2024-11-13T14:53:09-06:00 2023-12-31 381357951 PLANTE & MORAN PLLC 1111 MICHIGAN AVE STE 100 EAST LANSING MI 48823 990 2023-01-01 381675667 RENAISSANCE HEALTH SERVICE CORPORATION (FORMERLY DELTA HEALTH PLAN INC) RENA 5173496000 PO BOX 30416 LANSING MI 489097916 AMY BASEL CHIEF FINANCIAL OFFICER 5173496000 2024-11-11 1 1 DAVID LOWENTHAL P00378651 5173326200 2024-11-11 2023 2024-10-15 13:58:12Z GORAN JURKOVIC PO BOX 30416 LANSING MI 489097916 3485348 0 X WWW.RENAISSANCEFAMILY.COM X 1968 MI RENAISSANCE HEALTH SERVICE CORPORATION'S MISSION HAS ALWAYS BEEN TO VIGOROUSLY PROMOTE THE IMPORTANCE OF ORAL HEALTH AS AN ESSENTIAL PART OF OVERALL HEALTH BY OFFERING UNMATCHED QUALITY, INNOVATION AND VALUE IN OUR DENTAL HEALTH PROGRAMS AND SERVICES. 13 13 0 0 0 0 390199 488912 0 0 1358649 507597 0 0 1748848 996509 0 0 0 0 0 0 0 0 0 579813 780304 579813 780304 1169035 216205 20180773 22681194 153806 470665 20026967 22210529 X RENAISSANCE HEALTH SERVICE CORPORATION'S MISSION HAS ALWAYS BEEN TO BE THE LEADER IN OUR MARKETS, TO DELIVER UNMATCHED QUALITY AND VALUE IN OUR PROGRAMS AND SERVICES, AND TO VIGOROUSLY PROMOTE THE IMPORTANCE OF ORAL HEALTH AS AN ESSENTIAL PART OF OVERALL HEALTH. 0 0 488912 TO INNOVATE AND CONDUCT PROGRAMS FOR DENTAL CARE AND MAKE AVAILABLE ON A BROAD SCALE, THE BENEFITS OF THE SCIENCE OF DENTISTRY TO MEMBERS OF THE PUBLIC AND TO PROMOTE AND ADVANCE RESEARCH, STUDY AND LEARNING IN THE FIELD OF DENTISTRY AND RELATED SERVICES.RENAISSANCE HEALTH SERVICE CORPORATION AND AFFILIATES PROCESSED OVER 27 MILLION CLAIMS AND PROVIDED DENTAL COVERAGE FOR 15 OVER MILLION PEOPLE IN 2023.SEE CONTINUATION ON SCHEDULE ORENAISSANCE HEALTH SERVICE CORPORATION PROVIDES FUNDING TO SUPPORT RESEARCH FOCUSED ON ORAL HEALTH AND THE USE OF BIOTECHNOLOGY AND GENETIC TOOLS FOR CUTTING-EDGE DIAGNOSIS AND TREATMENT OF DISEASES. 488912 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 20 0 1 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X AMY BASEL CHIEF FINANCIAL OFFICER 5173496000 4100 OKEMOS ROAD OKEMOS MI 48864 X CHRISTOPHER TODD FISHER DIRECTOR 5.00 10.00 X 24996 142008 0 SARA DOLAN CHAIR 5.00 5.00 X X 30000 112008 0 MELISSA STOLICKER VICE CHAIR 5.00 5.00 X X 27504 121008 0 WAYNE CALLAHAN DIRECTOR - PART YEAR 5.00 0.00 X 10415 52293 0 STEPHEN A EKLUND DDH MHSA DRPH DIRECTOR 5.00 6.00 X 24996 62000 0 JAMES STAHL DDS DIRECTOR - PART YEAR 5.00 5.00 X 10415 20835 0 KELLY J SCHEIDERER RHIA MHA DIRECTOR 5.00 6.00 X 24996 62000 0 SARAH CLARK DIRECTOR 5.00 0.00 X 24996 54993 0 FRANK BUZAKI JR DIRECTOR 5.00 5.00 X 24996 25834 22500 CAROLE SIMONETTI WATKINS DIRECTOR 5.00 6.00 X 24996 46331 0 JAMES D TRUJILLO DIRECTOR - PART YEAR 5.00 5.00 X 10415 8333 0 J DAVID SMITH JR DIRECTOR 5.00 4.00 X 24996 21700 0 JAMES R ROSE JR DIRECTOR 5.00 2.00 X 24996 37000 0 MARTIN D ROBINSON DIRECTOR 5.00 1.00 X 24996 25252 0 PHILLIP W COX CPA DIRECTOR 5.00 0.00 X 16664 42220 0 CHRISTINE NATHE RHD MS DIRECTOR 5.00 5.00 X 16664 18750 0 GORAN M JURKOVIC CPA PRESIDENT & CEO 2.00 48.00 X 0 9219805 2613720 AMY L BASEL CPA CHIEF FINANCIAL OFFICER & TREASURER 2.00 48.00 X 0 2381009 644559 SUE ELLEN JENKINS CHIEF LEGAL OFFICER & SECRETARY 5.00 45.00 X 0 1632671 426193 347041 14086050 3706972 0 0 1 0 0 488912 488912 633635 633635 2362801 2488839 -126038 -126038 -126038 996509 0 0 507597 18324 18324 160400 160400 58113 58113 10178 10178 12197 12197 6516 6516 RESEARCH & DEVELOPMENT 488912 488912 REGULATORY FEES 13483 13483 DEFERRED COMPENSATION 12181 12181 780304 488912 291392 0 402904 242913 3477462 3910059 95916 111194 15944694 17919684 127500 127500 132297 369844 20180773 22681194 49363 345519 104443 125146 153806 470665 X 20026967 22210529 20026967 22210529 20180773 22681194 X 216205 1955176 12181 X 0 1 X 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DEFERRED COMPENSATION 111194 INTERCOMPANY PAYABLE 13952 125146 0 1 0 0 0 0 0 0 0 GORAN M JURKOVIC CPA PRESIDENT & CEO 0 1474566 0 3570478 0 4174761 0 2588461 0 25259 0 11833525 0 4141456 AMY L BASEL CPA CHIEF FINANCIAL OFFICER & TREASURER 0 528195 0 886909 0 965905 0 619300 0 25259 0 3025568 0 938703 SUE ELLEN JENKINS CHIEF LEGAL OFFICER & SECRETARY 0 542025 0 949448 0 141198 0 419012 0 7181 0 2058864 0 115832 CHRISTOPHER TODD FISHER DIRECTOR 24996 142008 0 0 0 0 0 0 0 0 24996 142008 0 0 PART I, LINE 3 THE CEO IS A W-2 EMPLOYEE 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, AMY BASEL, AND SUE ELLEN JENKINS ACCRUED BENEFITS AS PARTICIPANTS IN THE SERP PLAN. GORAN JURKOVIC, AMY BASEL, AND SUE ELLEN JENKINS 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 DEFERRED ON PRIOR FORM 990S. 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 ON A SECURE PORTAL FOR THE BOARD TO REVIEW, PRIOR TO THE 990 BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE COMPANY'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 15 COMPENSATION OF THE CEO IS DETERMINED BY THE COMPENSATION COMMITTEE OF A RELATED ORGANIZATION, DELTA DENTAL PLAN OF MICHIGAN. COMPENSATION OF THE OTHER EXECUTIVES IS DETERMINED BY THE CEO IN CONSULTATION WITH THE VP OF HUMAN RESOURCES AND THE EXECUTIVE VP, CHIEF LEGAL OFFICER, AND CAO OF THE RELATED ORGANIZATION. 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 AND OTHERS AS APPROPRIATE. THE RELATED ORGANIZATION CONTRACTS WITH TOWERS WATSON TO DO A COMPENSATION AND REASONABLENESS ANALYSIS EVERY TWO YEARS. 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. COMPENSATION DECISIONS ARE MADE UTILIZING THE DATA PROVIDED BY TOWERS WATSON. 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 XI, LINE 9: CHANGE IN DEFERRED COMPENSATION ACCOUNT ACTIVITY 12,181. FORM 990, PART IX, LINE 5: THE MAJORITY OF MEMBERS ARE ALSO MEMBERS OF BOARDS OF RELATED ORGANIZATIONS. IN THESE CASES, MEMBER COMPENSATION IS REIMBURSED BY THE RELATED ORGANIZATION TO RHSC. 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