2023-11-14T11:35:56-06:00 2022-12-31 381357951 PLANTE & MORAN PLLC 1111 MICHIGAN AVE STE 100 EAST LANSING MI 48823 990 2022-01-01 561018068 DELTA DENTAL OF NORTH CAROLINA DELT 8005879514 3737 GLENWOOD AVENUE 320 RALEIGH NC 27612 AMY BASEL CHIEF FINANCIAL OFFICER 8005879514 2023-11-08 1 AMY BASEL 999009999 1 X DAVID LOWENTHAL CPA P00378651 5173326200 2023-11-08 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X CURTIS R LADIG CPA 3737 GLENWOOD AVENUE 320 RALEIGH NC 27612 130330361 0 X WWW.DELTADENTALNC.COM X 1970 NC DELTA DENTAL OF NORTH CAROLINA'S MISSION IS TO ADVANCE AND PROMOTE THE IMPROVEMENT OF ORAL HEALTH THROUGH PREPAID DENTAL SERVICES, SUPPORT FOR RESEARCH AND EDUCATION, AND COMMUNITY OUTREACH DIRECTED TOWARD SECURING ACCESS TO QUALITY DENTAL CARE FOR ALL. 9 9 32 0 19612 0 0 0 105487945 127443213 683522 537624 0 0 106171467 127980837 125000 431000 0 0 4475919 5477988 0 0 0 97967809 117244909 102568728 123153897 3602739 4826940 35946857 39517941 12253904 12888885 23692953 26629056 X SEE SCHEDULE ODELTA DENTAL OF NORTH CAROLINA'S MISSION IS TO ADVANCE AND PROMOTE THE IMPROVEMENT OF ORAL HEALTH THROUGH PREPAID DENTAL SERVICES, SUPPORT FOR RESEARCH AND EDUCATION, AND COMMUNITY OUTREACH DIRECTED TOWARD SECURING ACCESS TO QUALITY DENTAL CARE FOR ALL. 0 0 116663852 431000 127423601 PROMOTING DENTAL CAREDELTA DENTAL OF NORTH CAROLINA IS A LEADING GROUP DENTAL BENEFITS PROVIDER. THE PURPOSE OF THE ORGANIZATION IS TO ADVANCE AND PROMOTE THE IMPROVEMENT OF ORAL HEALTH. THIS IS DONE BY OFFERING INNOVATIVE, COST-EFFECTIVE PRODUCTS THAT MEET THE NEEDS OF CUSTOMERS. THIS WAS DEMONSTRATED IN 2022 BY PAYING OUT OVER $95 MILLION IN CLAIMS AND BY PROVIDING DENTAL BENEFITS FOR THE PUBLIC AND ADVANCING THE SCIENCE OF DENTISTRY. IN ADDITION, OVER 1.4 MILLION CLAIMS WERE PROCESSED FOR OVER 850,000 MEMBERS. SEE SCHEDULE O FOR CONTINUATION COST SAVING STRATEGIESDELTA DENTAL BENEFIT PLANS ARE COMMITTED TO SAVING GROUPS AND MEMBERS MONEY. THE DELTA DIFFERENCE IS AN INTEGRATION OF ACTIVITIES SUCH AS COST MANAGEMENT POLICIES, FEE REDUCTION AGREEMENTS WITH DENTISTS, AND ANTI-FRAUD PROGRAMS, ALL OF WHICH ENSURE QUALITY, COST-EFFECTIVE DENTAL BENEFIT DELIVERY. COMMITMENT TO THE COMMUNITYTHE DELTA DENTAL FUND, THE COMPANY'S PHILANTHROPIC AFFILIATE, ENCOURAGES ADVANCES IN DENTISTRY AND SUPPORTS DENTAL EDUCATION AND RESEARCH. IN 2022, DELTA DENTAL FUND CONTRIBUTED OVER $175,000 TO ORGANIZATIONS IN NORTH CAROLINA TO SUPPORT THESE CAUSES. UNEQUALED ACCESS TO DENTISTS FOR FIVE DECADES, DELTA DENTAL HAS HELPED PROMOTE ORAL HEALTH BY DESIGNING AND ADMINISTERING INNOVATIVE, COST-EFFECTIVE DENTAL BENEFIT PROGRAMS. EXPERTS AT PLAN DESIGN, DELTA DENTAL HAS CREATED DENTAL BENEFIT PROGRAMS THAT MEET CUSTOMER COST-OBJECTIVES WHILE HELPING TO IMPROVE AND MAINTAIN ORAL HEALTH.OUR LONG STANDING RELATIONSHIPS WITH PROVIDERS IN THE COMMUNITIES WE SERVE ALLOW US TO MAINTAIN LARGE NETWORKS, ALLOWING BROAD ACCESS FOR MEMBERS AND COST-EFFECTIVE CARE. DELTA DENTAL'S GROUP MEMBERS ARE AFFORDED ADDED PROTECTION BECAUSE THEY GUARANTEE THAT PARTICIPATING DENTISTS WILL ACCEPT THEIR PAYMENT FOR COVERED SERVICES AND NO CHARGE, OTHER THAN CO-PAYMENTS AND DEDUCTIBLES ARE BILLED BACK TO THE MEMBER. THIS LOWERS CLAIM COSTS FOR CUSTOMERS AND REDUCES OUT-OF-POCKET COSTS FOR SUBSCRIBERS.WITH TWO NETWORKS OF FULL-TIME PARTICIPATING DENTISTS IN ONE INTEGRATED CLAIMS SYSTEM, DELTA DENTAL CAN DELIVER TO CUSTOMERS AND GROUP MEMBERS BROAD ACCESS TO CARE. 116663852 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 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 1 1 0 1 54550 0 1 32 1 1 1 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X AMY BASEL CHIEF FINANCIAL OFFICER 5173496000 4100 OKEMOS ROAD OKEMOS MI 48864 X AMY L BASEL CHIEF FINANCIAL OFFICER 5.00 45.00 X 0 1462790 485855 CURT R LADIG PRESIDENT & CEO 50.00 0.00 X 796110 0 23114 DEBORAH JONES SVP & CHIEF SALES OFFICER 50.00 0.00 X 411686 0 32705 JOHN PEATTIE ACCOUNT EXECUTIVE 40.00 0.00 X 354088 0 42290 MARIROSE STEIGERWALD SVP & CAO 50.00 0.00 X 301107 0 32543 HEATHER PICCIOTTI DIRECTOR, CLIENT MGT 40.00 0.00 X 221506 0 38381 JOHN SINGLETARY ACCOUNT EXECUTIVE 40.00 0.00 X 237049 0 17503 DENISE POWELL ACCOUNT EXECUTIVE 40.00 0.00 X 178576 0 17668 ELAINE LOYACK VP, COMMUNITY ENGAGEMENT 40.00 1.00 X 126877 0 33731 JAMES R ROSE JR CHAIR 2.00 5.00 X X 24000 16664 0 MOIRA S LOCASCIO IMMEDIATE PAST CHAIR 2.00 5.00 X X 18000 10415 0 SHEILA AHLER CPA SECRETARY & TREASURER 2.00 0.00 X X 21600 0 0 COURTNEY CROWDER VICE CHAIR 2.00 0.00 X X 18000 0 0 STEWART D HOLMES DIRECTOR 2.00 0.00 X 18000 0 0 CLAIRE B NIVER DIRECTOR 2.00 0.00 X 18000 0 0 LEAH DEVLIN DDS MPH DIRECTOR 2.00 0.00 X 18000 0 0 RAJESH MANICKAM PHARMD DIRECTOR 2.00 0.00 X 18000 0 0 KARA M HENDERSON DDS DIRECTOR 2.00 0.00 X 7500 0 0 2788099 1489869 723790 12 0 1 0 AP GLOBAL INSURANCE SERVICES LLC 4928 LINKSLAND DR HOLLY SPRINGS NC 27540 COMMISSIONS 894143 MERCER HEALTH & BENEFITS LLC 1000 RIDGEWAY LOOP RD MEMPHIS TN 38120 COMMISSIONS 749445 USI INSURANCE SERVICES LLC PO BOX 601478 CHARLOTTE NC 28260 COMMISSIONS 502322 GALLAGHER BENEFIT SERVICES INC 2081 VISTA PKWY WEST PALM BEACH FL 33411 COMMISSIONS 468781 JAMES A SCOTT & SON INC 628 GREEN VALLEY RD GREENSBORO NC 274087730 COMMISSIONS 456701 15 DENTAL CARE REVENUE 524114 127343663 127343663 SUBCRIBER FEE 524114 79938 79938 VISION CARE REVENUE 524298 19612 19612 127443213 424497 424497 2462651 2349524 113127 113127 113127 127980837 127423601 19612 537624 X 431000 431000 1865844 1366201 499643 2844672 1452298 1392374 128499 60455 68044 402736 185526 217210 236237 123520 112717 219831 6452 213379 391356 391356 77920 77920 27765 27765 98318585 97086362 1232223 467122 467122 1496478 976716 519762 494943 29148 465795 207493 207493 260428 165005 95423 25595 7242 18353 29088 17853 11235 69888 69888 COMMISSION 7236434 7236434 PROCESSING FEES 5022750 5022750 PREMIUM TAX 2347301 2347301 TAXES, FEES & LICENSES 470719 68376 402343 81213 81213 123153897 116663852 6490045 0 14295133 12836790 7579074 9831773 43039 855103 185873 90418 33392 95455 13552546 15304658 443673 594162 35946857 39517941 7564881 9175515 1897840 2058359 2791183 1655011 12253904 12888885 X 23692953 26629056 23692953 26629056 35946857 39517941 4826940 -1890837 0 X 0 1 X 1 0 185873 90418 95455 95455 DUE TO AFFILIATES 1578962 OPERATING LEASE LIABILITY 76049 1655011 127953072 0 127953072 27765 27765 127980837 123126132 0 123126132 27765 27765 123153897 1 GOODWILL INDUSTRIES OF SOUTHERN PIEDMONT 5301 WILKINSON BLVD CHARLOTTE NC 28208 560844639 501C3 6000 0 N/A N/A CHARITABLE CONTRIBUTION FRIENDS OF THE NC MUSEUM OF NATUAL SCIENCE 11 W JONES ST RALEIGH NC 27601 561240806 501C3 25000 0 N/A N/A DUELING DINOSAURS PROGRAM DELTA DENTAL FUND PO BOX 30416 LANSING MI 48909 381337000 501C3 400000 0 N/A N/A CHARITABLE CONTRIBUTION 3 0 PART I, LINE 2: CONTRIBUTIONS ARE MADE AT MANAGEMENT DISCRETION TO ORGANIZATIONS THAT SUPPORT DELTA DENTAL PLAN OF NORTH CAROLINA'S MISSION. CONTRIBUTIONS MADE TO THE DELTA DENTAL FUND ARE APPROVED BY THE BOARD OF DIRECTORS. IN ORDER FOR FUNDS TO BE DISBURSED, VOUCHER RECORDS MUST PASS THROUGH THE APPROVAL PROCESS, SIMILAR TO ANY OTHER EXPENDITURE MADE BY DELTA DENTAL PLAN OF NORTH CAROLINA. X X 1 1 X X X X 1 1 0 0 0 0 0 1 0 AMY L BASEL CHIEF FINANCIAL OFFICER 0 507383 0 561274 0 394133 0 462136 0 23719 0 1948645 0 364896 CURT R LADIG PRESIDENT & CEO 536121 0 196875 0 63114 0 15250 0 7864 0 819224 0 0 0 DEBORAH JONES SVP & CHIEF SALES OFFICER 174300 0 232130 0 5256 0 15250 0 17455 0 444391 0 0 0 JOHN PEATTIE ACCOUNT EXECUTIVE 66506 0 286694 0 888 0 15250 0 27040 0 396378 0 0 0 MARIROSE STEIGERWALD SVP & CAO 232754 0 65000 0 3353 0 15088 0 17455 0 333650 0 0 0 HEATHER PICCIOTTI DIRECTOR, CLIENT MGT 99682 0 120760 0 1064 0 11341 0 27040 0 259887 0 0 0 JOHN SINGLETARY ACCOUNT EXECUTIVE 5843 0 0 0 231206 0 15250 0 2253 0 254552 0 0 0 DENISE POWELL ACCOUNT EXECUTIVE 65229 0 110706 0 2641 0 8926 0 8742 0 196244 0 0 0 ELAINE LOYACK VP, COMMUNITY ENGAGEMENT 106277 0 20000 0 600 0 6691 0 27040 0 160608 0 0 0 PART I, LINE 1A TRAVEL MAY BE AVAILABLE TO SPOUSES ON OCCASION AND WOULD BE TREATED AS TAXABLE INCOME TO THE BOARD MEMBER OR EMPLOYEE AS APPROPRIATE. THE CEO IS ELIGIBLE FOR REIMBURSEMENT OF SUBSTANTIATED HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES THAT HAVE A BUSINESS PURPOSE. THIS BENEFIT IS NOT TAXABLE BUT THE EXPENSES MUST BE SUBSTANTIATED AS A BUSINESS EXPENSE. PART I, LINES 4A-B A 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 VICE PRESIDENT OR HIGHER 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 2022, AMY BASEL ACCRUED BENEFITS AS A PARTICIPANT IN THE SERP PLAN. AMY BASEL BECAME VESTED IN A PORTION OF HER ACCRUED BENEFITS AND, AS REQUIRED BY THE IRS, THE VESTED PORTION WAS TREATED AS TAXABLE WAGES DURING 2022. THESE WAGES WERE ALSO REPORTED ON SCHEDULE J AS COMPENSATION THAT HAS BEEN REPORTED AS DEFERRED ON PRIOR FORM 990S. EFFECTIVE SEPTEMBER 1, 2020, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN UNDER SEC. 457(F) IS MAINTAINED BY THE ORGANIZATION FOR CERTAIN EXECUTIVE EMPLOYEES. UPON SEVERANCE FROM SERVICE PRIOR TO ATTAINMENT OF NORMAL RETIREMENT AGE, THE PARTICIPANT SHALL FORFEIT INELIGIBLE AMOUNTS IN THE PLAN UNLESS SUCH SEVERANCE IS DUE TO DEATH, DISABILITY, INVOLUNTARY TERMINATION WITHOUT CAUSE, OR A SEVERANCE FROM EMPLOYMENT FOR GOOD REASON. IN 2022, CURTIS LADIG ACCRUED BENEFITS AS A PARTICIPANT IN THE PLAN, BUT DID NOT RECEIVE A DISTRIBUTION. IN 2022 JOHN SINGLETARY RECEIVED A SEVERANCE PAYMENT FOR $230,683. PART I, LINE 7 AS INDICATED IN SCHEDULE J, PART II, TOP MANAGEMENT OFFICIALS RECEIVED A BONUS BASED ON PERFORMANCE AND THE FINANCIAL RESULTS OF THE ORGANIZATION. THIS BONUS IS APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 DELTA DENTAL OF NORTH CAROLINA HAS A SOLE MEMBER, RENAISSANCE HEALTH SERVICE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS VOTING RIGHTS AND ELECTS DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS THE RIGHTS THAT ARE PRESCRIBED BY LAW, FOR MEMBERS OF NON-PROFIT CORPORATIONS, INCLUDING THE APPROVAL OF SIGNIFICANT EXPENDITURES AND CEO APPOINTMENT. 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. THIS IS DONE BEFORE THE RETURN IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ENTERPRISE'S CHIEF LEGAL OFFICER 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 CHIEF LEGAL OFFICER. IF A PROHIBITED TRANSACTION IS IDENTIFIED, THE MATTER IS ESCALATED TO THE CEO AND TO THE AUDIT AND FINANCE 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 15A CEO COMPENSATION IS SET BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. MARKET DATA PROVIDED BY OUTSIDE CONSULTANTS, TOWERS WATSON, IS USED TO VALIDATE THE REASONABLENESS OF THE TOTAL COMPENSATION PACKAGE. COMPENSATION FOR CERTAIN OFFICERS, INCLUDING THE CFO, IS DETERMINED AND PAID THROUGH A RELATED ORGANIZATION, DELTA DENTAL PLAN OF MICHIGAN, INC. 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. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,434,419. MANAGEMENT AND GENERAL EXPENSES 1,232,223. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,666,642. PURCHASED DENTAL SERVICES: PROGRAM SERVICE EXPENSES 95,651,943. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 95,651,943. RENAISSANCE HEALTH SERVICE CORPORATION PO BOX 30416 LANSING MI 489097916 381675667 PROMOTING DENTAL CARE MI 501(C)(4) N/A N/A 0 DELTA DENTAL FUND PO BOX 30416 LANSING MI 489097916 382337000 SUPPORT DENTAL EDUCATION AND RESEARCH PROGRAMS MI 501(C)(3) LINE 12A, I DELTA DENTAL PLAN OF MICHIGAN INC 0 DELTA DENTAL OF ARKANSAS FOUNDATION INC 1513 COUNTRY CLUB RD SHERWOOD AR 72120 261269324 EMPHASIZE DENTAL HEALTH IN COMMUNITIES AR 501(C)(3) PF DELTA DENTAL OF ARKANSAS 0 RENAISSANCE FAMILY FOUNDATION INC 225 S EAST ST INDIANAPOLIS IN 46202 461376165 EMPHASIZE DENTAL HEALTH IN COMMUNITIES IN 501(C)(3) PF RENAISSANCE HOLDING COMPANY 0 SMILE 180 FOUNDATION 240 VENTURE CIRCLE NASHVILLE TN 37228 471654054 EMPHASIZE DENTAL HEALTH IN COMMUNITIES TN 501(C)(3) LINE 12A, I DELTA DENTAL OF TENNESSEE INC 0 DELTA DENTAL PLAN OF INDIANA INC PO BOX 30416 LANSING MI 489097916 351545647 PROVIDE DENTAL SERVICE PLANS IN 501(C)(4) N/A DELTA DENTAL PLAN OF MICHIGAN INC 0 DELTA DENTAL PLAN OF MICHIGAN INC 4100 OKEMOS ROAD OKEMOS MI 48864 381791480 PROVIDE DENTAL SERVICE PLANS MI 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 0 DELTA DENTAL PLAN OF OHIO INC PO BOX 30416 LANSING MI 489097916 310685339 PROVIDE DENTAL SERVICE PLANS OH 501(C)(4) N/A DELTA DENTAL PLAN OF MICHIGAN INC 0 DELTA DENTAL PLAN OF NEW MEXICO INC 100 SUN AVE NE SUITE 400 ALBUQUERQUE NM 87109 850224562 PROVIDE DENTAL SERVICE PLANS NM 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 0 DELTA DENTAL OF KENTUCKY INC 10100 LINN STATION ROAD NO 700 LOUISVILLE KY 40223 610659432 PROVIDE DENTAL SERVICE PLANS KY 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 0 DELTA DENTAL OF TENNESSEE 240 VENTURE CIRCLE NASHVILLE TN 37228 620812197 PROVIDE DENTAL SERVICE PLANS TN 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 0 DELTA DENTAL PLAN OF ARKANSAS INC 1513 COUNTRY CLUB RD SHERWOOD AR 72120 710561140 PROVIDE DENTAL SERVICE PLANS AR 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 0 DELTA DENTAL OF KENTUCKY FOUNDATION INC 10100 LINN STATION ROAD SUITE 700 LOUISVILLE KY 40223 874045357 EMPHASIZE DENTAL HEALTH IN COMMUNITIES KY 501(C)(3) PF DELTA DENTAL OF KENTUCKY 0 RED CEDAR INVESTMENT MANAGEMENT LLC 333 BRIDGE STREET NW SUITE 601 GRAND RAPIDS MI 49546 462667997 CAPITAL MANAGEMENT MI N/A 0 0 RENAISSANCE HOLDING COMPANY PO BOX 30381 LANSING MI 48909 412177193 HOLDING COMPANY MI N/A C 0 RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA PO BOX 30381 LANSING MI 48909 470397286 INSURANCE IN N/A C 0 RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF NEW YORK PO BOX 30381 LANSING MI 48909 134098096 INSURANCE NY N/A C 0 FORE HOLDING CORPORATION 240 VENTURE CIRCLE NASHVILLE TN 37228 204116122 EMPLOYEE BENEFITS TN N/A C 0 DENTAL CHOICE INC 10100 LINN STATION RD SUITE 700 LOUISVILLE KY 402233861 611105118 PROVIDE DENTAL SERVICE PLANS KY N/A C 0 DENTAL CHOICE AGENCY INC 10100 LINN STATION RD SUITE 700 LOUISVILLE KY 402233861 611336003 PRIMARY GENERAL AGENCY FOR DDKY & DENTAL CHOICE KY N/A C 0 OMEGA ADMINISTRATORS INC 1513 COUNTRY CLUB ROAD SHERWOOD AR 72120 043740469 PROVIDING THIRD-PARTY ADMINISTRATIVE SERVICES AR N/A C 0 THE 4100 GROUP 4100 OKEMOS ROAD OKEMOS MI 48864 472557772 INVESTMENT IN SUBSIDIARIES MI N/A C 0 DEWPOINT INC 300 S WASHINGTON SQUARE LANSING MI 48933 383300595 IT CONSULTING MI N/A C 0 DENTAL CHOICE ANCILLARY INC 10100 LINN STATION RD SUITE 700 LOUISVILLE KY 402233861 881391091 PROVIDE DENTAL SERVICE PLANS KY N/A C 0 ANCILLARY CHOICE LIFE INC 10100 LINN STATION RD SUITE 700 LOUISVILLE KY 402233861 880574945 INSURANCE KY N/A C 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 DELTA DENTAL FUND B 400000 ACTUAL COST DELTA DENTAL PLAN OF MICHIGAN INC M 6860299 ACTUAL COST RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA M 1133432 ACTUAL COST DELTA DENTAL OF TENNESSEE M 169723 ACTUAL COST