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← DELTA DENTAL PLAN OF MICHIGAN

Form 990 for tax year 2024

Filed by DELTA DENTAL PLAN OF MICHIGAN.

Totals

Total revenue
$1,248,229,791
Total expenses
$1,241,778,511
Contributions and grants received
$0
Grants paid
$3,964,285
Program services expenses (Part IX)
$1,103,459,895
Management and general expenses
$138,318,616
Fundraising expenses
$0
Program service expenses (Part III)
$1,103,459,895

Program services were 88.9% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • MELISSA STOLICKER

    VICE CHAIR

    Total calculated
    $141,012
    From this org
    $73,500
    From related orgs
    $67,512
    Other
    $0
    Hours/week
    5 + 5 related

  • SARA DOLAN

    CHAIR

    Total calculated
    $142,008
    From this org
    $72,000
    From related orgs
    $70,008
    Other
    $0
    Hours/week
    5 + 5 related

  • ANDREW KOTARBA

    DIRECTOR

    Total calculated
    $107,089
    From this org
    $67,500
    From related orgs
    $39,589
    Other
    $0
    Hours/week
    5 + 5 related

  • ANTHONY O WILLIAMS JD

    DIRECTOR

    Total calculated
    $61,500
    From this org
    $60,000
    From related orgs
    $1,500
    Other
    $0
    Hours/week
    5 + 1 related

  • BLAKE LIVINGSTON DDS

    DIRECTOR

    Total calculated
    $60,000
    From this org
    $60,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • CHRISTOPHER T FISHER

    DIRECTOR

    Total calculated
    $167,004
    From this org
    $60,000
    From related orgs
    $107,004
    Other
    $0
    Hours/week
    5 + 10 related

    Schedule J breakdown matched by us

    Base
    $60,000 + $107,004 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $60,000 + $107,004 related

  • JUAN RODRIGUEZ DDS

    DIRECTOR

    Total calculated
    $35,000
    From this org
    $35,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • KELLY JUBB SCHEIDERER

    DIRECTOR - PART YEAR

    Total calculated
    $41,581
    From this org
    $12,000
    From related orgs
    $29,581
    Other
    $0
    Hours/week
    5 + 6 related

  • LARRY DEGROAT

    DIRECTOR

    Total calculated
    $61,500
    From this org
    $60,000
    From related orgs
    $1,500
    Other
    $0
    Hours/week
    5 + 1 related

  • LAURA DICKERSON

    DIRECTOR

    Total calculated
    $0
    Hours/week
    5

  • PATRICK K GILLESPIE

    DIRECTOR

    Total calculated
    $60,000
    From this org
    $60,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • RAYMOND F GIST DDS

    DIRECTOR

    Total calculated
    $62,000
    From this org
    $60,000
    From related orgs
    $2,000
    Other
    $0
    Hours/week
    5 + 1 related

  • STEPHEN A EKLUND DDS MHSA DR

    DIRECTOR - PART YEAR

    Total calculated
    $51,581
    From this org
    $35,000
    From related orgs
    $16,581
    Other
    $0
    Hours/week
    5 + 6 related

  • STEVEN M DATER DDS

    DIRECTOR

    Total calculated
    $60,000
    From this org
    $60,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • STEVEN M TACK

    DIRECTOR

    Total calculated
    $67,500
    From this org
    $67,500
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • SUNCICA TRAVAN DDS MS

    DIRECTOR

    Total calculated
    $62,000
    From this org
    $60,000
    From related orgs
    $2,000
    Other
    $0
    Hours/week
    5 + 1 related

  • TIMOTHY E DAMAN

    DIRECTOR

    Total calculated
    $35,000
    From this org
    $35,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • AMY L BASEL CPA

    EVP/CFO & CRO/TREASURER

    Total calculated
    $3,169,998
    From this org
    $2,481,908
    From related orgs
    $0
    Other
    $688,090
    Hours/week
    35 + 15 related

    Schedule J breakdown matched by us

    Base
    $552,581
    Bonus
    $968,814
    Other
    $960,513
    Deferred
    $660,849
    Nontaxable benefits
    $27,241
    Filer's total
    $3,169,998

  • ANTHONY D ROBINSON

    EVP, CMO & CRO

    Total calculated
    $3,627,421
    From this org
    $2,839,357
    From related orgs
    $0
    Other
    $788,064
    Hours/week
    43 + 7 related

    Schedule J breakdown matched by us

    Base
    $652,874
    Bonus
    $1,038,809
    Other
    $1,147,674
    Deferred
    $760,823
    Nontaxable benefits
    $27,241
    Filer's total
    $3,627,421

  • GORAN M JURKOVIC CPA

    CEO, PRESIDENT

    Total calculated
    $12,173,362
    From this org
    $9,457,582
    From related orgs
    $0
    Other
    $2,715,780
    Hours/week
    35 + 15 related

    Schedule J breakdown matched by us

    Base
    $1,511,908
    Bonus
    $3,756,580
    Other
    $4,189,094
    Deferred
    $2,688,539
    Nontaxable benefits
    $27,241
    Filer's total
    $12,173,362

  • JEFFERY W JOHNSTON DDS MS

    SVP & CHIEF SCIENCE OFFICER

    Total calculated
    $636,761
    From this org
    $517,662
    From related orgs
    $0
    Other
    $119,099
    Hours/week
    43 + 7 related

    Schedule J breakdown matched by us

    Base
    $350,158
    Bonus
    $160,568
    Other
    $6,936
    Deferred
    $100,022
    Nontaxable benefits
    $19,077
    Filer's total
    $636,761

  • MARK BAUGHMAN

    SVP & CIO

    Total calculated
    $1,033,516
    From this org
    $910,866
    From related orgs
    $0
    Other
    $122,650
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $385,464
    Bonus
    $496,763
    Other
    $28,639
    Deferred
    $103,573
    Nontaxable benefits
    $19,077
    Filer's total
    $1,033,516

  • POE A TIMMONS

    DIRECTOR (ROOSEVELT INNOVATIONS ONLY)

    Total calculated
    $89,089
    From this org
    $7,500
    From related orgs
    $81,589
    Other
    $0
    Hours/week
    5 + 10 related

  • SUE ELLEN JENKINS

    EVP, CHIEF LEGAL OFFICER, CAO & SECRETARY

    Total calculated
    $3,291,045
    From this org
    $2,838,668
    From related orgs
    $0
    Other
    $452,377
    Hours/week
    38 + 12 related

    Schedule J breakdown matched by us

    Base
    $567,525
    Bonus
    $1,037,144
    Other
    $1,233,999
    Deferred
    $447,227
    Nontaxable benefits
    $5,150
    Filer's total
    $3,291,045

  • KUSHTRIM SHAQIRI

    VP GOVERMENT PROGRAMS

    Total calculated
    $779,731
    From this org
    $734,767
    From related orgs
    $0
    Other
    $44,964
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $408,485
    Bonus
    $313,117
    Other
    $13,165
    Deferred
    $17,723
    Nontaxable benefits
    $27,241
    Filer's total
    $779,731

  • TOBY HALL

    PRESIDENT & CEO OF ROOSEVELT

    Total calculated
    $1,899,653
    From this org
    $1,461,472
    From related orgs
    $0
    Other
    $438,181
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $480,532
    Bonus
    $482,533
    Other
    $498,407
    Deferred
    $420,918
    Nontaxable benefits
    $17,263
    Filer's total
    $1,899,653

  • DANIEL LOVEJOY

    VP, SALES AND ACCT MGT

    Total calculated
    $748,206
    From this org
    $673,220
    From related orgs
    $0
    Other
    $74,986
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $293,456
    Bonus
    $370,543
    Other
    $9,221
    Deferred
    $47,745
    Nontaxable benefits
    $27,241
    Filer's total
    $748,206

  • EARL MAJOR

    VP HUMAN RESOURCES

    Total calculated
    $587,264
    From this org
    $550,807
    From related orgs
    $0
    Other
    $36,457
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $148,545
    Bonus
    $401,101
    Other
    $1,161
    Deferred
    $28,251
    Nontaxable benefits
    $8,206
    Filer's total
    $587,264

  • MATT GLOVER

    SR DIRECTOR, GOVT PROGRAMS, SALES & ACCT MGT

    Total calculated
    $530,589
    From this org
    $477,156
    From related orgs
    $0
    Other
    $53,433
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $169,169
    Bonus
    $307,446
    Other
    $541
    Deferred
    $26,192
    Nontaxable benefits
    $27,241
    Filer's total
    $530,589

  • MIKE BOBAK

    VP SALES & ACCT MGT

    Total calculated
    $795,139
    From this org
    $702,758
    From related orgs
    $0
    Other
    $92,381
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $266,268
    Bonus
    $420,047
    Other
    $16,443
    Deferred
    $65,140
    Nontaxable benefits
    $27,241
    Filer's total
    $795,139

  • MITCH NOTARO

    VP, INFORMATION TECHNOLOGY

    Total calculated
    $510,312
    From this org
    $449,198
    From related orgs
    $0
    Other
    $61,114
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $212,315
    Bonus
    $94,485
    Other
    $142,398
    Deferred
    $35,855
    Nontaxable benefits
    $25,259
    Filer's total
    $510,312

  • JEFF BOTKIN

    FORMER SVP, BUSINESS SERVICES

    Total calculated
    $597,773
    From this org
    $597,773
    From related orgs
    $0
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $31,064
    Bonus
    $506,668
    Other
    $60,041
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $597,773

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 1a · First-class or charter travel
  • 1a · Travel for companions
  • 1a · Health or social club dues or initiation fees
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

Answered no

  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 1a First-class or charter travel
FIRST CLASS TRAVEL FOR BUSINESS PURPOSES IS AVAILABLE TO SENIOR EXECUTIVES AND KEY EMPLOYEES. THIS AMOUNT WAS TREATED AS NONTAXABLE TO THESE INDIVIDUALS.
Schedule J, Part I, Line 1a Travel for companions
TRAVEL MAY BE AVAILABLE TO SPOUSES ON OCCASION AND WOULD BE TREATED AS TAXABLE INCOME TO THE BOARD MEMBER OR EMPLOYEE AS APPROPRIATE.
Schedule J, Part I, Line 1a Health or social club dues or initiation fees
VARIOUS INDIVIDUALS ON SCHEDULE J ARE ELIGIBLE FOR REIMBURSEMENT OF SUBSTANTIATED HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES THAT HAVE A BUSINESS PURPOSE. THE PERSONAL PORTION OF THIS BENEFIT IS REPORTED ANNUALLY AND IS INCLUDED AS TAXABLE INCOME ON THE EMPLOYEE'S W-2.
Schedule J, Part I, Line 4a Severance or change-of-control payment
MITCH NOTARO RECEIVED SEVERANCE IN AMOUNT OF $141,369 IN 2024.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
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 2024, GORAN JURKOVIC, AMY BASEL, TOBY HALL, SUE JENKINS, AND ANTHONY ROBINSON ACCRUED BENEFITS AS PARTICIPANTS IN THE SERP PLAN. GORAN JURKOVIC, AMY BASEL, SUE JENKINS, TOBY HALL, AND ANTHONY ROBINSON BECAME VESTED IN A PORTION OF THEIR ACCRUED BENEFITS AND, AS REQUIRED BY THE IRS, THE VESTED PORTION WAS TREATED AS TAXABLE WAGES DURING 2024. THESE WAGES WERE ALSO REPORTED ON SCHEDULE J AS COMPENSATION THAT HAS BEEN REPORTED AS DEFFERED ON PRIOR FORM 990S.
Schedule J, Part I, Line 7 Non-fixed payments
AS INDICATED IN SCHEDULE J, PART II, TOP MANAGEMENT OFFICIALS RECEIVED A BONUS BASED UPON PERFORMANCE AND THE FINANCIAL RESULTS OF THE ORGANIZATION. THE BONUS WAS APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD.
Schedule J, Part I, Line 3
THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS PERFORMANCE AND SETS TOTAL COMPENSATION FOR THE CEO WITHOUT THE PRESENCE OF INFLUENCE OF THE CEO. 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's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

The 10 largest by cash amount. The API serves every itemized grant.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2024
Filed
13 November 2025
IRS schema version
2024v5.1
Source object
202503179349309015

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

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