2024-11-13T14:54:39-06:00 2023-12-31 381357951 PLANTE & MORAN PLLC 1111 MICHIGAN AVE STE 100 EAST LANSING MI 48823 990 2023-01-01 382337000 DELTA DENTAL FUND D/B/A DELTA DENTAL FOUNDATION DELT 5173496000 PO BOX 30416 LANSING MI 489097916 AMY BASEL CHIEF FINANCIAL OFFICER 5173496000 2024-11-11 1 1 DAVID LOWENTHAL CPA P00378651 5173326200 2024-11-11 2023 2024-10-15 13:58:12Z KELLY SCHEIDERER PO BOX 30416 LANSING MI 489097916 36848595 0 X WWW.DELTADENTALMI.COM/DDF X 1980 MI SEE SCHEDULE O DELTA DENTAL FUND'S MISSION IS TO IMPROVE THE ORAL HEALTH OF THE PUBLIC AND TO ADVANCE DENTAL SCIENCE AND THE DENTAL PROFESSION THROUGH RESEARCH AND EDUCATION. 11 8 0 0 0 0 4411760 2508547 0 0 5322680 2651962 0 0 9734440 5160509 7158197 7266413 0 0 19000 16500 0 0 0 1787259 2040498 8964456 9323411 769984 -4162902 117928292 126821824 3886972 3939245 114041320 122882579 X DELTA DENTAL FUND'S MISSION IS TO IMPROVE THE ORAL HEALTH OF THE PUBLIC AND TO ADVANCE DENTAL SCIENCE AND THE DENTAL PROFESSION THROUGH RESEARCH AND EDUCATION. 0 0 8686199 7266413 THE DELTA DENTAL FUND'S (FUND) MISSION IS TO DEVELOP AND ENHANCE PARTNERSHIPS AND PROGRAMS TO IMPROVE ORAL AND OVERALL HEALTH. THE FUND HAS BEEN COMMITTED TO THIS PURPOSE FOR OVER FOUR DECADES. OVER THAT TIME, THOUSANDS HAVE BENEFITED FROM GRANTS, SCHOLARSHIPS AND CONTINUING EDUCATION PROGRAMS PROVIDED BY THE FUND. SINCE IT WAS ESTABLISHED IN 1980, THE FUND HAS CONTINUALLY INCREASED ITS EFFORTS TO ACHIEVE THESE GOALS IN MICHIGAN, OHIO, INDIANA AND NORTH CAROLINA.SEE SCHEDULE O FOR CONTINUATIONFOR MANY PEOPLE, ESPECIALLY COMMUNITIES HISTORICALLY OR SYSTEMICALLY EXPOSED TO INEQUITIES, SIMPLY HAVING ACCESS TO A DENTIST IS NOT ENOUGH TO ACHIEVE GOOD ORAL HEALTH. WHAT THEY NEED ARE FAIR AND JUST OPPORTUNITIES-AND ALL THE RESOURCES THEREIN-TO LIVE THEIR BEST, HEALTHIEST LIVES, NO MATTER WHO THEY ARE OR WHERE THEY COME FROM. WHICH IS WHY THE FUND SUPPORTS PROGRAMS AIMED AT HEALTH EQUITY.IN 2023, THE FUND SUPPORTED PROGRAMS FOCUSED ON ACCESS TO ORAL HEALTH CARE FOR PEOPLE WITH DISABILITIES INCLUDING: THE POSITIVE EXPOSURE PHOTO GALLERIES TO ADVOCATE FOR ACCESS AND INCLUSION FOR DENTAL CARE FOR PEOPLE WITH DISABILITIES, PROVIDED TRAINING BY FUNDING A SERIES OF FREE ONLINE COURSES, AND SENDING DENTAL STUDENTS TO CONFERENCES, SUCH AS THE SPECIAL CARE DENTISTRY ASSOCIATION CONFERENCE, TO LEARN MORE ABOUT TREATING PATIENTS WITH DISABILITIES. THE FUND ALSO CONTINUED THE CENTERS FOR INCLUSIVE DENTISTRY PROGRAM, A PROJECT TO PROVIDE RESOURCES AND IMMERSIVE TRAINING TO DELIVER HIGH-QUALITY DENTAL TREATMENT TO PEOPLE WITH DISABILITIES AT DESIGNATED FEDERALLY QUALIFIED HEALTH CENTERS WITH MORE THAN 50 PEOPLE RECEIVING TRAINING BY THE END OF 2023 AND 11 CLINICS PARTICIPATING. SINCE INCEPTION, MORE THAN $2 MILLION HAS BEEN PROVIDED TO MORE THAN A THOUSAND DENTAL STUDENTS THROUGH SCHOLARSHIPS AND AWARDS. IN 2023, 21 DENTAL, DENTAL HYGIENE, AND DENTAL ASSISTANT STUDENTS FROM DENTAL AND DENTAL HYGIENE SCHOOLS IN MICHIGAN, OHIO AND INDIANA RECEIVED FINANCIAL SUPPORT THROUGH THE FUND TO APPLY TOWARD THE COST OF EDUCATION. COMMUNITY COMMITMENT AWARDS OF $25,000 EACH WERE AWARDED TO FIVE GRADUATING DENTAL STUDENTS WHO COMMITTED TO PRACTICING FOR AT LEAST ONE YEAR IN AN IDENTIFIED HIGH-NEEDS COMMUNITY IN THE STATE IN WHICH THEY GRADUATED.WITH THE GOAL OF MAKING DENTAL EDUCATION MORE ACCESSIBLE, HELPING TO DIVERSIFY THE DENTAL PROFESSION, AND IMPROVING ORAL HEALTH EQUITY, THE DDF CONTINUED ITS $25,000 DIVERSITY DENTAL SCHOLARSHIP. GIVEN ANNUALLY, THIS SCHOLARSHIP IS AWARDED TO STUDENTS FROM SYSTEMICALLY DISADVANTAGED RACIAL AND ETHNIC BACKGROUNDS ENTERING DENTAL SCHOOL. IN 2023, FOR THE THIRD YEAR IN A ROW, SCHOLARSHIPS WERE GIVEN TO FIVE STUDENTS-ONE STUDENT FROM EACH DENTAL SCHOOL IN MICHIGAN, OHIO AND INDIANA.EDUCATION DOES NOT STOP WITH GRADUATION. CONTINUING EDUCATION IS NECESSARY TO STAY CURRENT WITH ADVANCEMENTS IN TREATMENT AND POLICIES AND IS MANDATORY TO MAINTAIN A LICENSE IN SOME STATES. THE FUND ASSISTED PRACTICING DENTISTS BY SPONSORING AND CO-SPONSORING SEMINARS IN DENTAL SCIENCE AND RELATED TOPICS. IN 2023, THE FUND CONTINUED ITS PARTNERSHIP WITH THE UNIVERSITY OF MICHIGAN SCHOOL OF DENTISTRY TO SUPPORT TWO CONTINUING EDUCATION SEMINARS. IN ADDITION, FOR THE THIRD YEAR THE FUND PROVIDED $50,000 TO PENN DENTAL MEDICINE TO SPONSOR A VIRTUAL CE SERIES FOR DENTAL PROFESSIONALS AIMED AT INCREASING KNOWLEDGE OF HOW TO CARE FOR PATIENTS WITH DISABILITIES. IN 2023, THE COMMUNITY MINI-GRANT PROGRAM CONTINUED IN MICHIGAN, OHIO AND INDIANA. THROUGH THE PROGRAM, 64 ORGANIZATIONS WERE AWARDED A TOTAL OF $259,000 IN SMALL GRANTS OF $5,000 OR LESS TO IMPROVE ORAL HEALTH IN THE COMMUNITIES IN WHICH THE FUND SERVES. THIRTY-THREE NON-PROFIT ORGANIZATIONS WERE AWARDED FUNDING THROUGH THE NORTH CAROLINA SMILES FOR KIDS GRANT PROGRAM, WHICH FOCUSES EXCLUSIVELY ON CHILDREN'S ORAL HEALTH WITHIN THE STATE. THIS MARKED THE 13TH YEAR THAT THESE GRANTS HAVE BEEN OFFERED IN NORTH CAROLINA. THE FUND PROVIDED A GRANT TO THE CITY OF DETROIT TO FUND A PILOT SELF-DRIVING SHUTTLE THAT WILL TRANSPORT OLDER ADULTS AND PEOPLE WITH DISABILITIES TO DENTAL APPOINTMENTS. THE FUND RENEWED FUNDING FOR THE IMPRESSION 5 SCIENCE CENTER STEM KIT PROGRAM. EVERY OTHER MONTH, IMPRESSION 5 SCIENCE CENTER DISTRIBUTES EDUCATION KITS TO HEAD START CHILDREN THREE TO FIVE YEARS OLD IN THE LANSING, MICHIGAN, AREA. EACH KIT HAS A DIFFERENT THEME, INCLUDING SCIENCE AND ORAL HEALTH, WITH CONCEPTS THAT INCORPORATE SOCIAL-EMOTIONAL DEVELOPMENT, LITERACY AND MATH. THE FUND ALSO CONTINUED ITS SUPPORT FOR THE UNIVERSITY OF MICHIGAN SCHOOL OF DENTISTRY'S VICTORS FOR VETERANS. THE PROGRAM IS PART OF A FOUR-YEAR "IMMERSION PATHWAY" AT THE SCHOOL WHERE STUDENTS DIRECT THEIR OWN LEARNING THROUGH AN IMMERSIVE CAPSTONE PROJECT AND PROVIDE TREATMENT TO VETERANS FREE-OF-CHARGE. BEGINNING THIS YEAR, STUDENTS WILL VISIT THE UNITED WE SMILE CLINIC IN TRAVERSE CITY TO PROVIDE CARE TO VETERANS AND CHILDREN. IN 2023, THE FUND PROVIDED A LARGE GRANT TO SUPPORT THE PRECLINICAL SIMULATION CLINIC AT THE NORTHEAST OHIO MEDICAL UNIVERSITY. THE BITONTE COLLEGE OF DENTISTRY IS ON TRACK TO WELCOME THEIR FIRST CLASS OF DENTAL STUDENTS IN 2025. THE FUND CONTINUED ITS LONGSTANDING PARTNERSHIP WITH THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR THE SEAL MICHIGAN SCHOOL-BASED SEALANT AND COMMUNITY WATER FLUORIDATION PROGRAMS. SUPPORT WAS ALSO RENEWED FOR THE OHIO DEPARTMENT OF HEALTH'S FLUORIDATION ASSISTANCE PROGRAM. THE FUND CONTINUED ITS PARTNERSHIP WITH MCMILLEN HEALTH BY PROVIDING FUNDING FOR THE BRUSH PRE-SCHOOL ORAL HEALTH PROGRAM AND "I NEED MY TEETH," AN ORAL HEALTH MUSICAL PRODUCTION. MCMILLEN CONTINUED PROVIDING THE ASSEMBLY IN A LIVE VIRTUAL FORMAT AND CONTINUED TO OFFER IT TO SCHOOLS IN MICHIGAN, OHIO AND INDIANA. FORTY PERFORMANCES WERE PRESENTED TO SCHOOLS, WHICH REACHED THOUSANDS OF STUDENTS, TEACHERS AND PARENTS. THE FUND'S TOTAL GRANTS HAVE NOW EXCEEDED $61 MILLION SINCE ITS INCEPTION. THIS FUNDING HAS IMPROVED ORAL AND OVERALL HEALTH AND HEALTH EQUITY, HELPED STUDENTS ACHIEVE THEIR GOALS AND IMPROVED THE WELL-BEING OF THOUSANDS OF CHILDREN AND ADULTS IN MICHIGAN, OHIO, INDIANA AND NORTH CAROLINA. EMPOWERED PEOPLE AND COMMUNITIES ARE CRITICAL TO MAKING CREATIVE SOLUTIONS TO SYSTEMIC CHALLENGES POSSIBLE-AND THAT MEANS SUPPORTING WORK BY AND FOR THE COMMUNITIES BEING SERVED. THE FUND IS COMMITTED TO CONTINUING AND ESTABLISHING STRONG TWO-WAY RELATIONSHIPS WITH THE PEOPLE AND ORGANIZATIONS ALIGNED WITH ITS AIMS. 8686199 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 35 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 8 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MI X AMY BASEL CHIEF FINANCIAL OFFICER 5173496000 4100 OKEMOS ROAD OKEMOS MI 48864 X GORAN JURKOVIC CPA PRESIDENT & BOARD TRUSTEE 1.00 49.00 X X 0 9219805 2613720 ELAINE LOYACK TRUSTEE 1.00 40.00 X 0 193217 36908 STEPHEN A EKLUND DDS MSHA PHD TRUSTEE 1.00 10.00 X 2000 84996 0 KELLY SCHEIDERER CHAIR 1.00 10.00 X X 2000 84996 0 CAROLE SIMONETTI WATKINS TRUSTEE 1.00 10.00 X 2000 69327 0 RAYMOND FRED GIST TRUSTEE 1.00 5.00 X 2000 60000 0 ANN FLERMOEN DDS TRUSTEE - PART YEAR 1.00 0.00 X 500 0 0 JOSEPH C HARRIS DDS TRUSTEE 1.00 0.00 X 2000 0 0 JAMES P HALLAN TRUSTEE - PART YEAR 1.00 0.00 X 0 0 0 JOHN A BREZA DDS TRUSTEE 1.00 0.00 X 1500 0 0 TASHA BLACKMON TRUSTEE - PART YEAR 1.00 0.00 X 500 0 0 FAIYAZ N SYED MD MPH VICE CHAIR 1.00 0.00 X X 1500 0 0 SUNCICA TRAVAN DDS MS TRUSTEE 1.00 5.00 X 1500 60000 0 VINOD MIRYALA BDS MPH DDS TRUSTEE 1.00 0.00 X 1000 0 0 AMY BASEL CPA CHIEF FINANCIAL OFFICER 1.00 49.00 X 0 2381009 644559 HOLLI SEABURY EXECUTIVE DIRECTOR 10.00 40.00 X 0 345629 87603 ERIN DULING CPA TREASURER 1.00 49.00 X 0 257884 69003 JORDAN LEAMING SECRETARY 1.00 49.00 X 0 228954 38482 16500 12985817 3490275 0 0 1 0 0 2500000 8547 2508547 3495135 3495135 30844913 31688086 -843173 -843173 -843173 5160509 0 0 2651962 6660480 6660480 605933 605933 16500 10725 5775 1161155 1102318 58837 24645 24645 394747 394747 159397 159397 38329 29009 9320 47376 47376 68349 68349 28163 28163 DENTAL ED SEMINARS 118337 118337 9323411 8686199 637212 0 145337 563885 8312444 5902391 109313474 120139980 157037 215568 117928292 126821824 3085771 3315176 801201 624069 3886972 3939245 X 108986777 119791293 5054543 3091286 114041320 122882579 117928292 126821824 -4162902 13004161 0 X 0 1 X 1 0 X X 1 DELTA DENTAL PLAN OF MICHIGAN INC 381791480 10 1 0 0 1 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 SCHEDULE A, PART IV, SECTION A, LINE 3B: SUPPORTED ORGANIZATIONS ARE PART OF OUR ENTERPRISE STRUCTURE, AND THE TAX DEPARTMENT KEEPS RECORDS OF THE TAX STATUS OF ALL ENTITIES. THE ENTIITES CONFIRM ANNUALLY THEY WOULD MEET THE SECTION 509(A)(2) PUBLIC SUPPORT TEST. SCHEDULE A, PART IV, SECTION A, LINE 3C: AN ANNUAL REPORTING FORM IS DUE TO DELTA DENTAL FUND WITHIN 12 MONTHS OF WHEN THE ORGANIZATION RECEIVES THE GRANT OR PRIOR TO THE ORGANIZATION REQUESTING ADDITIONAL FUNDS. THIS ANNUAL REPORTING FORM DETAILS HOW THE ORGANIZATION PLANS TO SPEND THE GRANT MONEY. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DEFERRED COMPENSATION FOR DIRECTORS 17296 RELATED PARTY PAYABLE 246773 NON-CURRENT CONTRIBUTIONS AND GRANTS PAYABLE 360000 624069 4758455 0 4758455 393507 8547 402054 5160509 8921357 -8547 -8547 8929904 393507 393507 9323411 PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTIONS RECLASSED TO REVENUE 8,547. PART XII, LINE 2D - OTHER ADJUSTMENTS: CONTRIBUTIONS RECLASSED TO REVENUE -8,547. 1 500 FESTIVAL INC 21 VIRGINIA AVE INDIANAPOLIS IN 46204 351004320 501(C)(3) 10000 0 GENERAL GRANT 85 HOPE INC PO BOX 27 WABASH IN 46992 450951305 501(C)(3) 10000 0 GENERAL GRANT AMERICA'S TOOTH FAIRYCHILDRENS ORAL HEALTH FOUNDATION 4530 PARK RD STE 320 CHARLOTTE NC 28209 203921574 501(C)(3) 75000 0 REFUGEE FUND GRANT APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS PO BOX 2597 ASHEVILLE NC 28802 463984362 501(C)(3) 10000 0 GENERAL GRANT ATRIUM HEALTH FOUNDATION 208 EAST BLVD CHARLOTTE NC 28203 566060481 501(C)(3) 33770 0 GENERAL GRANT BETHANY CHRISTIAN SERVICES 901 EASTERN AVE GRAND RAPIDS MI 49501 381405282 501(C)(3) 6000 0 GENERAL GRANT CATHERINE'S HEALTH CENTER 1211 LAFAYETTE AVE NE GRAND RAPIDS MI 49505 202572418 501(C)(3) 29517 0 GENERAL GRANT CENTERS FOR FAMILIES AND CHILDREN 4500 EUCLID AVE CLEVELAND OH 44103 237084455 501(C)(3) 10000 0 GENERAL GRANT CENTRAL NINE CAREER CENTER 1999 US HIGHWAY 31 SOUTH GREENWOOD IN 46143 351178803 GOVT 35000 0 GENERAL GRANT CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON ONE PERKINS SQUARE AKRON OH 44308 340714357 501(C)(3) 71095 0 GENERAL GRANT CINCINNATI HEALTH DEPARTMENT 3101 BURNET AVE CINCINNATI OH 45229 316000064 GOVT 324584 0 GENERAL GRANT CITY OF DETROIT 2 WOODWARD AVE SUITE 1200 DETROIT MI 48226 386004606 GOVT 206000 0 GENERAL GRANT COMMUNITY FREE CLINIC 528 A LAKE CONCORD ROAD NE CONCORD NC 28027 582131301 501(C)(3) 10000 0 GENERAL GRANT COVENANT COMMUNITY CARE INC 559 W GRAND BLVD DETROIT MI 48216 383533998 501(C)(3) 300000 0 GENERAL GRANT DENTAL LIFELINE NETWORK - INDIANA 1319 E STOP 10 RD INDIANPOLIS IN 46227 931025274 501(C)(3) 25000 0 GENERAL GRANT DENTAL LIFELINE NETWORK - NORTH CAROLINA PO BOX 3643 CARY NC 27519 271755412 501(C)(3) 10000 0 CENTER FOR INCLUSIVE DENTISTRRY DETROIT GOODFELLOWS PO BOX 44444 DETROIT MI 48244 386061491 501(C)(3) 10000 0 CENTER FOR INCLUSIVE DENTISTRRY EAST CAROLINA UNIVERSITY PO BOX 602790 CHARLOTTE NC 28260 566000403 501(C)(3) 19700 0 GENERAL GRANT EXALTA HEALTH 2060 DIVISION AVE S GRAND RAPIDS MI 49507 383273825 501(C)(3) 19839 0 GENERAL GRANT GREAT LAKES BAY 501 LAPEER AVE SAGINAW MI 48607 381908328 501(C)(3) 200000 0 GENERAL GRANT HEALTH DEPARTMENT OF NORTHWEST MICHIGAN 220 W GARFIELD CHARLEVOIX MI 49720 300168590 GOVT 25000 0 GENERAL GRANT HEALTH EMERGENCY LIFELINE PROGRAMS 1726 HOWARD ST DETROIT MI 48216 382719621 501(C)(3) 463933 0 GENERAL GRANT HEALTHLINC INC 2401 VALLY DR VALPARAISO IN 46383 352147791 501(C)(3) 19058 0 GENERAL GRANT HEALTHSOURCE OF OHIO INC 150 HEALTH PARTNERS CIR MOUNT ORAB OH 45154 310884250 501(C)(3) 50000 0 GENERAL GRANT HEALTHY SMILES OF INDIANA INC 11710 E PROSPECT ST INDIANAPOLIS IN 46239 202451178 501(C)(3) 16000 0 GENERAL GRANT HNC LIVING FOUNDATION 8100 NEWTON ST SUITE 100 OVERLAND PARK KS 66204 464214254 501(C)(3) 75000 0 GENERAL GRANT HOLLAND FREE HEALTH CLINIC 98 W 26TH ST HOLLAND MI 49423 300072620 501(C)(3) 18813 0 GENERAL GRANT IMPRESSION 5 SCIENCE CENTER 200 MUSEUM DR LANSING MI 48933 237200548 501(C)(3) 25000 0 GENERAL GRANT INDIANA UNIVERSITY FOUNDATION INC PO BOX 500 BLOOMINGTON IN 47402 356018940 501(C)(3) 25000 0 SPECIAL NEEDS CLINIC INDIANA UNIVERSITY SCHOOL OF DENTISTRY 2232 W MICHIGAN ST INDIANAPOLIS IN 46202 356001673 501(C)(3) 49568 0 SPECIAL NEEDS CLINIC INGHAM COUNTY HEALTH DEPARTMENT 5303 SOUTH CEDAR STREET LANSING MI 48911 386005629 GOVT 100000 0 GENERAL GRANT INSTITUTE FOR EXCEPTIONAL CARE 2000 PENNSYLVANIA AVE NW SUITE 500 WASHINGTON DC 20006 851278444 501(C)(3) 49980 0 GENERAL GRANT JEWISH FAMILY SERVICE ASSOC OF CLEVELAND 29125 CHAGRIN BLVD PEPPER PIKE OH 44122 340714441 501(C)(3) 10000 0 GENERAL GRANT MADISON DISTRICT PUBLIC SCHOOLS 26550 JOHN R RD MADISON HEIGHTS MI 48071 386003090 GOVT 7500 0 GENERAL GRANT MATTHEW 25 413 E JEFFERSON BLVD FORT WAYNE IN 46802 351484951 501(C)(3) 8471 0 GENERAL GRANT MCMILLEN CENTER FOR HEALTH EDUCATION 600 JIM KELLEY BLVD FORT WAYNE IN 46816 351186994 501(C)(3) 109828 0 GENERAL GRANT MEDWORKS 1950 RICHMOND RD LYNDHURST OH 44124 263858369 501(C)(3) 40000 0 GENERAL GRANT MICHIGAN DENTAL HYGIENISTS ASSOCIATION 2310 JOLLY OAK RD OKEMOS MI 48864 386091578 501(C)(6) 25000 0 GENERAL GRANT MY COMMUNITY DENTAL CENTERS INC 3890 CHARLEVOIX AVE SUITE 300 PETOSKEY MI 49770 300393232 501(C)(3) 70240 0 GENERAL GRANT NATIONWIDE CHILDRENS HOSPITAL FOUNDATION 700 CHILDRENS HOSPITAL COLUMBUS OH 43205 311036370 501(C)(3) 15276 0 GENERAL GRANT NEIGHBORHOOD FAMILY PRACTICE 4115 BRIDGE AVE CLEVELAND OH 44113 341300581 501(C)(3) 152575 0 GENERAL GRANT NORTHEAST OHIO MED UNIVERSITY 4209 STATE ROUTE 44 ROOTSTOWN OH 44272 341264220 501(C)(3) 250000 0 GENERAL GRANT OAKLAND INTEGRATED HEALTHCARE NETWORK PO BOX 430150 PONTIAC MI 48343 383844634 501(C)(3) 56000 0 GENERAL GRANT OHIO STATE UNIVERSITY FOUNDATION PO BOX 183112 COLUMBUS OH 43202 311145986 501(C)(3) 10000 0 GENERAL GRANT OTTAWA COUNTY HEALTH DEPARTMENT 12251 JAMES ST STE 400 HOLLAND MI 49424 386004883 GOVT 10000 0 GENERAL GRANT POPE FRANCIS CENTER FOR THE HOMELESS 438 ST ANTOINE DETROIT MI 48226 812516039 501(C)(3) 205996 0 GENERAL GRANT PORTER-STARKE SERVICES INC 601 WALL STREET VALPARAISO IN 46383 351330771 501(C)(3) 50000 0 GENERAL GRANT PRESBYTERIAN VILLAGES OF MICHIGAN 26200 LAHSER RD STE 300 SOUTHFIELD MI 48033 202559884 501(C)(3) 10000 0 GENERAL GRANT REFUGEE COMMUNITY PARTNERSHIP INC PO BOX 461 CARRBORO NC 27510 263608741 501(C)(3) 10000 0 GENERAL GRANT REGENTS OF UNIVERSITY OF MICHIGAN 1011 N UNIVERSITY ANN ARBOR MI 48109 386006309 501(C)(3) 95505 0 CENTER FOR INCLUSIVE DENTISTRY SMILES ON WHEELS 122 HIGHLAND DRIVE JACKSON MI 49201 205964788 501(C)(3) 34940 0 GENERAL GRANT STATE OF MICHIGAN 320 S WALNUT LANSING MI 48933 386000134 GOVT 1800000 0 ORAL HEALTH PROGRAM STATE OF OHIO COLLECTIONS ENFORCEMENT 150 E GRAY ST COLUMBUS OH 43215 311334820 GOVT 75000 0 GENERAL GRANT THE DAVIES PROJECT FOR MID MI CHILDREN 230 BINGHAM ST 100 LANSING MI 48912 461209200 501(C)(3) 15000 0 GENERAL GRANT THE HEALTHCARE CONNECTION 1401 STEFFEN AVENUE LINCOLN HEIGHTS OH 45215 310822524 501(C)(3) 100000 0 GENERAL GRANT THE NC ALBERT SCHWEITZER FELLOWSHIP INC PO BOX 1636 DAVIDSON NC 28036 822682491 501(C)(3) 24875 0 GENERAL GRANT THE OHIO STATE UNIVERSITY 1581 DODD DR RM 345 COLUMBUS OH 43210 316025986 GOVT 240000 0 GENERAL GRANT THE RESEARCH INSTITUTE AT NATIONWIDE CHILDRENS HOSPITAL 700 CHILDRENS DRIVE COLUMBUS OH 43205 316056230 501(C)(3) 7981 0 GENERAL GRANT THIRD STREET FAMILY HEALTH SERVICES 1404 PARK AVENUE WEST SUITE 2 MANSFIELD OH 44906 341753919 501(C)(3) 50000 0 GENERAL GRANT TRIANGLE RESIDENTIAL OPTIONS FOR SUBSTANCE ABUSERS INC 1820 JAMES ST DURHAM NC 27707 561861158 501(C)(3) 10000 0 GENERAL GRANT TRUSTEE'S UNIVERSITY OF PENNSYLVANIA 240 S 40TH ST PHILADELPHIA PA 19104 231352685 501(C)(3) 85000 0 GENERAL GRANT UNITED WAY OF NORTHWEST MICHIGANUNITED WE SMILE 4075 COPPER RIDGE DR TRAVERSE CITY MI 49684 922157664 501(C)(3) 19043 0 GENERAL GRANT UNIVERSITY OF CINCINNATI FOUNDATION 51 GOODMAN DR STE 100 CINCINNATI OH 45219 310896555 501(C)(3) 100000 0 GENERAL GRANT VAN BUREN CASS COUNTY DISTRICT HEALTH 302 S FRONT ST DOWAGIAC MI 49047 382715388 501(C)(3) 48819 0 GENERAL GRANT WAKE FOREST UNIVERSITY HEALTH SCIENCES MEDICAL CENTER BOULEVARD WINSTON SALEM NC 24157 223849199 501(C)(3) 10000 0 GENERAL GRANT WARREN ARTS & EDUCATION FOUNDATION 975 N POST RD INDIANAPOLIS IN 46219 351572560 501(C)(3) 30000 0 GENERAL GRANT WILKES PUBLIC HEALTH DENTAL CLINIC 1915 WEST PARK DRIVE SUITE 104 NORTH WILKEBORO NC 28659 911943799 501(C)(3) 10000 0 GENERAL GRANT 67 1 SCHOLARSHIPS 11 151500 CASH SUPPORT FOR DENTAL, DENTAL HYGIENE AND DENTAL ASSISTANT STUDENTS COMMUNITY COMMITMENT AWARD 9 112500 CASH AWARD TO GRADUATING SENIOR WHO IS PRACTICING IN AN AREA OF HIGH NEED ORAL HEALTH MATERIALS/SUPPLIES 341933 FMV ORAL HEALTH RELATED GIVEAWAYS PART I, LINE 2: THE DELTA DENTAL FUND (DDF) IS DEDICATED TO DEVELOPING AND ENHANCING PARTNERSHIPS AND PROGRAMS TO IMPROVE ORAL AND OVERALL HEALTH AND HEALTH EQUITY, AND FOCUSES ITS SUPPORT IN THESE CATEGORIES: -INCREASING DENTAL ACCESS TO UNDERSERVED AND HIGH-RISK POPULATIONS -PROVIDING EDUCATIONAL PROGRAMMING ON THE IMPORTANCE OF ORAL HEALTH AND HOW IT RELATES TO OVERALL HEALTH -IDENTIFYING AND REDUCING HEALTH DISPARITIES RELATED TO ORAL AND OVERALL HEALTH -PROVIDING SCHOLARSHIPS AND AWARDS TO DENTAL STUDENTS -CONTINUING EDUCATION PROGRAMS FOR THE DENTAL PROFESSION THE DDF AWARDS GRANTS TO NONPROFIT ORGANIZATIONS AND INSTITUTIONS WHO CONDUCT DENTAL RESEARCH, AND EDUCATE AND/OR PROVIDE DENTAL SERVICES TO UNDERSERVED AND AT-RISK POPULATIONS. THE GRANT PERIOD IS 12 MONTHS, UNLESS OTHERWISE INDICATED IN THE GRANT AGREEMENT. UPON COMPLETION OF THE GRANT PERIOD, ALL GRANTEES ARE REQUIRED TO SUBMIT A COMPLETED GRANT REPORTING FORM TO THE DDF OUTLINING HOW GRANT FUNDS WERE USED, METRICS AND OUTCOMES OF THE PROJECT, AND ROADBLOCKS THAT WERE ENCOUNTERED. THE DDF ALSO SUPPORTS CONTINUING EDUCATION PROGRAMS FOR DENTAL PROFESSIONALS, AS WELL AS SCHOLARSHIPS AND AWARDS TO DENTAL AND DENTAL HYGIENE STUDENTS WHO OBTAIN THEIR DEGREES FROM ACCREDITED SCHOOLS IN MICHIGAN, OHIO AND INDIANA. STUDENTS MUST MEET THE CRITERIA OUTLINED IN THE AGREEMENT BETWEEN THE SCHOOL AND THE DDF. 0 1 0 0 0 0 0 0 0 GORAN JURKOVIC CPA PRESIDENT & BOARD TRUSTEE 0 1474566 0 3570478 0 4174761 0 2588461 0 25259 0 11833525 0 4141456 AMY BASEL CPA CHIEF FINANCIAL OFFICER 0 528195 0 886909 0 965905 0 619300 0 25259 0 3025568 0 938703 HOLLI SEABURY EXECUTIVE DIRECTOR 0 339241 0 0 0 6388 0 62344 0 25259 0 433232 0 0 ERIN DULING CPA TREASURER 0 188498 0 68987 0 399 0 43744 0 25259 0 326887 0 0 JORDAN LEAMING SECRETARY 0 146708 0 69471 0 12775 0 16997 0 21485 0 267436 0 0 ELAINE LOYACK TRUSTEE 0 161756 0 30000 0 1461 0 6001 0 30907 0 230125 0 0 PART I, LINE 3 THE CEO AND EXECUTIVE DIRECTOR ARE W-2 EMPLOYEES OF A RELATED ORGANIZATION, DELTA DENTAL PLAN OF MICHIGAN, INC. COMPENSATION IS DETERMINED BY THAT ENTITY. THE DELTA DENTAL PLAN OF MICHIGAN, INC. COMPENSATION COMMITTEE REVIEWS PERFORMANCE AND SETS TOTAL COMPENSATION. EVERY TWO YEARS, A STUDY IS PERFORMED BY TOWERS WATSON AND THE DATA IS USED IN COMPENSATION DECISIONS. THE INDEPENDENT CONSULTANT PROVIDES AN OPINION AS TO THE REASONABLENESS AND APPROPRIATENESS OF THE TOTAL COMPENSATION, INCLUDING BASE PAY, INCENTIVE, BENEFITS AND RETIREMENT BENEFITS. PART I, LINE 4B THE RELATED ORGANIZATION, DELTA DENTAL PLAN OF MICHIGAN, HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). IN ORDER TO BE ELIGIBLE FOR THE SERP, AN EMPLOYEE MUST BE A SENIOR EXECUTIVE AND ADDED TO THE PLAN BY THE BOARD OF DIRECTORS. THE SERP BENEFITS ARE REVIEWED AS PART OF THE TOTAL COMPENSATION BY AN INDEPENDENT CONSULTANT; TOWERS WATSON. IN 2023, GORAN JURKOVIC AND AMY BASEL ACCRUED BENEFITS AS PARTICIPANTS IN THE SERP PLAN. GORAN JURKOVIC AND AMY BASEL BECAME VESTED IN A PORTION OF THEIR ACCRUED BENEFITS AND, AS REQUIRED BY THE IRS, THE VESTED PORTION WAS TREATED AS TAXABLE WAGES DURING 2023. THESE WAGES WERE ALSO REPORTED ON SCHEDULE J AS COMPENSATION THAT HAS BEEN REPORTED AS DEFFERED ON PRIOR FORM 990S. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION ARE DULY APPOINTED BY THE BOARD OF DIRECTORS OF THE DELTA DENTAL PLAN OF MICHIGAN, INC. FORM 990, PART VI, SECTION B, LINE 11B THE INFORMATION PRESENTED ON THE FORM 990 IS GATHERED BY THE SENIOR TAX ADMINISTRATOR FOR THE ORGANIZATION. THE CFO REVIEWS THE INFORMATION. ONCE APPROVED THE INFORMATION IS GIVEN TO OUTSIDE TAX PREPARERS WHO PREPARE AND REVIEW THE FORM 990. ONCE COMPLETE, AN ELECTRONIC COPY OF THE FORM 990 IS PLACED IN A SECURE PORTAL FOR THE BOARD TO REVIEW, PRIOR TO THE FORM 990 BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE COMPANY'S SENIOR VICE PRESIDENT, CHIEF LEGAL OFFICER, AND CAO IS CHARGED WITH REVIEWING AND MONITORING ANY POTENTIAL CONFLICT OF INTEREST TRANSACTIONS. ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO REVIEW AND EXECUTE A CONFLICT OF INTEREST POLICY. THIS POLICY REQUIRES THAT ANY CONFLICTS OF INTEREST BE DISCLOSED ON AN ANNUAL BASIS, OR AT ANY OTHER TIME THAT THE PERSON EXECUTING THE POLICY BECOMES AWARE OF A SITUATION OR TRANSACTION THAT ACTUALLY OR POTENTIALLY CREATES A CONFLICT OF INTEREST. ALL CONFLICT OF INTEREST DISCLOSURE FORMS ARE INITIALLY REVIEWED BY THE SENIOR VICE PRESIDENT, CHIEF LEGAL OFFICER, AND CAO. IF A PROHIBITED TRANSACTION IS IDENTIFIED, THE MATTER IS ESCALATED TO THE ADMINSTRATIVE COMMITTEE OF THE BOARD OF DIRECTORS FOR FURTHER REVIEW AND APPROPRIATE ACTION. IN THE EVENT OF A CONFLICT OF INTEREST INVOLVING A MEMBER OF THE BOARD OF DIRECTORS, SUCH AS A VOTE, IN WHICH A MEMBER HAS AN INTEREST, THE MEMBER IS REQUIRED TO DISCLOSE THE POTENTIAL CONFLICT AND ABSTAIN FROM ANY VOTE ON THE MATTER. WHETHER FURTHER PRECAUTIONS ARE REQUIRED (E.G., PROHIBITING THE INTERESTED PARTY FROM ENGAGING IN DISCUSSIONS) WOULD DEPEND UPON THE SPECIFIC NATURE AND BACKGROUND OF THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE CEO AND OTHER EXECUTIVES IS DETERMINED BY A RELATED ORGANIZATION, DELTA DENTAL PLAN OF MICHIGAN, INC. OUTSIDE COMPENSATION CONSULTANTS ARE USED TO DETERMINE MARKET DATA WHICH IS USED TO SET TOTAL COMPENSATION FOR OFFICERS AND KEY EMPLOYEES INCLUDING CEO AND CFO. THE RELATED ORGANIZATION CONTRACTS WITH TOWERS WATSON TO DO A COMPENSATION AND REASONABLENESS ANALYSIS EVERY TWO YEARS. COMPENSATION IS SET BASED ON THE DATA PROVIDED, BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. TOWERS WATSON ALSO PROVIDES AN OPINION AS TO THE REASONABLENESS OF THE TOTAL COMPENSATION PACKAGES, INCLUDING BASE PAY, INCENTIVE, BENEFITS AND RETIREMENT BENEFITS. THE COMPENSATION WAS LAST REVIEWED UNDER THIS PROCESS DURING 2022. FORM 990, PART VI, SECTION C, LINE 19 NO DOCUMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART VII: CERTAIN EMPLOYEES ARE OFFICERS OF MULTIPLE COMPANIES WITHIN THE LARGER ORGANIZATION. THE AVERAGE HOURS WORKED REFLECTS APPROXIMATE TIME SPENT IN EACH OF THOSE INDIVIDUAL COMPANIES. WHILE THE HOURS ARE ALLOCATED TO INDIVIDUAL COMPANIES, MUCH OF THE OFFICERS' TIME IS SPENT WORKING ON ISSUES THAT IMPACT THE ENTIRE ORGANIZATION, NOT JUST ONE COMPANY. COMPENSATION IS REPORTED IN FULL TO AGREE TO THE EMPLOYEE'S W-2 AS REQUIRED BY IRS INSTRUCTIONS. ANY ALLOCATION OF COMPENSATION IS INCLUDED ON SCHEDULE R. 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