Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public Inspection
Name of the organization
DELTA DENTAL OF IDAHO
 
Employer identification number

82-0299431
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
Yes
 
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
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
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) 2023

Schedule J (Form 990) 2023
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
1GREG DONACA
PRESIDENT AND CEO 		(i)

(ii)		 341,036
-------------
0 		92,148
-------------
0 		69,177
-------------
0 		63,438
-------------
0 		9,209
-------------
0 		575,008
-------------
0 		45,822
-------------
0
2CORY VAUGHN THROUGH 112023
VP OF IT AND OPERATIONS 		(i)

(ii)		 113,634
-------------
0 		108,430
-------------
0 		105,999
-------------
0 		39,105
-------------
0 		6,513
-------------
0 		373,681
-------------
0 		78,387
-------------
0
3DONALD MURRAY SVP SALES
ACCT MANAGEMENT AND GOVN'T RELATIONS 		(i)

(ii)		 155,755
-------------
0 		27,408
-------------
0 		45,346
-------------
0 		36,214
-------------
0 		10,730
-------------
0 		275,453
-------------
0 		22,846
-------------
0
4BILL SHRUM
SVP, FINANCE AND ACCOUNTING 		(i)

(ii)		 165,962
-------------
0 		19,807
-------------
0 		2,700
-------------
0 		32,682
-------------
0 		8,441
-------------
0 		229,592
-------------
0 		0
-------------
0
5CHRIS FERGUSON
DIRECTOR, ENTERPRISE APPLICATIONS 		(i)

(ii)		 150,342
-------------
0 		33,092
-------------
0 		0
-------------
0 		8,329
-------------
0 		19,715
-------------
0 		211,478
-------------
0 		0
-------------
0
6JOANNA RAMER
STRATEGIC SALES ACCOUNT EXECUTIVE 		(i)

(ii)		 151,586
-------------
0 		35,403
-------------
0 		0
-------------
0 		10,303
-------------
0 		9,207
-------------
0 		206,499
-------------
0 		0
-------------
0
7JODY DIPALMA
SENIOR ACCOUNT EXECUTIVE 		(i)

(ii)		 145,292
-------------
0 		29,436
-------------
0 		0
-------------
0 		8,739
-------------
0 		9,407
-------------
0 		192,874
-------------
0 		0
-------------
0
8JAMES PAULL
MANAGER, SOFTWARE DEVELOPMENT 		(i)

(ii)		 143,478
-------------
0 		7,034
-------------
0 		0
-------------
0 		9,027
-------------
0 		8,207
-------------
0 		167,746
-------------
0 		0
-------------
0
9HEATHER BROWN
SR. DIR., COM. OUTREACH & ORAL HEALT 		(i)

(ii)		 129,299
-------------
0 		10,578
-------------
0 		0
-------------
0 		8,522
-------------
0 		10,727
-------------
0 		159,126
-------------
0 		0
-------------
0
Schedule J (Form 990) 2023

Schedule J (Form 990) 2023
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 4B DELTA DENTAL OF IDAHO HAS A 457(F) PLAN IN PLACE. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE PLAN DURING THE TAX YEAR: GREG DONACA, CORY VAUGHN, DONALD MURRAY, AND BILL SHRUM. IN 2023 THE FOLLOWING INDIVIDUALS VESTED IN AND RECEIVED A PAYMENT FROM THE PLAN: - GREG DONACA $45,822 - CORY VAUGHN $105,999 - DONALD MURRAY $22,846
PART I, LINE 5A: THE CEO BONUS COMPENSATION IS A MIXTURE OF PERFORMANCE AND TARGETED GROWTH, MEMBERSHIP AND CONTROLLING OPERATING EXPENSE FOR THE YEAR. BONUS TARGETS ARE ESTABLISHED ANNUALLY BY THE BOARD TO ENSURE THE ONGOING FINANCIAL SUCCESS OF DELTA DENTAL OF IDAHO AND STRIVE TO MEET THE MISSION. AT THE BEGINNING OF THE YEAR, THE TARGETS ARE ESTABLISHED AND APPROVED BY THE BOARD WITH ACTUAL RESULTS ALSO APPROVED BY THE BOARD AT THE END OF THE YEAR. CALCULATIONS ARE COMPLETED BY THE VP OF FINANCE AND ACCOUNTING AND REVIEWED BY THE VP OF HUMAN RESOURCES BEFORE THEY ARE PRESENTED TO THE BOARD FOR APPROVAL.
Schedule J (Form 990) 2023

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Schedule L
(Form 990)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public Inspection
Name of the organization
DELTA DENTAL OF IDAHO
 
Employer identification number

82-0299431
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... $
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ $
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ............... $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990) 2023
Schedule L (Form 990) 2023
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) POCATELLO FAMILY DENTISTRY
  		SEE PART V. 101,192 DENTAL CLAIM PAYMENTS WERE MADE TO POCATELLO FAMILY DENTISTRY, WHICH IS MORE THAN 35% OWNED BY KYLE SIEMEN, A CURRENT BOARD MEMBER OF DELTA DENTAL OF IDAHO.   No
(2) PERIODONTAL HEALTH SPECIALISTS OF IDAHO
  		SEE PART V. 449,439 DENTAL CLAIM PAYMENTS WERE MADE TO PERIODONTAL HEALTH SPECIALISTS OF IDAHO, WHICH IS MORE THAN 35% OWNED BY JACK LINCKS, A CURRENT BOARD MEMBER OF DELTA DENTAL OF IDAHO.   No
(3) KURT PETELLIN DDS
  		SEE PART V. 114,599 DENTAL CLAIM PAYMENTS WERE MADE TO KURT PETELLIN, DDS., WHICH IS MORE THAN 35% OWNED BY KURT PETELLIN, A CURRENT BOARD MEMBER OF DELTA DENTAL OF IDAHO.   No
(4) MARK ALEXANDER DDS
  		SEE PART V. 101,724 DENTAL CLAIM PAYMENTS WERE MADE TO ALEXANDER DENTAL GROUP, WHICH IS MORE THAN 35% OWNED BY MARK ALEXANDER, A CURRENT BOARD MEMBER OF DELTA DENTAL OF IDAHO.   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990) 2023


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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.
Attach to Form 990 or 990-EZ.
 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2023
Open to Public
Inspection
Name of the organization
DELTA DENTAL OF IDAHO
 
Employer identification number

82-0299431
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 1A THE CHAIR, IMMEDIATE PAST-CHAIR, SECRETARY AND CEO CAN COMPRISE A STANDING EXECUTIVE COMMITTEE. ALTERNATIVELY, THE BOARD OF DIRECTORS ("BOD") MAY REPLACE THE STANDING EXECUTIVE COMMITTEE BY DESIGNATING TWO OR MORE DIRECTORS TO CONSTITUTE THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE CAN HAVE THE POWER AND AUTHORITY OF THE BOD IN THE DAY-TO-DAY MANAGEMENT OF THE BUSINESS OF THE COMPANY, SUBJECT TO THE LIMITATIONS IMPOSED BY THE IDAHO NONPROFIT CORPORATION ACT, OR THE BOD.
FORM 990, PART VI, SECTION A, LINE 6 TO BE ELIGIBLE TO BECOME AND REMAIN A MEMBER OF DELTA DENTAL OF IDAHO, A PERSON MUST BE 1) HOLD A CURRENT LICENSE BY THE STATE OF IDAHO TO PRACTICE DENTISTRY; 2) CARRY AND MAINTAIN ADEQUATE PROFESSIONAL LIABILITY INSURANCE AND COMMERCIAL GENERAL LIABILITY POLICIES; 3) MEET THE CREDENTIALING CRITERIA; AND 4) EXECUTE A SERVICE AGREEMENT WITH DELTA DENTAL OF IDAHO. ALL MEMBERS SHALL ABIDE BY THE APPLICABLE RULES, REGULATIONS AND POLICIES THAT MAY BE ADOPTED BY THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS INCLUDES TWO CLASSES OF DIRECTORS: MEMBER DIRECTORS AND INDEPENDENT DIRECTORS. A MAJORITY OF THE DIRECTORS ARE INDEPENDENT DIRECTORS APPOINTED BY THE BOARD OF DIRECTORS. THE MEMBER DIRECTORS ARE MEMBERS IN GOOD STANDING AND ARE ELECTED BY A MAJORITY OF THE MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7B DELTA DENTAL OF IDAHO IS A MEMBER COMPANY OF THE DELTA DENTAL PLANS ASSOCIATION (DDPA) WHICH HAS GOVERNING RULES AND CRITERIA THAT ALL MEMBER COMPANIES MUST FOLLOW. THEREFORE CERTAIN BOARD DECISIONS ARE SUBJECT TO THESE GOVERNING RULES AND REQUIRE APPROVAL BY DDPA. IN ADDITION THE COMPANY IS SUBJECT TO RULES AND REGULATIONS ESTABLISHED BY THE IDAHO DEPARTMENT OF INSURANCE.
FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED BY AN EXTERNAL CPA FIRM AND REVIEWED IN DETAIL BY SENIOR MANAGEMENT AND ACCOUNTING STAFF. THE IRS FORM 990 IS REVIEWED AND APPROVED BY THE INVESTMENT AND FINANCE COMMITTEE. A COPY OF THE FORM IS PROVIDED TO THE FULL BOARD FOR REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED AND SIGNED BY EACH BOARD MEMBER AND OFFICER OR KEY EMPLOYEE OF THE COMPANY ON AN ANNUAL BASIS. A DETAIL REVIEW OF THE SIGNED CONFLICT FORMS IS COMPLETED BY THE CEO AND THE GOVERNANCE COMMITTEE CHAIR. AFTER REVIEW, THE GOVERNANCE COMMITTEE CHAIR REPORTS TO THE FULL BOARD. IF A CONFLICT EXISTS, THE CHAIR IS RESPONSIBLE FOR ELIMINATION OF THE CONFLICT WITHIN A REASONABLE PERIOD OF TIME. THE EXTERNAL AUDITORS ARE CONSULTED AS NEEDED.
FORM 990, PART VI, SECTION B, LINE 15 AT LEAST ANNUALLY, THE CEO COMPENSATION PACKAGES ARE REVIEWED BY THE COMPENSATION COMMITTEE USING COMPARABLE SALARY DATA AND OUTSIDE CONSULTANT DATA. THE COMPENSATION COMMITTEE CONSISTS OF 7 BOARD MEMBERS. IN ADDITION, A MARKET STUDY IS COMPLETED BY THE VP OF HR FOR ALL KEY EMPLOYEES AND IS REVIEWED BY THE CEO. OFFICER AND KEY EMPLOYEE COMPENSATION PROCESS CONSISTS OF SETTING GOALS AT THE BEGINNING OF THE YEAR FOR THE CALENDAR YEAR'S SALARY INCREASES AND BONUSES. THE GOALS ARE REVIEWED DURING THE YEAR WITH A FORMAL REVIEW AT THE END OF THE YEAR. DEPENDING ON THE PERFORMANCE OF THE COMPANY, INDIVIDUAL AND OVERALL ECONOMY, RAISES AND BONUSES ARE DETERMINED. DURING THE PROCESS, THE INDIVIDUALS AND COMPANY'S ACTUAL RESULTS ARE COMPARED AGAINST GOALS AND TARGETS.
FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE FILED WITH THE DEPARTMENT OF INSURANCE. INDIVIDUALS CAN MAKE REQUESTS FOR THE FINANCIAL STATEMENTS FOLLOWING THE DOI'S REGULAR PROCESS. IN ADDITION, FINANCIAL STATEMENTS ARE SHARED UPON REQUEST TO THE CEO AND CAN BE OBTAINED ONLINE THROUGH GUIDESTAR.
FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2023


Additional Data


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

OMB No. 1545-0047
2023
Open to Public Inspection
Name of the organization
DELTA DENTAL OF IDAHO
 
Employer identification number

82-0299431
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity
(1) HEALTH SERVICES GROUP
555 E PARKCENTER BLVD
BOISE,ID83706
46-0920203 		SUPPORT SERVICES ID 56,372 14,328 DELTA DENTAL OF IDAHO
 
(2) ADVANCED HEALTH SERVICES
555 E PARKCENTER BLVD
BOISE,ID83706
35-2651482 		IT SERVICES ID 619,195 493,893 DELTA DENTAL OF IDAHO
 








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












For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2023
Schedule R (Form 990) 2023
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












Schedule R (Form 990) 2023
Schedule R (Form 990) 2023
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
 
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
 
e Loans or loan guarantees by related organization(s) ............................
1e
 
 
f Dividends from related organization(s) ............................
1f
 
 
g Sale of assets to related organization(s) ............................
1g
 
 
h Purchase of assets from related organization(s) ............................
1h
 
 
i Exchange of assets with related organization(s) ............................
1i
 
 
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
 
o Sharing of paid employees with related organization(s) ............................
1o
 
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
 
r Other transfer of cash or property to related organization(s) ............................
1r
 
 
s Other transfer of cash or property from related organization(s) ............................
1s
 
 
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) 2023
Schedule R (Form 990) 2023
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) 2023
Schedule R (Form 990) 2023
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) 2023

Additional Data


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