2025-05-05T13:33:14-05:00 2024-12-31 450250958 EIDE BAILLY LLP 345 N REID PL STE 400 SIOUX FALLS SD 571037034 990 2024-01-01 460309258 DELTA DENTAL OF SOUTH DAKOTA DELT 6052247345 PO BOX 1157 PIERRE SD 57501 JEFFREY MILLER PRESIDENT/CEO 6052247345 2025-05-05 1 1 LAURIE HANSON CPA P00851848 6053391999 2025-05-05 2024 2025-03-06 01:10:19Z JEFFREY MILLER PO BOX 1157 PIERRE SD 57501 114262600 0 X WWW.DELTADENTALSD.COM X 1963 SD DEDICATED TO ADVANCING AND PROMOTING THE IMPROVEMENT OF ORAL HEALTH. 15 7 92 0 2057127 0 0 0 100500986 106983519 487953 1958776 2052288 1783882 103041227 110726177 1925486 2183547 0 0 8781802 9641505 0 0 0 93539225 100543651 104246513 112368703 -1205286 -1642526 45726829 45098602 9185933 10466631 36540896 34631971 DELTA DENTAL OF SOUTH DAKOTA IS DEDICATED TO ADVANCING AND PROMOTING THE IMPROVEMENT OF ORAL HEALTH. 0 0 100231613 2183547 106983519 DELTA DENTAL PAID THROUGH ITS CONTRACTS WITH INDEPENDENT DENTISTS 739,287 CLAIMS FOR DENTAL BENEFIT SERVICES FOR APPROXIMATELY 334,075 INDIVIDUALS WITH GROUP PLANS, 1,681 INDIVIDUALS WITH DENTAL ACCIDENT PLANS, 143,339 SOUTH DAKOTA MEDICAID RECIPIENTS, 9,490 MEDICARE ADVANTAGE ENROLLEES, AND 130,000 NATIVE AMERICANS UNDER GREAT PLAINS AREA INDIAN HEALTH SERVICES. DELTA DENTAL ALSO GRANTED THE DELTA DENTAL OF SOUTH DAKOTA FOUNDATION, A 501(C)(3) CHARITABLE ORGANIZATION, $1,245,148 TO PROMOTE THE IMPROVEMENT OF ORAL HEALTH. 100231613 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 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 4807 0 1 92 1 1 1 0 0 0 0 0 0 0 X 15 7 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X LAURIE MIKKONEN 6054942479 720 N EUCLID AVE PIERRE SD 57501 MONTY BECHTOLD DDS CHAIRMAN OF THE BOARD 2.00 1.00 X X 20069 0 0 THOMAS HUBER MD VICE CHAIRMAN OF BOARD 1.00 0.00 X X 11450 0 0 JOHN CLAUSEN CPA TREASURER 2.00 1.00 X X 15850 0 0 CHRIS MAXWELL SECRETARY 1.00 0.00 X X 10250 0 0 PAUL REZICH DDS DIRECTOR 1.00 1.00 X 11450 0 0 GREG GERTSEN DDS DIRECTOR (END MAY) 1.00 0.00 X 5000 1000 0 JEFF FEIOCK DDS DIRECTOR (END SEP) 1.00 0.00 X 6000 0 0 G VERNE GOODSELL DIRECTOR 1.00 0.00 X 11350 0 0 GREG HANSON DDS DIRECTOR 1.00 0.00 X 9850 23500 0 JASON AANENSON DDS DIRECTOR 1.00 0.00 X 9750 0 0 ELLEN LEE DIRECTOR (END MAY) 1.00 1.00 X 4600 0 0 ANLEE ROLA DDS DIRECTOR 1.00 1.00 X 9950 0 0 THANE CRUMP DDS DIRECTOR 1.00 1.00 X 9750 0 0 TOM SIMMONS DIRECTOR 1.00 0.00 X 9950 0 0 ROB WYLIE DIRECTOR 1.00 0.00 X 10350 0 0 STEPHANIE SCHMITZ DDS DIRECTOR (BEG SEP) 1.00 1.00 X 1600 0 0 STEPHANIE JUDSON DIRECTOR (BEG MAY) 1.00 0.00 X 5350 0 0 TRAVIS BJORDAHL DDS DIRECTOR (BEG MAY) 1.00 1.00 X 5350 0 0 JEFF MILLER PRESIDENT/CEO 40.00 1.00 X 554004 0 89490 LAURIE MIKKONEN CFO 40.00 0.00 X 256734 0 47290 KIRBY SCOTT VP OF FINANCE 40.00 0.00 X 310148 0 63341 MICK HECKENLIABLE VP OF OPERATIONS 40.00 0.00 X 231726 0 46611 GENE TETZLAFF VP OF IT 40.00 0.00 X 223080 0 79959 CONNIE HALVERSON VP OF PUBLIC BENEFIT 10.00 30.00 X 194255 0 67582 DAYNA HEPPER VP OF GROWTH & CUSTOMER EXPERIENCE 40.00 0.00 X 175906 0 50902 ANN SCHWARTZ VP OF PROVIDER SERVICES & GOVT PROGRAMS 40.00 0.00 X 172906 0 65336 JAMEY HERR DIRECTOR OF INFRASTRUCTURE & SECURITY 40.00 0.00 X 177000 0 43185 EUGENE CAMPBELL DIRECTOR OF DEVELOPMENT & MODERNIZATION 40.00 0.00 X 167369 0 49513 LORI HALL DIRECTOR OF CLAIMS PROCESSING 40.00 0.00 X 130075 0 26531 MARY WESTERN PROGRAMMER/ANALYST 40.00 0.00 X 126641 0 40921 SCOTT JONES FOUNDATION PRESIDENT 30.00 10.00 X 251945 0 72664 3139708 24500 743325 20 0 1 0 MIDWEST BENEFITS PO BOX 10481 DES MOINES IA 50306 COMMISSIONS 200000 MARSH & MCLENNAN AGENCY PO BOX 5113 SIOUX FALLS SD 57117 COMMISSIONS 151203 EIDE BAILLY PO BOX 5125 SIOUX FALLS SD 57117 ACCOUNTING SERVICES 146709 ACRIPOINT LLC PO BOX 218 PIERRE SD 57501 COMMISSIONS 128636 VYNE DENTAL 6510 TELECOM DRIVE SUITE 300 INDIANAPOLIS IN 64278 CLAIMS CLEARINGHOUSE 123108 6 PREMIUM EARNED 812900 106983519 106983519 106983519 1413952 1413952 38700 59811 -21111 -21111 -21111 4021436 3476612 544824 544824 544824 MANAGEMENT FEE INCOME 541610 2057127 2057127 SUBSIDIARY REVENUE 524114 -252134 -252134 1804993 110726177 106983519 2057127 1685531 2183547 2183547 2807602 2807602 3725419 3725419 1423708 1423708 1234835 1234835 449941 449941 202233 202233 146709 146709 66591 66591 624919 624919 465525 465525 796789 796789 384757 384757 81688 81688 84023 84023 246781 246781 317632 317632 287885 287885 CLAIMS INCURRED 91508526 91508526 MANAGEMENT SERVICE EXPE 2057127 2057127 COMMISSIONS 1756303 1756303 ALLOCATED CLAIMS ADJUST 0 4783237 -4783237 1516163 1516163 112368703 100231613 12137090 0 1661513 10960 256951 1158635 8283307 8997690 345704 484715 9154294 5808788 3431562 3345506 27241294 25761904 3320559 3969889 1185939 1369303 45726829 45098602 4882089 5138064 247134 4303844 5081433 9185933 10466631 X 36540896 34631971 36540896 34631971 45726829 45098602 -1642526 -266399 0 X 0 1 X 1 0 397371 397371 5166299 2647469 2518830 3590624 3161319 429305 3345506 INVESTMENT IN SPRINGROCK VENTURES II LP 3769889 F INVESTMENT IN WELLNESS 605, INC. 200000 F 3969889 ADMINISTRATIVE REIMBURSEMENT PAYABLE 196146 COST PLUS GROUP DEPOSITS 74100 DEFERRED PREMIUMS 1257211 UNPAID CLAIMS ADJUSTMENT EXPENSES 311300 UNPAID CLAIMS AND CLAIMS INCURRED BUT NOT REPORTED 3113000 RIGHT OF USE LEASE LIABILITY 129676 5081433 X 108395871 -266399 -2057127 -2323526 110719397 66591 -59811 6780 110726177 110304796 59811 59811 110244985 66591 2057127 2123718 112368703 PART X, LINE 2: ACCOUNTING STANDARDS PRESCRIBE A RECOGNITION THRESHOLD OF MORE LIKELY THAN NOT, AND A MEASUREMENT ATTRIBUTE FOR ALL TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN, IN ORDER FOR THOSE TAX POSITIONS TO BE RECOGNIZED IN THE FINANCIAL STATEMENTS. AT DECEMBER 31, 2024 AND 2023, THE COMPANY BELIEVES THAT THERE ARE NO UNCERTAIN TAX POSITIONS OR LIABILITIES, OR INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX POSITIONS. IF THE COMPANY HAD INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IT WOULD BE ACCOUNTED FOR AS A COMPONENT OF INCOME TAX EXPENSE. PART XI, LINE 2D - OTHER ADJUSTMENTS: ADMINISTRATION SERVICE EXPENSES RECLASSIFIED FOR 990 -2,057,127. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES RECLASSIFIED TO REVENUE FOR 990 -59,811. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES RECLASSIFIED TO REVENUE FOR 990 59,811. PART XII, LINE 4B - OTHER ADJUSTMENTS: ADMINISTRATION SERVICE EXPENSES RECLASSIFIED FOR 990 2,057,127. 1 DELTA DENTAL OF SOUTH DAKOTA FOUNDATION 804 NORTH EUCLID SUITE 1 PIERRE SD 57501 911776857 501(C)(3) 1245148 0 PROMOTE DENTAL HEALTH IN SOUTH DAKOTA CAPITAL AREA UNITED WAY 221 SOUTH CENTRAL AVE PIERRE SD 57501 460403398 501(C)(3) 81001 0 DISTRIBUTE CHARITABLE DONATIONS MISSOURI SHORES DOMESTIC VIOLENCE CENTER PO BOX 398 PIERRE SD 57501 460352133 501(C)(3) 102600 0 PROGRAM SUPPORT SD COMMUNITY FOUNDATION PO BOX 296 PIERRE SD 57501 460398115 501(C)(3) 257600 0 COMMUNITY IMPROVEMENT SUPPORT AVERA HEALTH FOUNDATION 3900 W AVERA DRIVE SIOUX FALLS SD 57108 460367530 501(C)(3) 51960 0 PROGRAM SUPPORT OAHE FOUNDATION PO BOX 998 PIERRE SD 57501 363309554 501(C)(3) 200000 0 COMMUNITY IMPROVEMENT SUPPORT OAHE YMCA 900 E CHURCH ST PIERRE SD 57501 237169291 501(C)(3) 102150 0 PROGRAM SUPPORT SD DISCOVERY CENTER 805 W SIOUX AVENUE PIERRE SD 57501 363599183 501(C)(3) 100000 0 GENERAL SUPPORT 8 0 PART I, LINE 2: GRANTS MADE TO ORGANIZATIONS ARE APPROVED BY THE BOARD OF DIRECTORS. GRANTS MADE TO 501(C)(3) ORGANIZATIONS, GOVERNMENTAL ENTITIES, AND OTHER ORGANIZATIONS WITH AN INTEREST IN FURTHERING DENTAL RESEARCH, EDUCATION, AND SERVICES TO DISADVANTAGED POPULATIONS ARE APPROVED BY THE BOARD. X 1 1 X X X X X 1 1 0 0 0 0 0 0 0 JEFF MILLER PRESIDENT/CEO 388200 0 144000 0 21804 0 57500 0 33373 0 644877 0 0 0 KIRBY SCOTT VP OF FINANCE 162910 0 47970 0 99268 0 47005 0 17591 0 374744 0 0 0 SCOTT JONES FOUNDATION PRESIDENT 124900 0 103499 0 23546 0 48366 0 25495 0 325806 0 0 0 LAURIE MIKKONEN CFO 182532 0 50700 0 23502 0 31314 0 17275 0 305323 0 0 0 GENE TETZLAFF VP OF IT 175200 0 46644 0 1236 0 46361 0 34968 0 304409 0 0 0 MICK HECKENLIABLE VP OF OPERATIONS 183300 0 47268 0 1158 0 28389 0 19586 0 279701 0 0 0 CONNIE HALVERSON VP OF PUBLIC BENEFIT 152160 0 41028 0 1067 0 24648 0 44001 0 262904 0 0 0 ANN SCHWARTZ VP OF PROVIDER SERVICES & GOVT PROGRAMS 123780 0 34320 0 14806 0 22142 0 44521 0 239569 0 0 0 DAYNA HEPPER VP OF GROWTH & CUSTOMER EXPERIENCE 140800 0 34320 0 786 0 21112 0 31138 0 228156 0 0 0 JAMEY HERR DIRECTOR OF INFRASTRUCTURE & SECURITY 148500 0 27720 0 780 0 18095 0 26270 0 221365 0 0 0 EUGENE CAMPBELL DIRECTOR OF DEVELOPMENT & MODERNIZATION 139600 0 27061 0 708 0 16915 0 32874 0 217158 0 0 0 MARY WESTERN PROGRAMMER/ANALYST 104124 0 22146 0 371 0 13191 0 27981 0 167813 0 0 0 LORI HALL DIRECTOR OF CLAIMS PROCESSING 107570 0 21884 0 621 0 9485 0 18118 0 157678 0 0 0 PART I, LINE 1A ALL EMPLOYEES ARE ELIGIBLE FOR THE ORGANIZATION TO PAY 50% OF LOCAL GYM MEMBERSHIP. PART I, LINES 4A-B KIRBY SCOTT RECEIVED A SEVERANCE PAYMENT OF $75,000. THE ORGANIZATION CONTRIBUTES TO A 457F PLAN ON BEHALF OF CERTAIN EMPLOYEES. THE CONTRIBUTION AMOUNT IS 2% OF SALARY AND BONUS FOR DESIGNATED EMPLOYEES AGE 62 OR LESS DURING THE CALENDAR YEAR. THE CONTRIBUTION AMOUNT FOR EMPLOYEES AGE 63 OR OLDER DURING THE CALENDAR YEAR = $23,000. THE CONTRIBUTIONS FOR JEFF MILLER AND SCOTT JONES WILL VEST JANUARY 5, 2027. THE CONTRIBUTIONS FOR THE OTHER INDIVIDUALS VEST ON JANUARY 5, 2028. THE INDIVIDUALS INVOLVED & THE CONTRIBUTION AMOUNTS ON THEIR BEHALF FOLLOWS: JEFFREY MILLER $23,000.00 MICK HECKENLAIBLE $4,725.36 LAURIE MIKKONEN $5,214.00 KIRBY SCOTT $23,000.00 SCOTT JONES $23,000.00 CONNIE HALVERSON $4,102.56 GENE TETZLAFF $23,000.00 DAYNA HEPPER $3,686.40 ANN SCHWARTZ $3,686.40 JACLYN SCHULER DDS DAUGHTER OF BOARD MEMBER ANLEE ROLA 490954 INSURANCE REIMBURSEMENT 0 JASON AANENSON DDS BOARD MEMBER 245709 INSURANCE REIMBURSEMENT 0 JEFF FEIOCK DDS BOARD MEMBER 410605 INSURANCE REIMBURSEMENT 0 KIM SUGA DDS DAUGTHER-IN-LAW OF BOARD MEMBER GREG GERTSEN 315423 INSURANCE REIMBURSEMENT 0 LEE GERTSEN DDS SON OF BOARD MEMBER GREG GERTSEN 321549 INSURANCE REIMBURSEMENT 0 STEPHANIE SCHMITZ DDS BOARD MEMBER 398329 INSURANCE REIMBURSEMENT 0 THANE CRUMP DDS BOARD MEMBER 192790 INSURANCE REIMBURSEMENT 0 TRAVIS BJORDAHL DDS BOARD MEMBER 203469 INSURANCE REIMBURSEMENT 0 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE CHAIRMAN, VICE-CHAIRMAN, SECRETARY, TREASURER, AND SUCH OTHER MEMBERS AS THE BOARD DESIGNATES AND SHALL BE VESTED WITH SUCH POWERS AS THE BOARD OF DIRECTORS SHALL BY RESOLUTION DETERMINE. IT SHALL MAKE A WRITTEN REPORT OF ITS PROCEEDINGS AND ACTIONS AT THE NEXT SUCCEEDING MEETING OF THE BOARD OF DIRECTORS. THE CHAIRMAN SHALL BE THE CHAIRMAN OF THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION UPDATED ITS ARTICLES OF INCORPORATION TO ALLOW IT TO ENGAGE IN ANY OTHER PURPOSE FOR WHICH A NONPROFIT CORPORATION SUBJECT TO SOUTH DAKOTA CODIFIED LAW (SDCL) CHAPTERS 47-22 TO 47-28, INCLUSIVE, MAY BE ORGANIZED PURSUANT TO SDCL 47-22-4, AND TO ESTABLISH SUCH SUBSIDIARY OR AFFILIATE LEGAL ENTITIES AS THE DIRECTORS OF THE CORPORATION MAY DECIDE NECESSARY TO AID IN FURTHERANCE OF THE GENERAL OBJECTS AND PURPOSES OF THE CORPORATION. THE BYLAWS WERE AMENDED TO CORRESPOND TO THE AMENDED ARTICLES AND TO PROVIDE THAT ANY SUBSIDIARY OR AFFILIATE ENTITY ESTABLISHED OR ACQUIRED BY THE CORPORATION MUST CONDUCT ITS ACTIVITIES IN A MANNER THAT (1) COMPLEMENTS THE PLAN AND THE PURPOSES FOR WHICH THE CORPORATION IS FORMED; AND (2) DOES NOT JEOPARDIZE THE CORPORATION'S STATUS AS A NON-PROFIT DENTAL SERVICE CORPORATION UNDER APPLICABLE LAW. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERSHIP CONSISTS OF DENTISTS LICENSED IN SOUTH DAKOTA THAT PAY ONE-TIME MEMBERSHIP DUES. FORM 990, PART VI, SECTION A, LINE 7A ALL MEMBER DENTISTS IN ATTENDANCE AT THE ANNUAL MEETING HAVE ONE VOTE. FORM 990, PART VI, SECTION A, LINE 7B ALL MEMBER DENTISTS IN ATTENDANCE AT THE ANNUAL MEETING ARE ALLOWED ONE VOTE ON ALL AGENDA ITEMS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS AT THE MAY BOARD MEETING. A REVIEW OF THE FORM IS CONDUCTED BY THE CHAIR OF THE AUDIT AND FINANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY, IN MAY, AT THE REGULARLY SCHEDULED BOARD MEETING. EACH FORM IS READ AT THE FOLLOWING MEETING, WITH ACTION TAKEN AS NEEDED. ACTION MAY INCLUDE ABSTENTION FROM DISCUSSION AND VOTING AND POSSIBLE TERMINATION AS A BOARD MEMBER. FORM 990, PART VI, SECTION B, LINE 15 DELTA DENTAL OF SOUTH DAKOTA HAS A COMPENSATION COMMITTEE CHARTER, WHICH STATES THE PURPOSE OF THE COMPENSATION COMMITTEE IS TO REVIEW AND REPORT TO THE BOARD ON COMPENSATION AND PERSONNEL POLICIES, PROGRAMS AND PLANS AND TO APPROVE EMPLOYEE COMPENSATION AND BENEFIT PLANS. THE COMMITTEE CONSISTS OF THE BOARD CHAIR, VICE-CHAIR, AND AT LEAST TWO OTHER BOARD MEMBERS. COMMITTEE MEMBERS ARE APPOINTED TO ANNUAL TERMS AND MAY BE REAPPOINTED TO UNLIMITED CONSECUTIVE TERMS. THE COMMITTEE ANNUALLY REVIEWS THE CEO'S PERFORMANCE AND DETERMINES SALARY ADJUSTMENTS AND INCENTIVE PAYMENTS FOR THE CEO, ENSURING COMPLIANCE WITH THE IRS "REBUTTABLE PRESUMPTION" SAFETY ZONE FOR EXECUTIVE COMPENSATION MATTERS. THE COMMITTEE ALSO REVIEWS THE CEO'S RECOMMENDATIONS AS TO SALARY ADJUSTMENTS AND INCENTIVE PAYMENTS FOR EXECUTIVE STAFF, ENSURING COMPENSATION WITHIN THE RANGES OF THE EXECUTIVE COMPENSATION PHILOSOPHY. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS AND POLICIES ARE AVAILABLE UPON REQUEST. DELTA DENTAL OF SOUTH DAKOTA FOUNDATION PO BOX 1157 PIERRE SD 57501 911776857 ACCESS TO DENTAL CARE SD 501(C)(3) LINE 12A, I DELTA DENTAL OF SOUTH DAKOTA 1 WELLNESS 605 INC 720 N EUCLID AVE PIERRE SD 57501 332478058 VISION BENEFITS SD DELTA DENTAL OF SOUTH DAKOTA C -252134 464813 1.00000 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 1 0 DELTA DENTAL OF SOUTH DAKOTA FOUNDATION O 2027127 CASH DELTA DENTAL OF SOUTH DAKOTA FOUNDATION R 1245148 CASH WELLNESS 605 INC B 452134 CASH WELLNESS 605 INC O 209842 CASH