2023-11-14T15:33:15-06:00 2022-12-31 420714325 RSM US LLP 4622 PENNSYLVANIA AVE STE 1100 KANSAS CITY MO 64112 990 2022-01-01 274417052 DELTA DENTAL OF OKLAHOMA FOUNDATION DELT 4056072100 PO BOX 54709 OKLAHOMA CITY OK 731541709 ASHLEY ALBRIGHT CFO 4056072100 2023-11-13 1 ASHLEY ALBRIGHT 999009999 0 KEVIN ENSMINGER P01310558 8167533000 2023-11-13 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z ASHLEY ALBRIGHT PO BOX 54709 OKLAHOMA CITY OK 731541709 1007560 0 X WWW.DDOKFOUNDATION.ORG X 2010 OK TO FACILITATE DENTAL HEALTH AND EDUCATION IN THE STATE OF OKLAHOMA BY FUNDING PROGRAMS AND SERVICES THAT PROMOTE ORAL HEALTH. 9 3 4 0 0 0 5118326 1007471 0 0 375 89 0 0 5118701 1007560 5321500 1848666 0 0 290878 370117 0 0 0 212525 274971 5824903 2493754 -706202 -1486194 4735987 2264482 1344997 359686 3390990 1904796 IMPROVE THE ORAL HEALTH OF ALL OKLAHOMANS BY INCREASING ACCESS TO DENTAL CARE, FUNDING ORAL HEALTH EDUCATION AND SUPPORTING ORGANIZATIONS WHO SERVE VITAL ORAL HEALTH NEEDS IN OUR COMMUNITIES. 0 0 2139838 1848666 PROVIDING GRANTS TO NUMEROUS FREE AND LOW-COST INNER-CITY AND RURAL DENTAL CLINICS AND SERVICES TO HELP PROVIDE VITAL CARE TO THOSE LESS FORTUNATE. 2139838 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 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 1 0 0 0 1 42 0 1 4 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 3 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OK X ASHLEY ALBRIGHT 4056072100 16 NW 63RD ST OKLAHOMA CITY OK 73116 BRAD HOGAN BOARD MEMBER 1.00 1.00 X 0 3492 0 DANNY RAMSEY BOARD MEMBER 1.00 1.00 X 0 18048 0 DR ANDREW MINNIGH VICE CHAIRMAN 1.00 1.00 X 0 102053 0 DR DEBORAH CORWIN CHAIRMAN 1.00 1.00 X 0 10090 0 DR JEREMY JOHNSON BOARD MEMBER 1.00 1.00 X 0 74873 0 DR LYMAN COLIN FOSTER BOARD MEMBER 1.00 1.00 X 0 2868 0 DR MICHAEL HOWL BOARD MEMBER 1.00 1.00 X 0 86510 0 DR MICHAEL MCLEOD BOARD MEMBER 1.00 1.00 X 0 24498 0 DR ROSS ALLEN BOARD MEMBER 1.00 1.00 X 0 66008 0 DR STEVE BERKLACY BOARD MEMBER 1.00 1.00 X X 0 140851 0 DR TOMMY MAYHUE TREASURER/SECRETARY 1.00 1.00 X X 0 88802 0 GEAN ATKINSON BOARD MEMBER 1.00 1.00 X 0 5262 0 JOHN GLADDEN PRESIDENT AND CEO 1.00 40.00 X X 0 1099536 61113 JOY SWANSON LABAR BOARD MEMBER 1.00 1.00 X 0 7083 0 KATHY SNYDER BOARD MEMBER 1.00 1.00 X 0 6459 0 MICHAEL MCCULLOUGH BOARD MEMBER 1.00 1.00 X 0 7083 0 MIKE MEANS BOARD MEMBER 1.00 1.00 X 0 5345 0 SANDY P BJORNSON BOARD MEMBER 1.00 1.00 X 0 7640 0 WILLIAM CARLISLE MABREY IV BOARD MEMBER 1.00 1.00 X 0 6443 0 ASHLEY ALBRIGHT CHIEF FINANCIAL OFFICER 1.00 40.00 X 0 320173 105218 DAVID JONES CHIEF INFO. AND SECURITY OFFICER 1.00 40.00 X 0 307948 103823 LAN MILLER CHIEF SALES OFFICER 1.00 40.00 X 0 250433 87828 TANIA FOSS CHIEF OPERATING OFFICER 1.00 40.00 X 0 343484 107743 TERRISA SINGLETON EXECUTIVE DIRECTOR 40.00 0.00 X 106449 0 26233 106449 2984982 491958 1 0 1 0 0 1007471 1007471 89 89 1007560 0 0 89 1848666 1848666 132682 132682 156333 60761 95572 13426 5691 7735 45048 13355 31693 22628 4557 18071 33456 33456 28625 25933 2692 22251 15911 6340 11035 2451 8584 13543 2384 11159 10804 695 10109 3263 1980 1283 DENTAL PROGRAM EXPENSE 123998 123998 OTHER EXPENSES 27996 27996 2493754 2139838 353916 0 1886195 1867441 2840000 340000 6945 6457 79871 29287 2847 50584 4735987 2264482 1344997 359686 1344997 359686 X 3390990 1904796 3390990 1904796 4735987 2264482 -1486194 0 X 0 1 X 1 0 X X 39 AMERICA'S DENTISTS CARE FOUNDATION 262275291 10 0 45000 0 CAMERON UNIVERSITY FOUNDATION 237168952 5 0 25000 0 CATHOLIC CHARITIES DIOCESE OF TULSA 731171950 1 0 100000 0 CITY CARE INC 731497381 7 0 25000 0 COMPASSION OUTREACH CENTER INC 900148536 7 0 30000 0 CROSSINGS COMMUNITY CLINIC 861115863 3 0 30950 0 D-DENT 731325324 7 0 167500 0 DELTA DENTAL PLAN OF OKLAHOMA 237322578 10 0 0 0 DENTAL LIFELINE NETWORK 846129064 10 0 15000 0 EASTERN OKLAHOMA DONATED DENTAL SERVICES 412103655 7 0 140000 0 FAMILY & CHILDREN'S SERVICES INC 730580270 7 0 15000 0 GATEWAY TO PREVENTION & RECOVERY INC 731215510 7 0 20000 0 GIRLS SCOUTS - WESTERN OKLAHOMA INC 730677849 10 0 1000 0 GOOD SHEPHERD COMMUNITY CLINIC INC 731509801 7 0 1000 0 GOOD SHEPHERD MINISTRIES OF OKLAHOMA 200526892 7 0 139000 0 HEALTHCORPS INC 261269358 7 0 15000 0 HEART AND HAND MINISTRIES 731521227 10 0 3000 0 HEARTS THAT CARE VOLUNTEER HEALTH CLINIC 208373475 3 0 10000 0 HNC LIVING FOUNDATION 464214254 7 0 50000 0 MAMA T'S INC 474096424 7 0 5000 0 MINISTRIES OF JESUS INC 731622804 7 0 92400 0 MORTON COMPREHENSIVE HEALTH SERVICE 731177858 3 0 16000 0 NEIGHBORHOOD SERVICES ORGANIZATION 730785944 7 0 125000 0 NORTHEASTERN STATE UNIVERSITY FOUNDATION 237135815 5 0 25000 0 OKLAHOMA DENTAL FOUNDATION 730678114 10 0 250000 0 RED ROCK BEHAVIORAL HEALTH SERVICES 736111618 7 0 10000 0 REMERGE OF OK COUNTY INC 464504748 7 0 17500 0 SMILE FOR GOOD FOUNDATION 843288491 10 0 10000 0 SOUTHERN OKLAHOMA TECHNOLOGY CENTER 731019541 5 0 5000 0 SOUTHWESTERN OKLAHOMA STATE UNIVERSITY 731024870 5 0 20000 0 SPECIAL OLYMPICS OF OKLAHOMA 237174120 7 0 2000 0 STERLING ANGEL OF SMILES NONPROFIT ORGANIZATION 471915858 7 0 25000 0 THE HOMELESS ALLIANCE INC 113718005 7 0 10000 0 TRI COUNTY TECH CENTER 731188682 5 0 6000 0 UNIVERSITY OF OKLAHOMA FOUNDATION INC 736091755 7 0 1278200 0 VARIETY CARE FOUNDATION 731088577 7 0 30000 0 WESTERN OKLAHOMA FAMILY CARE CENTER 261284785 7 0 5000 0 WESTERN TECHNOLOGY CENTER 731105189 5 0 4600 0 STATE OF OKLAHOMA - OKLAHOMA STATE DEPARTMENT OF HEALTH 000000000 6 0 75000 0 39 2844150 0 0 1 1 1 1 0 1 0 1 0 0 1 0 0 0 0 0 0 1 1 PART IV, SECTION A, LINE 1: DELTA DENTAL OF OKLAHOMA FOUNDATION (THE FOUNDATION) IS GOVERNED AND FULLY FUNDED BY ITS SUPPORTED ORGANIZATION, DELTA DENTAL PLAN OF OKLAHOMA (DDPOK). THE FOUNDATION IS GOVERNED BY A COMMITTEE WHICH ARE APPOINTED BY, AND CONSIST OF, PERSONS SERVING THE BOARD OF DIRECTORS OF DDPOK. THE FOUNDATION OPERATES AT THE DIRECTION OF DDPOK TO IMPROVE ORAL HEALTH IN OKLAHOMA BY FUNDING DENTAL AND EDUCATIONAL PROGRAMS AND SERVICES. THE FOUNDATION FINANCIALLY SUPPORTS OTHER ORGANIZATIONS, AS LISTED IN SCHEDULE A PART I AND SCHEDULE R PART II, TO FURTHER ITS CHARITABLE MISSION. THESE ORGANIZATIONS ARE PUBLIC CHARITIES OR PUBLIC HIGHER EDUCATION INSTITUTIONS THAT CONDUCT DENTAL HEALTH OR EDUCATION PROGRAMS IN OKLAHOMA. THESE SUPPORTED ORGANIZATIONS APPLY FOR GRANT AWARDS THROUGH AN ANNUAL PROCESS, SUBJECT TO APPROVAL BY FOUNDATION AND DDPOK MANAGEMENT AND GOVERNANCE. AS A RESULT, THESE OTHER SUPPORTED ORGANIZATIONS ARE NOT EXPLICITLY LISTED IN THE FOUNDATION'S GOVERNING DOCUMENTS. PART IV, SECTION A, LINE 2: THE FOUNDATION'S SUPPORTED ORGANIZATION, DDPOK, HAS AN IRS DETERMINATION OF STATUS AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(4). DDPOK HAS DETERMINED THAT IT WOULD BE DESCRIBED IN SECTION 509(A)(2) IF IT WERE AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3). PART IV, SECTION A, LINE 3B: SEE DISCLOSURE FOR SCHEDULE A, PART IV, SECTION A, LINE 2. PART IV, SECTION A, LINE 3C: ALL OF THE DIRECTORS OF THE FOUNDATION CONSIST OF PERSONS SERVING ON THE BOARD OF DIRECTORS OF DDPOK. AS DIRECTORS AND OFFICERS OF THE SUPPORTED ORGANIZATION, THE INDIVIDUALS WHO COMPRISE THE BOARD OF DIRECTORS OF THE SUPPORTING ORGANIZATION ALSO SHARE RESPONSIBILITY IN THE MANAGEMENT, SUPERVISION, AND INTERNAL CONTROLS OF THE FOUNDATION TO ENSURE THAT ALL SUPPORT TO EXTERNAL SUPPORTED ORGANIZATIONS IS USED EXCLUSIVELY FOR SECTION 170(2)(B) PURPOSES PART IV, SECTION A, LINE 6: THE FOUNDATION CARRIES OUT GRANT-MAKING ACTIVITIES AND PERFORMING INTERNAL INITIATIVES TO FURTHER DENTAL HEALTH AND EDUCATION PROGRAMS IN OKLAHOMA AT THE DIRECTION OF DDPOK MANAGEMENT AND BOARD OF DIRECTORS. ALL OF THE BOARD OF DIRECTORS OF THE FOUNDATION ALSO SERVE AS DDPOK BOARD DIRECTORS. AS SUCH, DDPOK MAINTAINS RESPONSIBILITY FOR MANAGING, SUPERVISING, AND CONTROLLING ITS SUPPORTED ORGANIZATION, TO ENSURE THE ACTIVITIES OF THE FOUNDATION ARE CONSISTENT WITH ITS CHARITABLE MISSION. PART IV, SECTION A, LINE 9A: THE FOUNDATION'S SUPPORTED ORGANIZATION, DDPOK, HAS AN IRS DETERMINATION OF STATUS AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(4). DDPOK HAS DETERMINED THAT IT WOULD BE DESCRIBED IN SECTION 509(A)(2) IF IT WERE AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3). PART IV, SECTION B, LINE 2: THE FOUNDATION IS SUPERVISED AND CONTROLLED BY ITS SUPPORTED ORGANIZATION, DDPOK, WHICH IS COMMITTED TO IMPROVING ORAL HEALTH IN OKLAHOMA. DDPOK DIRECTS THE FOUNDATION TO SUPPORT SECTION 501(C)(3) PUBLIC CHARITIES THROUGHOUT OKLAHOMA, AS IDENTIFIED IN SCHEDULE A, PART I, TO FURTHER ITS MISSION OF FUNDING DENTAL HEALTH AND EDUCATION PROGRAMS. PART IV, SECTION A, LINE 5A: NEW SUPPORTED ORGANIZATIONS: AMERICA'S DENTISTS CARE FOUNDATION (26-2275291) CAMERON UNIVERSITY FOUNDATION (23-7168952) GIRL SCOUTS - WESTERN OKLAHOMA (73-0677849) HEALTHCORPS INC (26-1269358) HEARTS THAT CARE VOLUNTEER HEALTH CLINIC (20-8373475) NORTHEASTERN STATE UNIVERSITY FOUNDATION (23713815) SMILE FOR GOOD FOUNDATION (84-3288491) THE HOMELESS ALLIANCE (11-3718005) STATE OF OKLAHOMA - OKLAHOMA STATE DEPARTMENT OF HEALTH PART IV, SECTION A, LINE 5A: REMOVED SUPPORTING ORGANIZATIONS: CITY RESCUE MISSION (73-0713883) COMMUNITY HEALTH CONNECTION (04-3766364) NORMAN REGIONAL HEALTH FOUNDATION (73-1203942) GREEN COUNTY FREE CLINIC (73-1363792) UNIVERSITY OF SCIENCE AND ARTS OF OKLAHOMA (73-1031040) RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 79871 29287 50584 50584 X PART X, LINE 2: WITH THE EXCEPTION OF DELTA DENTAL PRACTICE SUPPORT (DPS), DELTA DENTAL PLAN OF OKLAHOMA (THE PLAN) IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE AND SECTION 501(C)(3) FOR THE RELATED FOUNDATION, AND ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. NET INCOME GENERATED BY DPS WILL BE TAXABLE WHEN IT OCCURS. SINCE INCEPTION, DPS'S OPERATIONS HAVE BEEN MINIMAL AND NO TAX IS REFLECTED IN THE ACCOMPANYING FINANCIAL STATEMENTS. MANAGEMENT HAS EVALUATED THE PLAN'S TAX POSITIONS AND CONCLUDED THAT THE PLAN HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE CONSOLIDATED FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. 1 AMERICA'S DENTISTS CARE FOUNDATION 9110 E 35TH ST N WICHITA KS 67226 262275291 501C3 45000 0 HEALTH, GENERAL CAMERON UNIVERSITY FOUNDATION 2800 W GORE BLVD LAWTON OK 73505 237168952 501C3 25000 0 HEALTH, GENERAL CATHOLIC CHARITIES DIOCESE OF TULSA 2450 N HARVARD AVE TULSA OK 74115 731171950 501C3 100000 0 HEALTH, GENERAL CITY CARE INC 2000 N CLASSEN BLVD STE N50 OKLAHOMA CITY OK 73106 731497381 501C3 25000 0 DENTAL CARE PROGRAM COMPASSION OUTREACH CENTER INC 1124 CRADDUCK ROAD ADA OK 74820 900148536 501C3 30000 0 HEALTH, GENERAL CROSSINGS COMMUNITY CLINIC 10255 N PENNSYLVANIA AVE OKLAHOMA CITY OK 73120 861115863 501C3 30950 0 HEALTH, GENERAL D-DENT 3000 UNITED FOUNDERS BLVD STE 122 OKLAHOMA CITY OK 73112 731325324 501C3 167500 0 HEALTH, GENERAL DENTAL LIFELINE NETWORK 1800 15TH ST STE 100 DENVER CO 80202 846129064 501C3 15000 0 DENTAL CARE PROGRAM EASTERN OKLAHOMA DONATED DENTAL SERVICES 9810 E 42ND ST STE 210 TULSA OK 74146 412103655 501C3 140000 0 HEALTH, GENERAL FAMILY & CHILDREN'S SERVICES INC 1055 S HOUSTON AVE TULSA OK 74127 730580270 501C3 15000 0 DENTAL CARE PROGRAM GATEWAY TO PREVENTION & RECOVERY INC PO BOX 3848 SHAWNEE OK 74802 731215510 501C3 20000 0 DENTAL CARE PROGRAM GOOD SHEPHERD MINISTRIES OF OKLAHOMA 222 NW 12TH OKLAHOMA CITY OK 73103 200526892 501C3 139000 0 HUMAN SERVICE HEALTHCORPS INC 304 SW A AVE LAWTON OK 73501 261269358 501C3 15000 0 HUMAN SERVICE HEARTS THAT CARE VOLUNTEER HEALTH CLINIC 8100 NEWTON ST STE 100 OVERLAND PARK KS 66204 208373475 501C3 10000 0 HUMAN SERVICE HNC LIVING FOUNDATION 8100 NEWTON ST STE 100 OVERLAND PARK KS 66204 464214254 501C3 50000 0 DENTAL CARE PROGRAM MINISTRIES OF JESUS INC 1100 E I-35 SERVICE ROAD EDMOND OK 73034 731622804 501C3 92400 0 HUMAN SERVICE MORTON COMPREHENSIVE HEALTH SERVICE 1334 N LANSING AVE TULSA OK 74106 731177858 501C3 16000 0 DENTAL CARE PROGRAM NEIGHBORHOOD SERVICES ORGANIZATION 431 SW 11TH ST OKLAHOMA CITY OK 73109 730785944 501C3 125000 0 HUMAN SERVICE NORTHEASTERN STATE UNIVERSITY FOUNDATION 812 N CEDAR AVE TAHLEQUAH OK 74464 237135815 501C3 25000 0 HUMAN SERVICE OKLAHOMA DENTAL FOUNDATION 317 NE 13TH ST OKLAHOMA CITY OK 73104 730678114 501C3 250000 0 HEALTH, GENERAL RED ROCK BEHAVIORAL HEALTH SERVICES 4400 N LINCOLN BLVD OKLAHOMA CITY OK 73105 736111618 501C3 10000 0 DENTAL CARE PROGRAM REMERGE OF OK COUNTY INC PO BOX 2845 OKLAHOMA CITY OK 73101 464504748 501C3 17500 0 DENTAL CARE PROGRAM SMILE FOR GOOD FOUNDATION 1050 E 2ND ST STE 234 EDMOND OK 73034 843288491 501C3 10000 0 DENTAL CARE PROGRAM SOUTHWESTERN OKLAHOMA STATE UNIVERSITY 100 CAMPUS DR WEATHERFORD OK 73096 731024870 501C3 20000 0 GENERAL SUPPORT STERLING ANGEL OF SMILES NONPROFIT ORGANIZATION PO BOX 891330 OKLAHOMA CITY OK 73189 471915858 501C3 25000 0 HUMAN SERVICE THE HOMELESS ALLIANCE INC 1724 NW 4TH OKLAHOMA CITY OK 73106 113718005 501C3 10000 0 HUMAN SERVICE TRI COUNTY TECH CENTER 6101 SE NOWATA BARTLESVILLE OK 74006 731188682 501C3 6000 0 GENERAL SUPPORT UNIVERSITY OF OKLAHOMA FOUNDATION INC 100 TIMBERDELL ROAD NORMAN OK 730190685 736091755 501C3 1278200 0 GENERAL SUPPORT VARIETY CARE FOUNDATION 3000 N GRAND BLVD OKLAHOMA CITY OK 73107 731088577 501C3 30000 0 GENERAL SUPPORT OKLAHOMA STATE DEPARTMENT OF HEALTH 123 ROBERT S KERR STE 172 OKLAHOMA CITY OK 73102 STATE OF OKLAHOMA 75000 0 HEALTH, GENERAL 29 1 PART I, LINE 2: GRANTEES MUST MEET FOUR ELIGIBILITY REQUIREMENTS IN ORDER TO BE AWARDED A GRANT. FIRST, THE ORGANIZATION SEEKING THE GRANT MUST BE A 501(C)(3) NONPROFIT ORGANIZATION WITH PUBLIC CHARITY STATUS, AN EDUCATIONAL INSTITUTION, A GOVERNMENT AGENCY, OR A FAITH-BASED ORGANIZATION THAT SERVES ALL MEMBERS OF THE COMMUNITY REGARDLESS OF RELIGIOUS BELIEF. WE DO NOT AWARD GRANTS TO INDIVIDUALS. SECOND, THE PROGRAM, PROJECT OR INITIATIVE BEING FUNDED MUST BE DENTAL HEALTH OR EDUCATION RELATED. THIRD, THE PROGRAM CANNOT DISCRIMINATE ON THE BASIS OF RACE, ETHNICITY, NATIONAL ORIGIN, OR RELIGION. FOURTH, THE PROGRAM MUST SERVE OKLAHOMANS. THE ORGANIZATION MONITORS TO ENSURE THAT THE CHARITABLE PURPOSES ARE SATISFIED AND REQUIRES DETAILED SUPPORTING DOCUMENTATION FROM THE RECIPIENT ORGANIZATION TO CONFIRM USE AND VALUE OF SERVICES RENDERED. 0 1 0 0 0 0 0 0 0 JOHN GLADDEN PRESIDENT AND CEO 0 713177 0 104363 0 281996 0 38950 0 22163 0 1160649 0 0 TANIA FOSS CHIEF OPERATING OFFICER 0 274780 0 40627 0 28077 0 79241 0 28502 0 451227 0 0 ASHLEY ALBRIGHT CHIEF FINANCIAL OFFICER 0 272152 0 39162 0 8859 0 75169 0 30049 0 425391 0 0 DAVID JONES CHIEF INFO. AND SECURITY OFFICER 0 260971 0 38790 0 8187 0 75100 0 28723 0 411771 0 0 LAN MILLER CHIEF SALES OFFICER 0 206416 0 27121 0 16896 0 58029 0 29799 0 338261 0 0 PART I, LINE 3 COMPENSATION FOR THE ORGANIZATION'S EXECUTIVE DIRECTOR WAS ESTABLISHED BY DELTA DENTAL PLAN OF OKLAHOMA (DDPOK), A RELATED ORGANIZATION. DDPOK USED THE FOLLOWING TO ESTABLISH THE EXECUTIVE DIRECTOR'S COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT (2) COMPENSATION SURVEY OR STUDY PART I, LINE 4B THE RELATED ORGANIZATION PROVIDES A SUPPLEMENTAL RETIREMENT PLAN FOR CERTAIN EXECUTIVES. THE FOLLOWING INDIVIDUALS PARTICIPATE IN THE PLAN AND RECEIVED CURRENT YEAR DISTRIBUTIONS AS FOLLOWS: JOHN GLADDEN $178,118 TANIA FOSS $40,385 DAVID JONES $36,351 LAN MILLER $27,320 ASHLEY ALBRIGHT $36,100 FORM 990, PART VI, SECTION A, LINE 7A THE FOUNDATION'S BOARD OF TRUSTEES IS APPOINTED BY THE DELTA DENTAL OF OKLAHOMA BOARD OF DIRECTORS. THE TRUSTEES SERVE FOR A TERM OF THREE YEARS. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE RETURN IS MADE AVAILABLE TO THE GOVERNING BODY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY HAVING MEMBERS SIGN AN AGREEMENT AND DISCLOSING ANY BUSINESS RELATIONSHIPS WHICH CONFLICT WITH THEIR DUTIES OF DELTA DENTAL OF OKLAHOMA ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 DDOK HIRED AND RETAINS THE KORN FERRY AS A CONSULTANT. THEY EVALUATE THE JOB DESCRIPTIONS OF DDOK AND DDOKF EMPLOYEES AND COMPARE IT TO MARKET ANALYSIS DATA TO DETERMINE COMPENSATION LEVELS. THIS ANALYSIS IS PRESENTED TO THE DDOK FINANCE AND AUDIT COMMITTEE FOR REVIEW AND APPROVAL. DDOK AND DDOKF UTILIZE THE SAME COMPENSATION METHODOLOGY. FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS ARE AVAILABLE UPON REQUEST. DELTA DENTAL PLAN OF OKLAHOMA PO BOX 54709 OKLAHOMA CITY OK 73116 237322578 DENTAL CARE OK 501(C)(4) N/A N/A 0 CATHOLIC CHARITIES DIOCESE OF TULSA 2450 N HARVARD AVE TULSA OK 74115 731171950 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 1 N/A 0 CITY CARE INC 2000 N CLASSEN BLVD STE N50 OKLAHOMA CITY OK 73106 731497381 DENTAL CARE OK 501(C)(3) LINE 7 - AN ORGANIZA N/A 0 CITY RESCUE MISSION 800 W CALIFORNIA AVE OKLAHOMA CITY OK 73106 730713883 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 - AN ORGANIZA N/A 0 COMMUNITY HEALTH CONNECTION 2321 E 3RD ST TULSA OK 74104 043766364 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 - AN ORGANIZA N/A 0 COMPASSION OUTREACH CENTER INC 1124 CRADDUCK ROAD ADA OK 74820 900148536 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 - AN ORGANIZA N/A 0 CROSSINGS COMMUNITY CLINIC 10255 N PENNSYLVANIA AVE OKLAHOMA CITY OK 73120 861115863 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 3 N/A 0 D-DENT 3000 UNITED FOUNDERS BLVD STE 122 OKLAHOMA CITY OK 73112 731325324 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 N/A 0 DENTAL LIFELINE NETWORK 1800 15TH ST STE 100 DENVER CO 80202 846129064 DENTAL CARE CO 501(C)(3) LINE 10 - AN ORGANIZ N/A 0 EASTERN OKLAHOMA DONATED DENTAL SERVICES 9810 E 42ND ST STE 210 TULSA OK 74146 412103655 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 N/A 0 FAMILY & CHILDREN'S SERVICES INC 1055 S HOUSTON AVE TULSA OK 74127 730580270 DENTAL CARE OK 501(C)(3) LINE 7 - AN ORGANIZA N/A 0 GATEWAY TO PREVENTION & RECOVERY INC PO BOX 3848 SHAWNEE OK 74802 731215510 DENTAL CARE OK 501(C)(3) LINE 7 - AN ORGANIZA N/A 0 GOOD SHEPHERD COMMUNITY CLINIC INC 20 12TH AVE NW ARDMORE OK 73401 731509801 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 N/A 0 GOOD SHEPHERD MINISTRIES OF OKLAHOMA 222 NW 12TH OKLAHOMA CITY OK 73103 200526892 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 N/A 0 GREEN COUNTRY FREE CLINIC 500 SE FRANK PHILLIPS BLVD BARTLESVILLE OK 74003 731363792 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 N/A 0 HEART AND HAND MINISTRIES 1308 NW 9TH ST OKLAHOMA CITY OK 73106 731521227 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 10 - AN ORGANIZ N/A 0 HNC LIVING FOUNDATION 8100 NEWTON ST STE 100 OVERLAND PARK KS 66204 464214254 DENTAL CARE KS 501(C)(3) LINE 7 - AN ORGANIZA N/A 0 MAMA T'S INC 222 E 12TH ST ADA OK 74820 474096424 DENTAL CARE OK 501(C)(3) LINE 7 - AN ORGANIZA N/A 0 MINISTRIES OF JESUS INC 1100 E I-35 SERVICE ROAD EDMOND OK 73034 731622804 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 N/A 0 MORTON COMPREHENSIVE HEALTH SERVICE 1334 N LANSING AVE TULSA OK 74106 731177858 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 3 N/A 0 NEIGHBORHOOD SERVICES ORGANIZATION 431 SW 11TH ST OKLAHOMA CITY OK 73109 730785944 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 N/A 0 NORMAN REGIONAL HEALTH FOUNDATION 901 N PORTER AVE NORMAN OK 73071 731203942 DENTAL CARE OK 501(C)(3) LINE 7 N/A 0 OKLAHOMA DENTAL FOUNDATION 317 NE 13TH ST OKLAHOMA CITY OK 73104 730678114 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 10 N/A 0 RED ROCK BEHAVIORAL HEALTH SERVICES 4400 N LINCOLN BLVD OKLAHOMA CITY OK 73105 736111618 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 N/A 0 REMERGE OF OK COUNTY INC PO BOX 2845 OKLAHOMA CITY OK 73101 464504748 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 N/A 0 SMILE FOR GOOD FOUNDATION 1050 E 2ND ST STE 234 EDMOND OK 73034 843288491 DENTAL CARE OK 501(C)(3) LINE 10 - AN ORGANIZ N/A 0 SOUTHERN OKLAHOMA TECHNOLOGY CENTER 2610 SAM NOBLE PARKWAY ARDMORE OK 73401 731019541 EDUCATIONAL OK 501(C)(3) LINE 5 - AN ORGANIZA N/A 0 SOUTHWESTERN OKLAHOMA STATE UNIVERSITY 100 CAMPUS DR WEATHERFORD OK 73096 731024870 EDUCATIONAL OK 501(C)(3) LINE 5 - AN ORGANIZA N/A 0 STERLING ANGEL OF SMILES NONPROFIT ORGANIZATION PO BOX 891330 OKLAHOMA CITY OK 73189 471915858 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 N/A 0 TRI COUNTY TECH CENTER 6101 SE NOWATA BARTLESVILLE OK 74006 731188682 EDUCATIONAL OK 501(C)(3) LINE 5 - AN ORGANIZA N/A 0 UNIVERSITY OF OKLAHOMA FOUNDATION INC 100 TIMBERDELL ROAD NORMAN OK 730190685 736091755 EDUCATIONAL OK 501(C)(3) LINE 7 N/A 0 UNIVERSITY OF SCIENCE AND ARTS OF OKLAHOMA 1727 WEST ALABAMA CHICKASHA OK 73018 731031040 EDUCATIONAL OK 501(C)(3) LINE 7 - AN ORGANIZA N/A 0 VARIETY CARE FOUNDATION 3000 N GRAND BLVD OKLAHOMA CITY OK 73107 731088577 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 N/A 0 WESTERN OKLAHOMA FAMILY CARE CENTER 609 W E AVE ELK CITY OK 73648 261284785 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 N/A 0 WESTERN TECHNOLOGY CENTER 2605 E MAIN ST WEATHERFORD OK 73096 731105189 EDUCATIONAL OK 501(C)(3) LINE 5 - AN ORGANIZA N/A 0 AMERICA'S DENTISTS CARE FOUNDATION 9110 E 35TH ST N WICHITA KS 67226 262275291 DENTAL CARE KS 501(C)(3) LINE 10 N/A 0 CAMERON UNIVERSITY FOUNDATION 2800 W GORE BLVD LAWTON OK 73505 237168952 EDUCATIONAL OK 501(C)(3) LINE 5 - AN ORGANIZA N/A 0 HEALTHCORPS INC 304 SW A AVE LAWTON OK 73501 208373475 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 N/A 0 NORTHEASTERN STATE UNIVERSITY FOUNDATION 812 N CEDAR AVE TAHLEQUAH OK 74464 237135815 EDUCATIONAL OK 501(C)(3) LINE 5 - AN ORGANIZA N/A 0 THE HOMELESS ALLIANCE 1724 NW 4TH OKLAHOMA CITY OK 73106 113718005 HEALTH AND HUMAN SERVICES OK 501(C)(3) LINE 7 N/A 0 DELTA DENTAL OF OK DENTAL PRACTICE SUPPORT INC PO BOX 54709 OKLAHOMA CITY OK 73154 461958347 SUPPORT SERVICES OK N/A C 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0