2024-11-14T09:59:13-06:00 2023-12-31 390859910 BAKER TILLY ADVISORY GROUP LP 790 N WATER ST SUITE 2000 MILWAUKEE WI 53202 990 2023-01-01 470685003 DELTA DENTAL OF NEBRASKA DELT 6122243276 1299 FARNAM STREET 300 OMAHA NE 68102 CAROL M HOUGHTBY WATSON CFO 6122243276 2024-11-14 1 1 SHELBY NETZ CPA P01405265 4147775500 2024-11-06 2023 2024-10-15 13:58:12Z RODNEY A YOUNG 1299 FARNAM STREET 300 OMAHA NE 68102 39861180 0 X WWW.DELTADENTALNE.ORG X 1985 NE DELTA DENTAL OF NEBRASKA PROVIDES NON-PROFIT DENTAL INSURANCE PLANS ON BOTH A RISK BASIS AND ADMINISTRATIVE SERVICES ONLY BASIS TO IMPROVE ORAL HEALTH, ACCESS AND AVAILABILITY AND PROVIDES ECONOMICAL DENTAL SERVICES FOR THE COMMUNITIES IT SERVES. 8 6 0 0 0 0 0 0 27134471 38163510 201833 247702 0 3000 27336304 38414212 0 29249 0 0 618072 682292 0 0 0 26427404 36519811 27045476 37231352 290828 1182860 13035895 15084980 1998435 2636086 11037460 12448894 DELTA DENTAL OF NEBRASKA ADMINISTERS PREPAID DENTAL SERVICE PLANS UNDER AGREEMENTS WITH VARIOUS GROUP AND INDIVIDUAL SUBSCRIBERS. THESE AGREEMENTS ARE OFFERED TO ITS SUBSCRIBERS AS PREPAID DENTAL PLANS ON EITHER A RISK BASIS OR AN ADMINISTRATIVE SERVICE PLAN BASIS. 0 0 36087639 29249 38163510 DELTA DENTAL OF NEBRASKA ADMINISTERS PREPAID DENTAL SERVICE PLANS UNDER AGREEMENTS WITH VARIOUS GROUP AND INDIVIDUAL SUBSCRIBERS. THESE AGREEMENTS ARE OFFERED TO ITS SUBSCRIBERS AS PREPAID DENTAL PLANS ON EITHER A RISK BASIS OR AN ADMINISTRATIVE SERVICE PLAN BASIS. 36087639 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 X 6183 0 1 0 0 0 0 0 0 0 0 0 X 8 6 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X CAROL M HOUGHTBY WATSON 6122243173 500 WASHINGTON AVE S NO 2060 MINNEAPOLIS MN 55415 RODNEY A YOUNG CHAIR, CEO & DIRECTOR 0.10 49.90 X X 0 2510954 50347 TAMERA K ROBINSON PRESIDENT & DIRECTOR 1.30 48.70 X X 0 1320859 24911 STEPHANIE A ALBERT EVP & CHIEF LEGAL OFFICER 0.20 49.80 X 0 898305 49267 CAROL M HOUGHTBY WATSON ASSISTANT TREASURER 0.10 49.90 X 0 514703 36554 NADIA MARTYN ASSISTANT SECRETARY 0.10 49.90 X 0 408577 63431 DR RICHARD D FITZGERALD DDS VICE CHAIR 0.90 X X 4000 0 0 DEE A TEKRONY SECRETARY 0.70 X X 4000 0 0 PATRICK J BOLER TREASURER 1.00 X X 4000 0 0 JENNIFER HASSLEN DDS DIRECTOR 0.80 X 4000 0 0 DR JAMES D PALMER DDS DIRECTOR 0.80 X 2000 0 0 PATRICK D GARVEY DIRECTOR 0.50 X 2000 0 0 20000 5653398 224510 0 0 1 0 DELTA DENTAL PLAN OF MICHIGAN 16082 COLLECTION CENTER DRIVE CHICAGO IL 68504 DENTAL ADMINISTRATIVE SERVICES 806836 NE SPECIALTY DENTAL SERVICES LLC 3821 N 167TH CT STE 150 OMAHA NE 68116 DENTAL CLAIMS 750365 STARK AND JOHNSON LLC 3272 SALT CREEK CIR STE A LINCOLN NE 68504 DENTAL CLAIMS 301649 RENAISSANCE LIFE AND HEALTH INSURANCE CO 6606 COLLECTION CTR DR CHICAGO IL 60693 DENTAL ADMINISTRATIVE SERVICES 291696 HILLSBOROUGH FAMILY DENTRISTRY PC 13808 W MAPLE RD STE 112 OMAHA NE 68164 DENTAL CLAIMS 237856 26 DENTAL COVERAGE: ADMIN 524292 28646060 28646060 DENTAL COVERAGE: RISK 525100 9517450 9517450 38163510 270583 270583 1424087 1446968 -22881 -22881 -22881 MISCELLANEOUS REVENUE 900099 3000 3000 3000 38414212 38163510 0 250702 29249 29249 70450 52837 17613 539866 404900 134966 14397 10798 3599 37196 27897 9299 20383 15287 5096 1059438 1059438 30439 30439 54857 54857 28864 28864 147388 147388 2820 2820 125821 125821 66506 66506 55944 55944 39350 39350 261 261 54400 54400 27449 27449 CLAIMS EXPENSE 33732687 33732687 COMMISSIONS EXPENSE 754546 754546 MEMBERSHIP FEES 123157 123157 BANK CHARGES 118909 118909 96975 96975 37231352 36087639 1143713 0 1676 3877420 2878107 283684 848646 1357077 0 472 0 0 1653 0 9300509 9551230 5304 15097 13035895 15084980 1771936 2354714 140807 169700 85692 111672 1998435 2636086 X 0 0 0 0 11037460 12448894 11037460 12448894 13035895 15084980 1182860 228574 0 X X 0 1 X 1 0 0 INTERCOMPANY PAYABLE 97170 LEASE LIABILITY 14502 111672 X 37630802 -754546 -754546 38385348 28864 28864 38414212 36447942 0 36447942 28864 754546 783410 37231352 PART X, LINE 2: DELTA DENTAL OF NEBRASKA (DDNE) IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(4), THOUGH IT IS SUBJECT TO TAX ON INCOME UNRELATED TO ITS EXEMPT PURPOSE, UNLESS THAT INCOME IS OTHERWISE EXCLUDED BY THE IRC. DDNE HAS PROCESSES IN PLACE TO ENSURE THE MAINTENANCE OF THE TAX-EXEMPT STATUS FOR THE ORGANIZATION, TO IDENTIFY AND REPORT UNRELATED INCOME, TO DETERMINE ITS FILING AND TAX OBLIGATIONS IN JURISDICTIONS FOR WHICH IT HAS NEXUS, AND TO IDENTIFY AND EVALUATE OTHER MATTERS THAT MAY BE CONSIDERED TAX POSITIONS. DDNE FILES TAX RETURNS IN THE U.S. FEDERAL AND APPLICABLE STATE JURISDICTION. THE TAX YEARS ENDING DECEMBER 31, 2020 AND THEREAFTER ARE STILL OPEN TO AUDIT FOR FEDERAL PURPOSES AND THE TAX YEARS ENDING DECEMBER 31, 2019 AND THEREAFTER ARE STILL OPEN TO AUDIT FOR STATE PURPOSES. DDNE HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN TAX YEARS AND HAS CONCLUDED THAT IT DOES NOT MEET THE THRESHOLD FOR FINANCIAL STATEMENT RECOGNITION OF AN UNCERTAIN INCOME TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. PART XI, LINE 2D - OTHER ADJUSTMENTS: COMMISSION EXPENSES NETTED FOR AUDIT, NOT FOR TAX -754,546. PART XII, LINE 4B - OTHER ADJUSTMENTS: COMMISSION EXPENSES NETTED FOR AUDIT, NOT FOR TAX 754,546. 1 NEBRASKA MISSION OF MERCY 17117 OAK DRIVE OMAHA NE 68130 273385904 501(C)(3) 25000 0 2023 NEBRASKA MISSION OF MERCY VETERANS EVENT 1 0 PART I, LINE 2: THE ORGANIZATION WORKS WITH EACH OF THE GRANTEES TO DETERMINE HOW THE FUNDS HAVE BEEN USED, VERIFY THAT THE USE OF THE FUNDS MATCHES THE PURPOSE OF THE GRANT AND OBTAIN REPORTS REGARDING THE IMPACT SUCH AS NUMBER OF INDIVIDUALS THAT RECEIVED CARE, IMPACT OF THE CARE RECEIVED TO THE INDIVIDUAL'S HEALTH, ETC. 0 0 0 0 1 0 1 0 0 RODNEY A YOUNG CHAIR, CEO & DIRECTOR 0 1154461 0 1333993 0 22500 0 19800 0 30547 0 2561301 0 0 TAMERA K ROBINSON PRESIDENT & DIRECTOR 0 743737 0 554622 0 22500 0 19800 0 5111 0 1345770 0 0 STEPHANIE A ALBERT EVP & CHIEF LEGAL OFFICER 0 496845 0 378960 0 22500 0 19800 0 29467 0 947572 0 0 CAROL M HOUGHTBY WATSON ASSISTANT TREASURER 0 344458 0 147745 0 22500 0 19800 0 16754 0 551257 0 0 NADIA MARTYN ASSISTANT SECRETARY 0 280986 0 111225 0 16366 0 19800 0 43631 0 472008 0 0 PART I, LINE 3 ALL COMPENSATION IS PAID BY STRATACOR OR ABOVA TALENT, BOTH RELATED ORGANIZATIONS. STRATACOR AND ABOVA TALENT USE THE FOLLOWING TO ESTABLISH COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY BOARD OR COMPENSATION COMMITTEE PART I, LINE 5 ALL ELIGIBLE EMPLOYEES MAY PARTICIPATE IN THE EMPLOYEE INCENTIVE PLAN WHICH IS APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE BOARD. THE PLAN ALLOWS FOR AN INCENTIVE PLAN PAYOUT BASED ON THREE COMPONENTS: THE RELATED COMPANY'S FINANCIAL PERFORMANCE, CUSTOMER AND EMPLOYEE EXPERIENCE, AND INDIVIDUAL GOALS. WITHIN THE CALCULATION OF THE RELATED COMPANY'S FINANCIAL PERFORMANCE, THERE IS A COMPONENT BASED ON REVENUE AND A COMPONENT BASED ON OPERATING EARNINGS. THE INCENTIVE AMOUNT IS BASED ON THE MATHEMATICAL CALCULATION OF THE RESULTS FOR EACH COMPONENT. FOR 2023, EACH EMPLOYEE'S AMOUNT WAS CALCULATED WITH 75% WEIGHT BASED ON THE RELATED COMPANY PERFORMANCE AND 25% WEIGHT BASED ON THEIR INDIVIDUAL PERFORMANCE. PART I, LINE 6 ALL ELIGIBLE EMPLOYEES MAY PARTICIPATE IN THE EMPLOYEE INCENTIVE PLAN WHICH IS APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE BOARD. THE PLAN ALLOWS FOR AN INCENTIVE PLAN PAYOUT BASED ON THREE COMPONENTS: THE RELATED COMPANY'S FINANCIAL PERFORMANCE, CUSTOMER AND EMPLOYEE EXPERIENCE, AND INDIVIDUAL GOALS. WITHIN THE CALCULATION OF THE RELATED COMPANY'S FINANCIAL PERFORMANCE, THERE IS A COMPONENT BASED ON REVENUE AND A COMPONENT BASED ON OPERATING EARNINGS. THE INCENTIVE AMOUNT IS BASED ON THE MATHEMATICAL CALCULATION OF THE RESULTS FOR EACH COMPONENT. FOR 2023, EACH EMPLOYEE'S AMOUNT WAS CALCULATED WITH 75% WEIGHT BASED ON THE RELATED COMPANY PERFORMANCE AND 25% WEIGHT BASED ON THEIR INDIVIDUAL PERFORMANCE. FORM 990, PART V, LINES 2A AND 2B: ALL EMPLOYEES ARE LEGAL EMPLOYEES OF STRATACOR (FEIN: 41-1852523) OR ABOVA TALENT (FEIN: 85-3884782), EACH OF WHICH FILES ALL REQUIRED FEDERAL EMPLOYMENT FORMS EACH YEAR. FORM 990, PART VI, SECTION A, LINE 3 DELTA DENTAL OF NEBRASKA ("DDNE", "DELTA DENTAL") IS MANAGED BY STRATACOR PURSUANT TO AN ADMINISTRATIVE SERVICES AGREEMENT EFFECTIVE JULY 16, 2019. STRATACOR PERFORMS ADMINISTRATIVE SERVICES WHICH INCLUDE GROUP SALES AND RETENTION, UNDERWRITING PRODUCT DEVELOPMENT, PROFESSIONAL SERVICES, WEBSITE HOSTING, CASH AND INVESTMENT MANAGEMENT REGULATORY COMPLIANCE, FINANCIAL REPORTING AND OTHER ADMINISTRATIVE SERVICES INCLUDING REPORTING TO THE DDNE BOARD OF DIRECTORS. STRATACOR ALSO PERFORMS CERTAIN OUTSOURCED SERVICES THROUGH ITS CONTRACT WITH DELTA DENTAL OF MICHIGAN AND RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA (DDMI) FOR DELTA DENTAL OF NEBRASKA, WHICH INCLUDES CLAIMS PROCESSING, ELIGIBILITY, BILLING AND CUSTOMER SERVICE DUTIES, COLLECTION OF PAST DUE ACCOUNTS RECEIVABLE, ENROLLMENT AND ID CARD GENERATION AS WELL AS DATA PROCESSING SERVICES. EFFECTIVE JUNE 2019, STRATACOR BECAME THE SOLE MEMBER OF DDNE. FORM 990, PART VI, SECTION A, LINE 6 STRATACOR IS THE SOLE MEMBER OF DELTA DENTAL OF NEBRASKA. FORM 990, PART VI, SECTION A, LINE 7A THE MAJORITY VOTE OF THOSE DIRECTORS PRESENT AT ANY MEETING SHALL BE SUFFICIENT TO PASS ANY MEASURE EXCEPT MEASURES ON WHICH A GREATER VOTE IS REQUIRED BY THE ARTICLES OF INCORPORATION, BYLAWS OR ANY PROVISION OF APPLICABLE NEBRASKA LAW. THE BYLAWS OF THE CORPORATION MAY BE AMENDED BY TWO THIRDS (2/3) VOTE OF THOSE MEMBERS OF THE BOARD OF DIRECTORS PRESENT AND VOTING ON ANY SUCH AMENDMENT. ANY AMENDMENTS TO THE CORPORATION'S BYLAWS, ONCE SO ADOPTED BY THE BOARD OF DIRECTORS SHALL BE DISTRIBUTED IN THE FORM OF A WRITTEN NOTICE TO THE CORPORATION'S MEMBERSHIP NOT LESS THAN THIRTY (30) DAYS AFTER THE DATE OF ADOPTION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE PRESIDENT AND CFO OF DELTA DENTAL OF NEBRASKA. THESE POSITIONS ARE EMPLOYEES OF STRATACOR. THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES THE CONFLICT OF INTEREST POLICY BY PERIODICALLY REQUIRING EMPLOYEES TO VALIDATE THAT THEY ARE NOT ENGAGED IN ANY ACTIVITY THAT WOULD BE CONSIDERED A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 OFFICERS OF THE FILING ORGANIZATION ARE NOT COMPENSATED BY THE FILING ORGANIZATION. INDIVIDUALS SERVING AS OFFICERS OF THE FILING ORGANIZATION SERVE IN THE SAME OR SIMILAR CAPACITY FOR A RELATED 501 (C)(4) ORGANIZATION, STRATACOR. ALL COMPENSATION RECEIVED BY OFFICERS OF THE FILING ORGANIZATION (IN THEIR CAPACITIES AS EMPLOYEES OF STRATACOR) IS PAID BY STRATACOR, AND STRATACOR IS RESPONSIBLE FOR COMPENSATION SETTING POLICY AND PROCEDURE. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURES AS SET FORTH IN SECTION 6104(D). FORM 990, PART XII, LINE 2C: STRATACOR, THE SOLE MEMBER OF DELTA DENTAL OF NEBRASKA, MONITORS THE PROCESS FOR OVERSEEING THE AUDIT AND SELECTING THE INDEPENDENT ACCOUNTANT. DELTA DENTAL OF MINNESOTA FOUNDATION 500 WASHINGTON AVENUE S SUITE 2060 MINNEAPOLIS MN 55415 264482509 FOUNDATION MN 501 (C)(3) LINE 12B, II STRATACOR 0 STRATACOR 500 WASHINGTON AVENUE S SUITE 2060 MINNEAPOLIS MN 55415 411852523 HOLDING COMPANY MN 501 (C)(4) N/A N/A 0 DELTA DENTAL OF MINNESOTA 500 WASHINGTON AVE S SUITE 2060 MINNEAPOLIS MN 55415 410952670 DENTAL SERVICE PLANS MN 501 (C)(4) N/A STRATACOR 0 HEALTH VENTURES NETWORK 500 WASHINGTON AVENUE S SUITE 2060 MINNEAPOLIS MN 55415 411539439 VISION COVERAGE MN N/A C 0 ABOVA INC 500 WASHINGTON AVENUE S SUITE 2060 MINNEAPOLIS MN 55415 814457588 SALE OF DENTAL PRODUCTS AND CONSULTING DE N/A C 0 TRASKA INC 500 WASHINGTON AVENUE S SUITE 2060 MINNEAPOLIS MN 55415 831531907 BEMIDJI BUILDING HOLDING CO DE N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0