2024-11-14T12:26:12-06:00 2023-12-31 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2023-01-01 710561140 DELTA DENTAL PLAN OF ARKANSAS INC DELT 5018353400 1513 COUNTRY CLUB ROAD SHERWOOD AR 72120 DEBORAH LOWTHARP VP FINANCE AND CFO 5018353400 2024-11-14 1 1 DAVID LOWENTHAL P00378651 3122071040 2024-11-14 2023 2024-10-15 13:58:12Z DEBORAH LOWTHARP 1513 COUNTRY CLUB ROAD SHERWOOD AR 72120 281995928 0 X WWW.DELTADENTALAR.COM X 1982 AR SEE SCHEDULE O 13 10 252 0 14145342 1326134 0 0 228070721 237813728 7933 2746805 14295407 541362 242374061 241101895 3808983 3748366 164357010 163055678 22603991 23996211 0 0 0 40231466 50044136 231001450 240844391 11372611 257504 184568310 189052654 34237615 29938664 150330695 159113990 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 201962214 3748366 223668386 PROMOTE THE ORAL HEALTH CARE OF THE COMMUNITY THROUGH GROUP AND INDIVIDUAL DENTAL INSURANCE CONTRACTS AND THIRD PARTY DENTAL CLAIMS ADMINISTRATION. 201962214 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 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 67680 0 1 252 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 DR TROY JOHN DRYDEN BARTELS DIRECTOR 8.00 0.00 X 285561 0 83937 R MARK BAILEY DIRECTOR 8.00 0.00 X 116817 0 26173 SARAH CLARK CHAIRMAN 8.00 5.00 X X 54993 24996 0 WAYNE CALLAHAN DIRECTOR 8.00 5.00 X 52293 10415 0 TAMIKA EDWARDS DIRECTOR 8.00 0.00 X 42315 0 0 JOE THOMPSON DIRECTOR 8.00 0.00 X 49195 0 0 PHILLIP COX VICE CHAIR 8.00 5.00 X X 19720 16664 59374 CINDY BOYLE SECRETARY 8.00 0.00 X X 19690 0 44367 NED ALLEY DIRECTOR 8.00 0.00 X 195907 0 30185 MARK LANGSTON DIRECTOR 8.00 0.00 X 36258 0 0 PAUL BEAHM DIRECTOR 8.00 0.00 X 31618 0 0 DESIREE DARE DIRECTOR 8.00 0.00 X 35368 0 0 ARNOUD KRIJT TREASURER 8.00 0.00 X X 19915 0 53534 KRISTIN MERLO PRESIDENT & CEO 60.00 0.00 X 924833 0 195858 BRADLEY CLOTHIER EVP & COO 60.00 0.00 X 633666 0 126747 DEBORAH LOWTHARP VP, FINANCE/CFO 60.00 0.00 X 368692 0 102277 THOMAS REDD VP, PROFESSIONAL RELATIONS 60.00 0.00 X 362194 0 52752 JIMMY ANTHONY VP, STRATEGIC CUSTOMER SOLUTIONS 60.00 0.00 X 326860 0 97417 KATIE MEHDIZADEGAN VP & GENERAL COUNSEL 60.00 0.00 X 273446 0 52591 DAVE HAWSEY VP, MARKETING 60.00 0.00 X 269684 0 51135 JENNIFER MORALES VP, HUMAN RESOURCES 60.00 0.00 X 193652 0 46302 CALEB CASTLEBERRY VP, IT - PART YEAR 60.00 0.00 X 192838 0 10718 ELIZABETH JONES DIRECTOR, MEDICAID OPERATIONS 60.00 0.00 X 112338 0 34922 NIKI CARTER DENTAL DIR & MANAGER, PROF. RELATIONS 40.00 0.00 X 279709 0 40045 KATHLEEN SMITH DENTAL CONSULTANT 40.00 0.00 X 181839 0 32215 ROBERT JONES DENTAL CONSULTANT 40.00 0.00 X 153854 0 22278 JEB STEEN MANAGER, SALES 40.00 0.00 X 175319 0 34279 TOMMY SORROWS MANAGER, APP & REPORTING 40.00 0.00 X 150504 0 33578 JAMES COUCH FORMER SVP & COO 0.00 0.00 X 113452 0 0 EBB JOHNSON FORMER VP, EX. DIRECTOR, DDAR FOUND. 0.00 0.00 X 104322 0 0 5776852 52075 1230684 45 1 1 0 ROCK DENTAL ARKANSAS PLLC PO BOX 3450 LITTLE ROCK AR 72203 DENTAL SERVICES 17851696 DELTA DENTAL PLAN OF MICHIGAN PO BOX 30381 LANSING MI 48909 DENTAL PROCESSING SERVICES 14096081 SANDERS TOMPKINS SCHIRO LANDERS AND SAND 1607 E RAINFOREST RD FAYETTEVILLE AR 72703 DENTAL SERVICES 4852129 SMILES OF ARKANSAS DENTAL CENTER 110 W 18TH ST HOPE AR 71801 DENTAL SERVICES 2471413 BILLY RANDALL MACHEN DDS PA 4220 N RODNEY PARHAM RD LITTLE ROCK AR 72212 DENTAL SERVICES 2176460 637 DENTAL BENEFIT 524298 206304243 206304243 DENTAL ASC & ADMIN INCOME 524298 17364143 17364143 VISION BENEFIT 524298 14145342 14145342 237813728 2926409 2926409 40714429 40894033 -179604 -179604 -179604 541362 541362 541362 241101895 223668386 14145342 3288167 3748366 3748366 163055678 163055678 4318407 4318407 12832943 7699766 5133177 2282522 2282522 3450187 2070112 1380075 1112152 1112152 388057 232834 155223 2880943 2880943 236035 236035 144000 144000 291166 291166 13640522 12276470 1364052 1025602 1025602 2961442 1776865 1184577 9939654 8945689 993965 624153 624153 398790 239274 159516 211359 190223 21136 670621 670621 1612190 1612190 217669 217669 FEDERAL INCOME TAX 598352 598352 PROGRAM HEART 9617672 9617672 TAXES, LICENSES AND FEE 3810679 3810679 BOD EXPENSES 638159 638159 137071 114747 22324 240844391 201962214 38882177 0 12566192 11344571 29974283 25969808 7277977 8253479 2000000 2305494 1233700 1895094 30880350 8300510 23761951 22579840 77152214 83983393 27082056 27702940 3519937 5018035 184568310 189052654 25116247 22217420 2879964 2922122 6241404 4799122 34237615 29938664 X 150330695 159113990 150330695 159113990 184568310 189052654 X 257504 8455505 70286 X 0 1 X 1 0 2154359 2154359 21961706 3861468 18100238 3779836 2886125 893711 2984449 1552917 1431532 22579840 26674503 F INVESTMENT IN CAPROCQ CORE REAL ESTATE FUND, LP 1028437 F 27702940 PREFUND DEPOSITS AND REFUND CHECKS 2788422 PAYABLE TO AFFILIATES 2010700 4799122 0 AMERICAN RED CROSS PO BOX 37839 BOONE IA 50037 237169407 501(C)(3) 50000 0 GENERAL SUPPORT ARKANSAS SPORTS HALL OF FAME 3 SIMMONS BANK ARENA DR NORTH LITTLE ROCK AR 72114 201957993 501(C)(3) 12500 0 GENERAL SUPPORT ARKANSAS WRESTLING ASSOCIATION PO BOX 3505 LITTLE ROCK AR 72203 202129318 501(C)(3) 30000 0 GENERAL SUPPORT BAPTIST HEALTH FOUNDATION 9601 I 630 EXIT 7 LITTLE ROCK AR 72205 300034070 501(C)(3) 10750 0 GENERAL SUPPORT MID-AMERICA SCIENCE MUSEUM 500 MID AMERICA BOULEVARD HOT SPRINGS AR 71913 710513011 501(C)(3) 20700 0 GENERAL SUPPORT OUR HOUSE PO BOX 34155 LITTLE ROCK AR 72203 710208511 501(C)(3) 5500 0 GENERAL SUPPORT THE BROYLES FOUNDATION PO BOX 8370 FAYETTEVILLE AR 72703 716056774 501(C)(3) 7500 0 GENERAL SUPPORT THEA FOUNDATION 401 MAIN STREET STE 100 NORTH LITTLE ROCK AR 72114 710239729 501(C)(3) 10000 0 GENERAL SUPPORT DELTA DENTAL OF ARKANSAS FOUNDATION INC 1513 COUNTRY CLUB RD SHERWOOD AR 72120 261569324 501(C)(3) 3570334 0 GENERAL SUPPORT 9 0 X X X X 1 1 0 0 0 0 0 1 0 KRISTIN MERLO PRESIDENT & CEO 600356 0 311637 0 12840 0 174566 0 21292 0 1120691 0 0 0 BRADLEY CLOTHIER EVP & COO 465449 0 168217 0 0 0 120029 0 6718 0 760413 0 0 0 DEBORAH LOWTHARP VP, FINANCE/CFO 273091 0 95601 0 0 0 80985 0 21292 0 470969 0 0 0 JIMMY ANTHONY VP, STRATEGIC CUSTOMER SOLUTIONS 241876 0 84984 0 0 0 76125 0 21292 0 424277 0 0 0 THOMAS REDD VP, PROFESSIONAL RELATIONS 252597 0 109597 0 0 0 37496 0 15256 0 414946 0 0 0 DR TROY JOHN DRYDEN BARTELS DIRECTOR 19838 0 0 0 265723 0 83937 0 0 0 369498 0 0 0 KATIE MEHDIZADEGAN VP & GENERAL COUNSEL 209992 0 63454 0 0 0 31364 0 21227 0 326037 0 0 0 DAVE HAWSEY VP, MARKETING 198550 0 71134 0 0 0 29843 0 21292 0 320819 0 0 0 NIKI CARTER DENTAL DIR & MANAGER, PROF. RELATION 223507 0 56202 0 0 0 33327 0 6718 0 319754 0 0 0 JENNIFER MORALES VP, HUMAN RESOURCES 165964 0 27688 0 0 0 25010 0 21292 0 239954 0 0 0 NED ALLEY DIRECTOR 15488 0 0 0 180419 0 30185 0 0 0 226092 0 0 0 KATHLEEN SMITH DENTAL CONSULTANT 172831 0 9008 0 0 0 25497 0 6718 0 214054 0 0 0 JEB STEEN MANAGER, SALES 93994 0 81325 0 0 0 12987 0 21292 0 209598 0 0 0 CALEB CASTLEBERRY VP, IT - PART YEAR 57135 0 60703 0 75000 0 2412 0 8306 0 203556 0 0 0 TOMMY SORROWS MANAGER, APP & REPORTING 131522 0 18982 0 0 0 17917 0 15661 0 184082 0 0 0 ROBERT JONES DENTAL CONSULTANT 146422 0 7432 0 0 0 21477 0 801 0 176132 0 0 0 JAMES COUCH FORMER SVP & COO 0 0 0 0 113452 0 0 0 0 0 113452 0 0 0 EBB JOHNSON FORMER VP, EX. DIRECTOR, DDAR FOUND. 0 0 0 0 104322 0 0 0 0 0 104322 0 104322 0 PART I, LINES 4A-B LINE 4A: IN 2023, CALEB CASTLEBERRY RECIEVED A SEVERANCE PAYMENT IN THE AMOUNT OF $75,000 AND JAMES COUCH RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $113,452. LINE 4B: 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 2023, KRISTIN MERLO, DEBORAH LOWTHARP, BRAD CLOTHIER AND JIMMY ANTHONY ACCRUED BENEFITS AS A PARTICIPANT IN THE PLAN, BUT DID NOT RECEIVE A DISTRIBUTION. PART I, LINE 7 DELTA DENTAL ACCRUES AND PAYS AN ANNUAL BONUS TO OFFICERS BASED ON A VARIETY OF PERFORMANCE FACTORS INCLUDING THE PROFITABILITY OF THE ORGANIZATION. TROY BARTELS BOARD OF DIRECTOR 265723 INDEPENDENT CONTRACTOR AGREEMENT 0 NADER ALLEY BOARD OF DIRECTOR 180419 INDEPENDENT CONTRACTOR AGREEMENT 0 MARK BAILEY BOARD OF DIRECTOR 95394 INDEPENDENT CONTRACTOR AGREEMENT 0 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 ADMINSTRATOR 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 2023, 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 EXTENSION 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. - 7 P.M., WITH 99% OF INQUIRIES RESOLVED ON THE FIRST CALL. DELTA DENTAL OF ARKANSAS CONTINUES TO MAKE A DIFFERENCE BEYONCE 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 $27 MILLION IN SUPPORT OF ORAL HEALTH EDUCATION, PREVENTION, AND TREATMENT PROGRAMS ACROSS ARKANSAS. 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 CORORATION. 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 AMENDEMENTS ARE REVIEWED BY THE GOVERNANCE COMMITTEE IN CONJUNCTION WITH LEGAL COUNSEL, AND A REPORT OF DISCLOSED CONFLICTS ARE MADE TO DELTA DENTA'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 ORGANIZATION'S 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 OF 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 COMPARE 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 DOCUMENTS 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. FORM 990, PART XI, LINE 9: GAIN IN EQUITY SUBSIDY 70,286. DELTA DENTAL FUND PO BOX 30416 LANSING MI 48909 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 ROAD SHERWOOD AR 72120 261569324 EMPHASIZE DENTAL HEALTH IN COMMUNITIES AR 501(C)(3) PF DELTA DENTAL PLAN OF ARKANSAS 1 DELTA DENTAL OF ARKANSAS POLITICAL ACTION COMMITTEE 1513 COUNTRY CLUB ROAD SHERWOOD AR 72120 273207545 POL ACTION AR 527 N/A N/A 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 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 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 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 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 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 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 RENAISSANCE HEALTH SERVICE CORPORATION PO BOX 30416 LANSING MI 48909 381675667 PROMOTING DENTAL CARE MI 501(C)(4) N/A N/A 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 OF NORTH CAROLINA 3737 GLENWOOD AVENUE SUITE 320 RALEIGH NC 27612 561018068 PROVIDE DENTAL SERVICE PLANS NC 501(C)(4) N/A RENAISSANCE HEALTH SERVICE CORPORATION 0 ARCIS FUND I LLC 300 WASHINGTON SQUARE SUITE 225 LANSING MI 48933 932945609 INVESTMENTS MI N/A 0 0 RED CEDAR INVESTMENT MANGAGEMENT LLC 333 BRIDGE STREET NW SUITE 601 GRAND RAPIDS MI 49546 462667997 CAPITAL MANAGEMENT MI N/A 0 0 T4G FINANCIAL SERVICES LLC 300 WASHINGTON SQUARE SUITE 225 LANSING MI 48933 921020583 FINANCIAL PLANNING MI N/A 0 0 T4G MANAGEMENT LLC 300 WASHINGTON SQUARE SUITE 225 LANSING MI 48933 884271021 FINANCIAL PLANNING MI N/A 0 0 OMEGA ADMINISTRATORS INC 1513 COUNTRY CLUB ROAD SHERWOOD AR 72120 043740469 PROVIDING THIRD-PARTY ADMINISTRATIVE SERVICES AR DELTA DENTAL PLAN OF ARKANSAS INC C 7357 589391 1.00000 1 RENAISSANCE HOLDING COMPANY PO BOX 30381 LANSING MI 48909 412177193 HOLDING COMPANY MI DELTA DENTAL OF MICHIGAN C -1553699 12567991 0.13200 0 RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA PO BOX 30381 LANSING MI 48909 470397286 INSURANCE IN RENAISSANCE HOLDING COMPANY C -160320 17803745 0.13200 0 RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF NEW YORK PO BOX 30381 LANSING MI 48909 134098096 INSURANCE NY RENAISSANCE HOLDING COMPANY C 94909 2206979 0.13200 0 FORE HOLDING CORPORATION 240 VENTURE CIRCLE NASHVILLE TN 37228 204116122 HOLDING COMPANY TN N/A C 0 DENTAL CHOICE INC 10100 LINN STATION RD 700 LOUISVILLE KY 402233861 611105118 PROVIDE DENTAL SERVICE PLANS KY N/A C 0 DENTAL CHOICE AGENCY INC 10100 LINN STATION RD 700 LOUISVILLE KY 402233861 611336003 PRIMARY GENERAL AGENCY FOR DDKY AND DENTAL CHOICE KY N/A C 0 THE 4100 GROUP 4100 OKEMOS ROAD OKEMOS MI 48864 472557772 INVESTMENT IN SUBSIDIARIES MI N/A C 0 DENTAL CHOICE ANCILLARY INC 10100 LINN STATION RD 700 LOUISVILLE KY 402233861 881391091 PROVIDE DENTAL SERVICE PLANS KY N/A C 0 ANCILLARY CHOICE LIFE INC 10100 LINN STATION RD 700 LOUISVILLE KY 402233861 880574945 INSURANCE KY N/A C 0 DYNTL INC 2800 WHITE OAK DR NASHVILLE TN 37215 934527543 DENTAL SERVICE TN N/A C 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 3570334 CASH DELTA DENTAL PLAN OF MICHIGAN M 8597582 CASH RENAISSANCE HOLDING COMPANY M 93850 CASH