2023-11-14T10:39:27-07:00 2022-12-31 990 2022-01-01 710561140 DELTA DENTAL PLAN OF ARKANSAS INC DELT 5018353400 1513 Country Club Road Sherwood AR 72120 Deborah Ann Lowtharp VP Finance and CFO 5019921616 2023-11-13 1 1 11 0 AAL2 X 2022 2023-04-26 12:10:37Z Deborah Lowtharp 1513 Country Club Rd Sherwood AR 72120 249493225 0 X www.deltadentalar.com X 1982 AR See Schedule O. 13 10 259 0 13716578 2551441 0 0 222741466 228070721 7996995 7933 13579413 14295407 244317874 242374061 2984876 3808983 165316088 164357010 22865579 22603991 0 0 0 37361363 40231466 228527906 231001450 15789968 11372611 185482857 184568310 32231227 34237615 153251630 150330695 Promote oral health and vision health in the state of Arkansas and to improve the awareness and education of the public on oral and vision health matters. 0 0 201940350 0 242374061 Promote the oral health care of the community through group and individual dental insurance contracts and third party dental claims administration 0 0 0 201940350 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 1 69790 0 1 259 1 1 1 0 0 0 0 0 0 0 X 13 10 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Deborah Lowtharp 5019921634 1513 Country Club Road Sherwood AR 72120 Kristin Merlo President & CEO 60 0 X 623711 0 171312 Ed Choate President & CEO 60 0 X X 748412 0 3342 Bradley Clothier VP, CGO 60 0 X 583657 0 162922 James Couch SVP &COO 60 0 X 531763 0 11424 Deborah Lowtharp VP, Finance/CFO 60 0 X 335372 0 59586 Thomas Redd VP, Professional Relations 60 0 X 313235 0 51349 Jimmy Anthony VP, Operations 60 0 X 302097 0 54834 Dave Hawsey VP, Marketing 60 0 X 249431 0 49146 Niki Carter Dental Director & Manager, Professional Relations 40 0 X 250144 0 38778 Dr Troy John Dryden Bartels Director 8 0 X 323722 0 -36466 Kathleen Mehdizadegan VP & General Counsel 60 0 X 229829 0 38029 Michael Stephens Director, Planning & Architecture 40 0 X X 211441 0 47145 Caleb Castleberry VP, Information Technology 60 0 X 192963 0 44937 Kathleen Smith Dental Consultant 40 0 X 175732 0 31951 Christina Jennings Executive Director, Foundation 40 0 X X 192481 0 12255 Nader Alley Director 8 0 X 173468 0 15563 Robert Jones Dental Consultant 40 0 X 149446 0 21454 Jennifer Morales VP, Human Resources 60 0 X 126326 0 36311 Ebb Johnson VP, Executive Director, DDAR Foundation 0 0 X 160694 0 -1263 R Mark Bailey Director 8 0 X 136496 0 -2459 Elizabeth Jones Director, Medicaid Operations 60 0 X 75074 0 31035 Wayne Callahan Chairman 8 5 X 68155 24996 0 Sarah Clark Vice Chairman 8 5 X 48321 24996 0 Joe Thompson Director 8 0 X 46871 0 0 Tamika Edwards Director 8 0 X 41428 0 0 Paul Beahm Director 8 0 X 39168 0 0 Mark Langston Director 8 0 X 35828 0 0 Dr Mel Collazo Director 8 0 X X 34368 0 0 Cindy Boyle Secretary 8 0 X 23076 0 -2583 Arnoud Krijt Treasurer 8 0 X 25206 0 -6132 Desiree Dare Director 8 0 X 4073 0 0 Phillip Cox Director 8 0 X 25251 0 -29412 6477239 49992 803058 41 1 1 0 Rock Dental Arkansas PLLC PO Box 3450 Little Rock AR 722033450 Dental Services 17642303 Delta Dental Plan of Michigan PO Box 30381 Lansing MI 48909 Dental Processing Services 11301254 Sanders Tompkins Schiro and Landers PLLC 1607 E Rainforest Rd Fayetteville AR 727035385 Dental Services 4542253 SMILES OF ARKANSAS DENTAL CENTER 110 W 18th St Hope AR 71801 Dental Services 2495018 ARKANSAS DENTAL PROFESSIONALS Mongrain PA 3801 Woodland Heights Ste 175 Little Rock AR 72212 Dental Services 2177458 636 0 Dental Benefit 524298 211895399 211895399 0 0 Dental ASC & Admin Income 524298 16175322 16175322 0 0 0 0 0 0 228070721 1450008 0 0 1450008 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6509666 -832577 7119164 0 -609498 -832577 -1442075 -832577 0 -609498 Vision Benefits 524298 13716578 0 13716578 0 Other Income 900099 578829 0 0 578829 0 0 0 0 14295407 242374061 227238144 13716578 1419339 3808983 3808983 0 0 0 0 164357010 164357010 4883273 0 4883273 0 0 0 0 0 12043022 7225813 4817209 0 1543429 0 1543429 0 2982741 1789645 1193096 0 1151526 0 1151526 0 707168 424301 282867 0 742433 0 742433 0 401640 0 401640 0 137000 0 137000 0 0 0 245460 0 245460 0 13483980 12135582 1348398 0 804187 0 804187 0 3000543 1800326 1200217 0 9179346 8261411 917935 0 0 0 0 0 628904 0 628904 0 420155 252093 168062 0 0 0 0 0 148702 133832 14870 0 0 0 0 0 641360 0 641360 0 1751354 1751354 0 0 255868 0 255868 0 Taxes 4325611 0 4325611 0 Program HEART 2523936 0 2523936 0 BOD Expenses 612840 0 612840 0 Business Transformation 92430 0 92430 0 128549 0 128549 0 231001450 201940350 29061100 0 9812841 12566192 27538572 29974283 0 7286688 7277977 2000000 1085603 1233700 30519136 6757185 28386879 23761951 79424969 77152214 28798927 27082056 3148378 3519937 185482857 184568310 23226693 25116247 2894202 2879964 6110332 6241404 32231227 34237615 X 153251630 150330695 0 0 153251630 150330695 185482857 184568310 11372611 -14539007 0 245461 0 0 X 0 1 X 1 0 0 2154359 2154359 0 21961705 3302797 18658908 0 0 0 0 0 3414612 2299040 1115572 0 2988460 1155348 1833112 23761951 0 F 26053619 F CapRocq2 Core Real Estate Fund 1028437 F 27082056 0 Payable to Affiliates 3645982 Prefund Deposits and Refund Checks 2595422 6241404 X Schedule D, Part X, Line 2 Not Applicable 0 Baptist Health Foundation 9601 I 630 Exit 7 Little Rock AR 72205 237169407 15750 0 General Support Arkansas Sports Hall of Fame 3 Simmons Bank Arena Drive North Little Rock AR 72114 237173855 12500 0 General Support Mid-America Science Museum 500 Mid America Boulevard Hot Springs AR 71913 202129318 8000 0 General Support Women and Children First PO Box 1954 Little Rock AR 72203 710513011 6000 0 General Support Centers for Youth & Family PO BOX 251801 Little Rock AR 72225 710826334 5100 0 General Support 5 0 Schedule I, Part I, Line 2 None X X X X 1 1 0 0 0 1 0 0 0 Kristin Merlo President & CEO 555704 0 55168 0 12840 0 150644 0 20668 0 795024 0 0 0 Ed Choate President & CEO 84402 0 266146 0 397865 0 2137 0 1206 0 751756 0 397865 0 Bradley Clothier VP, CGO 360211 0 187823 0 35623 0 152200 0 10722 0 746579 0 0 0 James Couch SVP &COO 136858 0 90848 0 304058 0 4629 0 6795 0 543188 0 122535 0 Deborah Lowtharp VP, Finance/CFO 252735 0 82637 0 0 0 38918 0 20668 0 394958 0 0 0 Thomas Redd VP, Professional Relations 238138 0 75097 0 0 0 36202 0 15146 0 364583 0 0 0 Jimmy Anthony VP, Operations 223439 0 78658 0 0 0 34166 0 20668 0 356931 0 0 0 Dave Hawsey VP, Marketing 188976 0 60456 0 0 0 28478 0 20668 0 298578 0 0 0 Niki Carter Dental Director & Manager, Professional Relations 211134 0 39011 0 0 0 31459 0 7319 0 288923 0 0 0 Dr Troy John Dryden Bartels Director 23943 0 0 0 299779 0 -36466 0 0 0 287256 0 0 0 Kathleen Mehdizadegan VP & General Counsel 168313 0 61516 0 0 0 25271 0 12758 0 267858 0 0 0 Michael Stephens Director, Planning & Architecture 173104 0 38336 0 0 0 26477 0 20668 0 258585 0 0 0 Caleb Castleberry VP, Information Technology 159790 0 33174 0 0 0 24269 0 20668 0 237901 0 0 0 Kathleen Smith Dental Consultant 167465 0 8267 0 0 0 24632 0 7319 0 207683 0 0 0 Christina Jennings Executive Director, Foundation 127408 0 25073 0 40000 0 5100 0 7155 0 204736 0 0 0 Nader Alley Director 17028 0 0 0 156441 0 15563 0 0 0 189032 0 0 0 Robert Jones Dental Consultant 142106 0 7340 0 0 0 20676 0 778 0 170900 0 0 0 Jennifer Morales VP, Human Resources 106767 0 19559 0 0 0 15643 0 20668 0 162637 0 0 0 Ebb Johnson VP, Executive Director, DDAR Foundation 0 0 0 0 160694 0 -1263 0 0 0 159431 0 0 159431 Elizabeth Jones Director, Medicaid Operations 71085 0 3989 0 0 0 10367 0 20668 0 106109 0 0 0 Schedule J, Part I, Line 4 a. James Couch - $181,523; Christina Jennings - $40,000 b. CEO & SVP participate in 457f plan. Schedule J, Part I, Line 6 Delta Dental accrues and pays an annual bonus to officers based partially on net earnings of the organization along with other factors. Troy Bartels Board of Director 299779 Independent Contractor Agreement 0 Nader Alley Board of Director 156411 Independent Contractor Agreement 0 Mark Bailey Board of Director 107546 Independent Contractor Agreement 0 Form 990, Part I, Line 1 Form 990, Part I, Line 1 - At Delta Dental of Arkansas, we are the champions of smiles. We're a local, not-for-profit service corporation headquartered in Sherwood, AR, since, 1982, whose mission is to improve the oral health of all Arkansans. We strive to provide comprehensive dental and vision insurance plans that are affordable plus deliver industry-leading technology and world-class customer service to our members, business clients, and dental service providers. Delta Dental of Arkansas is the state's largest dental benefits administrator and our unmatched expertise in providing and managing dental benefits is why over 4,000 Arkansas companies have chosen us to be their dental benefits provider. At the end of 2022, we were helping more than 800,000 Arkansans and a total of 2.2 million lives nationwide keep their smiles healthy through our commercial, Medicare Advantage, and Medicaid coverage. We offer individuals, families and businesses access to the state's (and country's) most extensive network of dentists - including 94% of all licensed and practicing dentists in Arkansas. Our highly-skilled customer service team is available to assist members from 7 a.m. - 7p.m., with 99% of inquiries resolved on the first call. Delta Dental of Arkansas continues to make a difference beyond the walls of our business. Our philanthropic corporate and Foundation work, benefits and reaches all Arkansans - even those who aren't members. Since 2003, Delta Dental of Arkansas has contributed over $25 million to oral health initiatives in dental education, prevention, and treatment for Arkansas. Most notably, our Foundation has invested over $7 million to fund startup costs to fluoridate Arkansas's community water systems growing the percentage of Arkansas enjoying the benefits of community water fluoridation from 65% to over 90%. Form 990, Part VI, Section A, Line 6 The organization has one corporate member -Renaissance Health Service Corporation Form 990, Part VI, Section A, Line 7a The directors shall be elected at the annual meeting of the members, consistent with the terms and conditions of any and all voting agreements, proxies and/or affiliation agreements entered into by the corporation and any other party or parties, then in effect with an affiliation corporation. Form 990, Part VI, Section B, Line 11b The information presented on the form 990 is gathered by the Senior Financial and Regulatory Accountant for the organization. The VP of Finance/CFO reviews the information. Once complete, an electronic copy of the form 990 is posted to our board's review prior to being filed with the IRS. Form 990, Part VI, Section B, Line 12c Each interested person shall sign an annual certification affirming (1) receipt of the conflict of interest (2) the policy and code of conduct has been read and understood (3) agreement to comply with policy and code of conduct. In addition, interested parties shall be required to annually complete and file an annual disclosure statement within one month of the date of request. Annual disclosure statements and any subsequent amendments are reviewed by the governance committee in conjunction with legal counsel, and a report of disclosed conflicts are made to Delta Dental's board of directors. Periodic reviews are also performed to ensure Delta Dental operates in accordance with the conflict of interest policy. Form 990, Part VI, Section B, Line 15 The compensation of the organizations CEO is reviewed annually by the compensation committee. The compensation committee consists of board members, none of who have a conflict with respect to the compensation of officers. On a bi-annual basis, the compensation committee reviews market pricing and benchmarking data for the compensation of the leadership team and staff. The analysis, from a variety of national, regional and local compensation surveys include the use of data as to comparable compensation for similarly situated organizations and reviews annual base salary compensation, incentive/bonus compensation, deferred compensation and benefits. The data meets the compensation philosophy and strategic plan as determined and approved by the board of directors. The documented results and recommendation of the analysis are presented to the compensation committee and board of directors. Form 990, Part VI, Section C, Line 19 Governing documents, conflicts of interest policies, and financial statements are available to the public upon request. Delta Dental of Arkansas Foundation 1513 Country Club Road Sherwood AR 72120 261569324 Public Act AR 501(c)(3) PF Delta Dental of Arkansas 1 Delta Dental of Arkansas Political Action Committee 1513 Country Club Road Sherwood AR 72120 273207545 Pol Action AR 527 Not applicable N/A 0 Renaisssance Health Service Corporation PO Box 30416 Lansing MI 489097916 381675667 Dental Health Coverage MI N/A 0 Delta Dental Plan of Michigan PO Box 30381 Lansing MI 48909 381791480 Dental Insurance MI Renaissance Health Service Corporation 0 Omega Administrators Inc 1513 Country Club Road Sherwood AR 72120 043740469 Claims Adm AR Delta Dental of Arkansas C 1 1 Renaissance Holding Company PO Box 30381 Lansing MI 48909 412177193 Holding Company MI N/A C 25971683 0.132 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 Delta Dental of Arkansas Foundation b 3694108 Cash Delta Dental Plan of Michigan m 11301254 Cash Renaissance Holding Company m 77306 Cash