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Nonprofiteer
← RENAISSANCE HEALTH SERVICE CORPORATION

Form 990 for tax year 2024

Filed by RENAISSANCE HEALTH SERVICE CORPORATION.

Totals

Total revenue
$1,783,765
Total expenses
$790,399
Contributions and grants received
$499,060
Grants paid
$0
Program service revenue
$0
Investment income
$1,284,705
Other revenue
$0
Total assets, end of year
$25,345,940
Total liabilities, end of year
$171,480
Net assets or fund balances, end of year
$25,174,460
Program services expenses (Part IX)
$499,060
Management and general expenses
$291,339
Fundraising expenses
$0
Program service expenses (Part III)
$499,060

Program services were 63.1% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • MELISSA S STOLICKER

    VICE CHAIR

    Total calculated
    $141,012
    From this org
    $27,504
    From related orgs
    $113,508
    Other
    $0
    Hours/week
    5 + 5 related

  • SARA M DOLAN

    CHAIR

    Total calculated
    $142,008
    From this org
    $30,000
    From related orgs
    $112,008
    Other
    $0
    Hours/week
    5 + 5 related

  • ANDREW J KOTARBA

    DIRECTOR

    Total calculated
    $107,089
    From this org
    $14,581
    From related orgs
    $92,508
    Other
    $0
    Hours/week
    5 + 5 related

  • CAROLE SIMONETTI-WATKINS

    DIRECTOR

    Total calculated
    $71,992
    From this org
    $24,996
    From related orgs
    $46,996
    Other
    $0
    Hours/week
    5 + 6 related

  • CHRISTINE NATHE RHD MS

    DIRECTOR

    Total calculated
    $44,996
    From this org
    $24,996
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    5 + 5 related

  • CHRISTOPHER TODD FISHER

    DIRECTOR

    Total calculated
    $167,004
    From this org
    $24,996
    From related orgs
    $142,008
    Other
    $0
    Hours/week
    5 + 10 related

    Schedule J breakdown matched by us

    Base
    $24,996 + $142,008 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $24,996 + $142,008 related

  • FRANK BUZAKI JR

    DIRECTOR - PART YEAR

    Total calculated
    $43,750
    From this org
    $14,581
    From related orgs
    $6,169
    Other
    $23,000
    Hours/week
    5 + 5 related

  • J DAVID SMITH JR

    DIRECTOR - PART YEAR

    Total calculated
    $36,006
    From this org
    $14,581
    From related orgs
    $21,425
    Other
    $0
    Hours/week
    5 + 4 related

  • JAMES R ROSE JR

    DIRECTOR

    Total calculated
    $61,996
    From this org
    $24,996
    From related orgs
    $37,000
    Other
    $0
    Hours/week
    5 + 2 related

  • KELLY J SCHEIDERER RHIA MHA

    DIRECTOR - PART YEAR

    Total calculated
    $41,581
    From this org
    $14,581
    From related orgs
    $27,000
    Other
    $0
    Hours/week
    5 + 6 related

  • MARTIN D ROBINSON

    DIRECTOR

    Total calculated
    $50,248
    From this org
    $24,996
    From related orgs
    $25,252
    Other
    $0
    Hours/week
    5 + 1 related

  • PHILLIP W COX CPA

    DIRECTOR

    Total calculated
    $53,476
    From this org
    $24,996
    From related orgs
    $28,480
    Other
    $0
    Hours/week
    5

  • POE A TIMMONS

    DIRECTOR

    Total calculated
    $89,089
    From this org
    $14,581
    From related orgs
    $74,508
    Other
    $0
    Hours/week
    5 + 10 related

  • RODNEY A JACKSON

    DIRECTOR

    Total calculated
    $51,677
    From this org
    $14,581
    From related orgs
    $37,096
    Other
    $0
    Hours/week
    5 + 4 related

  • SARAH CLARK

    DIRECTOR

    Total calculated
    $110,506
    From this org
    $24,996
    From related orgs
    $85,510
    Other
    $0
    Hours/week
    5

  • STEPHEN A EKLUND DDH MHSA DR

    DIRECTOR - PART YEAR

    Total calculated
    $51,581
    From this org
    $14,581
    From related orgs
    $37,000
    Other
    $0
    Hours/week
    5 + 6 related

  • AMY L BASEL CPA

    CHIEF FINANCIAL OFFICER & TREASURER

    Total calculated
    $3,169,998
    From this org
    $0
    From related orgs
    $2,481,908
    Other
    $688,090
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $552,581 related
    Bonus
    $0 + $968,814 related
    Other
    $0 + $960,513 related
    Deferred
    $0 + $660,849 related
    Nontaxable benefits
    $0 + $27,241 related
    Filer's total
    $0 + $3,169,998 related

  • GORAN M JURKOVIC CPA

    PRESIDENT & CEO

    Total calculated
    $12,173,362
    From this org
    $0
    From related orgs
    $9,457,582
    Other
    $2,715,780
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,511,908 related
    Bonus
    $0 + $3,756,580 related
    Other
    $0 + $4,189,094 related
    Deferred
    $0 + $2,688,539 related
    Nontaxable benefits
    $0 + $27,241 related
    Filer's total
    $0 + $12,173,362 related

  • SUE ELLEN JENKINS

    CHIEF LEGAL OFFICER & SECRETARY

    Total calculated
    $3,291,045
    From this org
    $0
    From related orgs
    $2,838,668
    Other
    $452,377
    Hours/week
    5 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $567,525 related
    Bonus
    $0 + $1,037,144 related
    Other
    $0 + $1,233,999 related
    Deferred
    $0 + $447,227 related
    Nontaxable benefits
    $0 + $5,150 related
    Filer's total
    $0 + $3,291,045 related

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, and on a Form 990-PF Part VIII's — 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

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 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
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
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 2024, 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 2024. THESE WAGES WERE ALSO REPORTED ON SCHEDULE J AS COMPENSATION THAT HAS BEEN REPORTED AS DEFERRED ON PRIOR FORM 990S.
Schedule J, 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, INVENTIVE, 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

No itemized grants to organizations on this return.

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.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

  • ROOSEVELT INNOVATIONS LLC

    CLAIMS PROCESSING · MI · income $0 · assets $0

    Directly controlled by DELTA DENTAL PLAN OF MICHIGAN INC

  • ROOSEVELT SOLUTIONS LLC

    CLAIMS PROCESSING · MI · income $0 · assets $0

    Directly controlled by DELTA DENTAL PLAN OF MICHIGAN INC

  • T4G HEALTH HOLDINGS LLC

    FINANCIAL PLANNING · MI · income $0 · assets $0

    Directly controlled by T4G MANAGEMENT LLC

  • T4G FUND MANAGEMENT LLC

    FINANCIAL PLANNING · MI · income $0 · assets $0

    Directly controlled by THE 4100 GROUP

  • DEWPOINT LLC

    IT CONSULTING · MI · income $0 · assets $0

    Directly controlled by T4G MANAGEMENT LLC

  • GRIES FINANCIAL LLC

    FINANCIAL PLANNING · MI · income $0 · assets $0

    Directly controlled by T4G FINANCIAL SERVICES LLC

  • LOGIX INVESTMENTS LLC

    FINANCIAL PLANNING · MI · income $0 · assets $0

    Directly controlled by GRIES FINANCIAL LLC

  • DENTAL CHOICE PROPERTIES LLC

    REAL ESTATE HOLDING COMPANY · KY · income $0 · assets $0

    Directly controlled by DELTA DENTAL OF KENTUCKY

  • DENTAL CHOICE HOLDINGS LLC

    HOLDING COMPANY · KY · income $0 · assets $0

    Directly controlled by DENTAL CHOICE INC

  • DCH DISTRIBUTION LLC

    RETAIL SALES · KY · income $0 · assets $0

    Directly controlled by DENTAL CHOICE HOLDINGS LLC

  • ANCILLARY CHOICE LLC

    HOLDING COMPANY · KY · income $0 · assets $0

    Directly controlled by DENTAL CHOICE INC

  • LIQUID CORN LLC

    OWNS SUITE 244 · TN · income $0 · assets $0

    Directly controlled by FORE HOLDING CORPORATION

  • PREMIER INSURANCE SERVICES LLC

    INSURANCE BROKER · TN · income $0 · assets $0

    Directly controlled by FORE HOLDING CORPORATION

  • SUITE 244 PARTNERS LLC

    HOLDS THE LEASE TO SUITE 244 AT LP FIELD (TITANS STADIUM) · TN · income $0 · assets $0

    Directly controlled by FORE HOLDING CORPORATION

  • T4G MFO HOLDINGS LLC

    FINANCIAL PLANNING · MI · income $0 · assets $0

    Directly controlled by T4G FINANCIAL SERVICES LLC

  • T4G REAL ESTATE HOLDINGS LLC

    REAL ESTATE · MI · income $0 · assets $0

    Directly controlled by T4G MANAGEMENT LLC

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • RED CEDAR INVESTMENT MANAGEMENT LLC

    Related · CAPITAL MANAGEMENT · MI · 49% owned · share of income $578,798 · share of assets $2,926,104

    Directly controlled by T4G MANAGEMENT LLC

  • T4G MANAGEMENT LLC

    Related · FINANCIAL PLANNING · MI · 100% owned · share of income -$6,477,088 · share of assets $99,459,969

    Directly controlled by THE 4100 GROUP

  • T4G FINANCIAL SERVICES LLC

    Related · FINANCIAL PLANNING · MI · 100% owned · share of income -$1,197,805 · share of assets $18,483,395

    Directly controlled by T4G MANAGEMENT LLC

  • ARCIS FUND I LLC

    Related · INVESTMENTS · MI · 100% owned · share of income -$181,970 · share of assets $12,032,332

    Directly controlled by RENAISSANCE HOLDING COMPANY

  • SYLVASON LLC DBA DENT-WELL LLC

    Related · DENTAL CARE · TX · 100% owned · share of income $70,758 · share of assets $1,899,990

    Directly controlled by T4G HEALTH HOLDINGS LLC

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • RENAISSANCE HOLDING COMPANY

    C Corporation · HOLDING COMPANY · MI · 100% owned · share of income -$312,743 · share of assets $90,992,631 · controlled entity

    Directly controlled by DELTA DENTAL OF MICHIGAN

  • RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA

    C Corporation · INSURANCE · IN · 100% owned · share of income -$3,436,380 · share of assets $129,691,678 · controlled entity

    Directly controlled by RENAISSANCE HOLDING COMPANY

  • RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF NEW YORK

    C Corporation · INSURANCE · NY · 100% owned · share of income $710,772 · share of assets $16,486,660 · controlled entity

    Directly controlled by RENAISSANCE HOLDING COMPANY

  • FORE HOLDING CORPORATION

    C Corporation · HOLDING COMPANY · TN · 100% owned · share of income -$41,701 · share of assets $16,052,537 · controlled entity

    Directly controlled by DELTA DENTAL OF TENNESSE

  • DENTAL CHOICE INC

    C Corporation · PROVDE DENTAL SERVICE PLANS · KY · 100% owned · share of income -$1,688,509 · share of assets $8,952,986 · controlled entity

    Directly controlled by DELTA DENTAL OF KENTUCKY

  • DENTAL CHOICE AGENCY INC

    C Corporation · PRIMARY GENERAL AGENCY FOR DELTA DENTAL OF KENTUCKY · KY · 100% owned · share of income -$600 · share of assets $0 · controlled entity

    Directly controlled by DELTA DENTAL OF KENTUCKY

  • OMEGA ADMINISTRATORS INC

    C Corporation · PROVIDING THIRD-PARTY ADMINISTRATIVE SERVICES · AR · 100% owned · share of income $0 · share of assets $0 · controlled entity

    Directly controlled by DELTA DENTAL OF ARKANSAS

  • THE 4100 GROUP

    C Corporation · INVESTMENT IN SUBSIDARIES · MI · 100% owned · share of income -$12,029,291 · share of assets $132,083,317 · controlled entity

    Directly controlled by DELTA DENTAL OF MICHIGAN

  • DENTAL CHOICE ANCILLARY INC

    C Corporation · PROVIDE DENTAL SERVICE PLANS · KY · 100% owned · share of income $0 · share of assets $0

    Directly controlled by DENTAL CHOICE INC

  • ANCILLARY CHOICE LIFE INC

    C Corporation · INSURANCE · KY · 100% owned · share of income $0 · share of assets $0

    Directly controlled by DENTAL CHOICE INC

  • DYNTL INC

    C Corporation · DENTAL SERVICE · TN · 100% owned · share of income -$236,929 · share of assets $0 · controlled entity

    Directly controlled by T4G HEALTH HOLDINGS

  • JOYN HEALTH INC

    C Corporation · DENTAL SERVICE · MI · 100% owned · share of income -$1,512,397 · share of assets $3,509,246 · controlled entity

    Directly controlled by T4G HEALTH HOLDINGS LLC

Provenance

Return type
form_990
Tax year
2024
Filed
13 November 2025
IRS schema version
2024v5.1
Source object
202523179349311007

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