STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

MAINE DENTAL SERVICE CORPORATION: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
MAINE DENTAL SERVICE CORPORATION (EIN 01-0286541)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-15
IRS object ID
202203199349302135
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-11-15T07:34:14-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010494526PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Baker Newman & NoyesBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1650 Elm Street Suite 302AddressLine1Txt
CityManchesterCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03101ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN010286541EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Maine Dental Service CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMAINBusinessNameControlTxt
Phone6032231000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 2002AddressLine1Txt
CityConcordCityNm
State AbbreviationNHStateAbbreviationCd
ZIP033022002ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonThomas RaffioPersonNm
Person TitlePresident & CEOPersonTitleTxt
Phone6032231000PhoneNum
Signature2022-11-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstThomasPersonFirstNm
Person LastRaffioPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonConnor SmartPreparerPersonNm
PTINP02285543PTIN
Phone6036262200PhoneNum
Preparation2022-11-10PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Delta Dental Plan of MaineBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerThomas RaffioPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 2002AddressLine1Txt
CityConcordCityNm
State AbbreviationNHStateAbbreviationCd
ZIP033022002ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$162,306,603GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website Addresswww.nedelta.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1965FormationYr
Legal Domicile StateMELegalDomicileStateCd
Activity Or MissionProvides programs of dental careActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee6TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$100,000TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$122,906,101PYProgramServiceRevenueAmt
CY Program Service Revenue$147,232,528CYProgramServiceRevenueAmt
PY Investment Income$1,264,848PYInvestmentIncomeAmt
CY Investment Income$932,137CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$124,170,949PYTotalRevenueAmt
CY Total Revenue$148,164,665CYTotalRevenueAmt
PY Grants And Similar Paid$589,093PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$600,400CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$98,747,328PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$125,125,793CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,017,742PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,057,128CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$19,409,468PYOtherExpensesAmt
CY Other Expenses$16,971,735CYOtherExpensesAmt
PY Total Expenses$119,763,631PYTotalExpensesAmt
CY Total Expenses$143,755,056CYTotalExpensesAmt
PY Revenues Less Expenses$4,407,318PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$4,409,609CYRevenuesLessExpensesAmt
Total Assets BOY$71,533,657TotalAssetsBOYAmt
Total Assets EOY$78,079,521TotalAssetsEOYAmt
Total Liabilities BOY$7,761,250TotalLiabilitiesBOYAmt
Total Liabilities EOY$7,653,369TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$63,772,407NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$70,426,152NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionIt is our mission to advance the oral health and overall wellness of our customers and the general public by providing innovative benefits and professional partnerships through diversified strategic business and philanthropic initiatives.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$130,361,655ExpenseAmt
Grant$0GrantAmt
Revenue$147,132,528RevenueAmt
DescMaine Dental Service Corporation, Inc. advances and promotes the improvement of oral health by offering innovative, cost effective dental benefits plans that meet the needs of our customers by integrating activities such as cost management policies, fee reduction agreements with dentists, ensuring quality and cost effective dental benefit delivery, and accurate and timely claims payment. We are recognized for our expertise in the dental benefits industry, the vibrancy of our participating dentist network, and our strong brand. Program services include the processing and payment of claims for dental benefits for various large and small groups, as well as individuals and families. Maine Dental Service Corporation, Inc. processed approximately 730,500 claims in 2021. There are approximately 379,100 members in Maine included in the various plans. Customer's expectations for quality standards are extremely rigorous and we provide a guarantee of service called GOSE, or Guarantee of Service Excellence, which guarantees seven key service claims: 1) Smooth implementation to Northeast Delta Dental; 2) Exceptional customer service; 3) Quick processing of claims; 4) No inappropriate billing by participating dentists; 5) Accurate and quick turnaround of identification cards; 6) Timely employee booklets; 7) Marketing service contracts. In the event one or more of these service guarantees are not met, a cash reimbursement is provided.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$600,400ExpenseAmt
Grant$600,400GrantAmt
Revenue$0RevenueAmt
DescMaine Dental Service Corporation Inc. is one of three members of the Northeast Delta Dental Foundation. The company contributes .075% of annual budgeted revenue, as well as 10% of annual revenue in excess of expenses, to the Northeast Delta Dental Foundation. The Northeast Delta Dental Foundation's purpose is to improve the access to, and the quality of, oral health care and education for the public and dental communities in Maine, New Hampshire, and Vermont. The Northeast Delta Dental Foundation awards numerous grants to community organizations and programs.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$130,962,055TotalProgramServiceExpensesAmt
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign ActyYes (1)PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (1)BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document213IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee6EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Frank BoucherBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6032231000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1One Delta Drive PO Box 2002AddressLine1Txt
CityConcordCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03302ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Donald Oakes
Chair & Director (end 2021)3.00Yes (X)Yes (X)$15,094$0$0
Kyra Chadbourne DDS
Chair & Director3.00Yes (X)Yes (X)$25,414$0$0
Michael P Goldberg DMD
Director3.00Yes (X)$10,030$0$0
Jeffrey R Walawender DDS
Vice Chair & Director3.00Yes (X)Yes (X)$14,400$0$0
Jayne Giles
Director3.00Yes (X)$7,450$0$0
Katherin O'Grady
Director3.00Yes (X)$8,740$0$0
Bruce Nickerson CPA
Treasurer & Director3.00Yes (X)Yes (X)$11,175$0$0
Scott Normandeau
Director3.00Yes (X)$7,450$0$0
Katherine Heer DMD
Director (end 2021)3.00Yes (X)$3,225$0$0
Kristine Avery
Director3.00Yes (X)$7,305$0$0
Burton Rankie DDS
Director3.00Yes (X)$6,805$0$0
Jennifer Brunacini DDS
Director (end 2021)3.00Yes (X)$4,225$0$0
David Daigler CPA
Director3.00Yes (X)$6,805$0$0
Kathy Reynolds
Director3.00Yes (X)$7,450$0$0
Laura Oakes DMD
Director3.00Yes (X)$6,805$0$0
Marcia Minter
Director (start 2021)3.00Yes (X)$2,580$0$0
Grace Odimayo DMD
Director (start 2021)3.00Yes (X)$3,870$0$0
Craig Bradford Rand DDS
Director (start 2021)3.00Yes (X)$3,225$0$0
Thomas Raffio
DDPNH President & CEO10.00Yes (X)$0$887,140$39,294
Francis Boucher
DDPNH Sr. Vice President10.00Yes (X)$0$269,765$37,675
FieldValueIRS element (for citing)
Total Reportable Comp From Org$152,048TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,156,905TotReportableCompRltdOrgAmt
Total Other Compensation$76,969TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (1)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Wyssta Services Inc
PO Box 86Stevens PointWI54481Contracted services$794,946
Cross Benefit Solutions
116 Community DriveAugustaME04330Insurance broker commissions$436,544
Combined Services LLC
2 Delta DriveConcordNH03301Insurance broker commissions$382,760
Encara Inc
4818 Starkey RoadRoanokeVA24018Contracted services$247,026
Maine Education Assoc
35 Community DriveAugustaME04330Admin Fees$233,409
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K10CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Admin service contract fees524292$74,774,616$74,774,616
Premium revenue524114$72,357,912$72,357,912
Management fees - CSLLC524298$100,000$100,000
FieldValueIRS element (for citing)
Total Program Service Revenue$147,232,528TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$924,182TotalRevenueColumnAmt
Exclusion$924,182ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$13,989,893SecuritiesAmt
Other$160,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$13,341,938SecuritiesAmt
Other$800,000OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$647,955SecuritiesAmt
Other-$640,000OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,955TotalRevenueColumnAmt
Exclusion$7,955ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$148,164,665TotalRevenueColumnAmt
Related Or Exempt Func Income$147,132,528RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$100,000UnrelatedBusinessRevenueAmt
Exclusion$932,137ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$600,400TotalAmt
Program Services$600,400ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$125,125,793TotalAmt
Program Services$125,125,793ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$152,048TotalAmt
Management And General$152,048ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$703,805TotalAmt
Management And General$703,805ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$36,802TotalAmt
Management And General$36,802ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$113,638TotalAmt
Management And General$113,638ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$50,835TotalAmt
Management And General$50,835ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$37,655TotalAmt
Management And General$37,655ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$144,915TotalAmt
Management And General$144,915ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,959TotalAmt
Management And General$5,959ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$830,281TotalAmt
Management And General$830,281ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$48,227TotalAmt
Management And General$48,227ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$54,682TotalAmt
Management And General$54,682ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$218TotalAmt
Management And General$218ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$6,551TotalAmt
Management And General$6,551ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,025TotalAmt
Management And General$1,025ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$22,595TotalAmt
Management And General$22,595ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Administration - DDPNH$11,899,686$5,235,862$6,663,824
Brokers' commissions$3,092,341$3,092,341
Strategic initiatives$516,184$516,184
Dues and subscriptions$245,398$245,398

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$66,018TotalAmt
Management And General$66,018ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$143,755,056TotalAmt
Program Services$130,962,055ProgramServicesAmt
Management And General$12,793,001ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$7,849,824BOYAmt
EOY$9,263,600EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$697,110BOYAmt
EOY$3,457,422EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,579,577BOYAmt
EOY$3,689,382EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$400,000BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$10,805BOYAmt
EOY$2,756EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$153,730LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$151,449LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,306BOYAmt
EOY$2,281EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$55,640,037BOYAmt
EOY$58,425,828EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$46,914BOYAmt
EOY$86,272EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$3,212,101BOYAmt
EOY$3,098,525EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$93,983BOYAmt
EOY$53,455EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$71,533,657BOYAmt
EOY$78,079,521EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,333,091BOYAmt
EOY$3,531,122EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$484,600BOYAmt
EOY$490,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,943,559BOYAmt
EOY$3,632,247EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,761,250BOYAmt
EOY$7,653,369EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$63,772,407BOYAmt
EOY$70,426,152EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$63,772,407BOYAmt
EOY$70,426,152EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$71,533,657BOYAmt
EOY$78,079,521EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$4,409,609ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$2,244,136NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Political Expenditures$4,000PoliticalExpendituresAmt
Expended527 Activities$4,000Expended527ActivitiesAmt
Total Exempt Function Expend$4,000TotalExemptFunctionExpendAmt
Form1120 POL FiledYes (1)Form1120POLFiledInd

Section527 Political Org Section527PoliticalOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPaid Internal FundsPaidInternalFundsAmt
House Republican Fund
PO Box 5629AugustaME04332364860692$1,000
House Democratic Campaign Committee
PO Box 2021AugustaME04338222695883$1,000
Senate Democratic Campaign Committee
PO Box 2207AugustaME04338010478979$1,000
Maine Senate Republican Majority PAC
PO Box 1AugustaME04332263733192$1,000

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I-A, Line 1:FormAndLineReferenceDesc
ExplanationFour campaign donations totaling $4,000 were made in Maine.ExplanationTxt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,116OtherCostOrOtherBasisAmt
Depreciation$21,116DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$132,614OtherCostOrOtherBasisAmt
Depreciation$130,333DepreciationAmt
Book Value$2,281BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,281TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Unearned revenue$1,938,947
Advances - admin service contracts$1,693,300
FieldValueIRS element (for citing)
Total Liability$3,632,247TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$80,989,988TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$2,244,136NetUnrealizedGainsInvstAmt
Revenue Not Reported$2,244,136RevenueNotReportedAmt
Revenue Subtotal$78,745,852RevenueSubtotalAmt
Investment Expenses Not Incld$144,915InvestmentExpensesNotIncldAmt
Other Revenues Not Included$69,273,898OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$69,418,813RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$148,164,665TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$74,679,997TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$74,679,997ExpensesSubtotalAmt
Investment Expenses Not Incld2$144,915InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$68,930,144OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$69,075,059ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$143,755,056TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X, Line 2:The 2021 audited financial statements contain the following paragraphs pertaining to tax positions under FIN 48: The Corporation is exempt from federal and state income taxes under the provisions of Section 501(c)(4) of the Internal Revenue Code. Management has evaluated the Corporation's tax positions taken on its filed tax returns and concluded that the Corporation has maintained its tax-exempt status.
Part XI, Line 4b - Other Adjustments:Dental claims paid under admin service contracts 68,930,144. Change in nonadmitted assets 343,754.
Part XII, Line 4b - Other Adjustments:Dental claims paid under admin service contracts 68,930,144.
Schedule D, Part XI, Line 2d:The Corporation has historically prepared its financial statements in accordance with accounting principles generally accepted in the United States of America (GAAP). Effective January 1, 2012 the Corporation elected to prepare its financial statements to conform with the statutory accounting practices of the National Association of Insurance Commissioners (NAIC), as prescribed or permitted by the Maine Bureau of Insurance. The change in nonadmitted assets reported here in Part XI is one of the reconciling items to meet the reporting requirements for the Form 990.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Northeast Delta Dental FoundationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1One Delta Drive PO Box 2002AddressLine1Txt
CityConcordCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03302ZIPCd
FieldValueIRS element (for citing)
Recipient EIN020489150RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$600,400CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Purpose Of GrantGeneral support to promote oral healthPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationMaine Dental Service Corporation (MDSC) makes elective annual charitable contributions to the Northeast Dental Foundation equal to 0.075% of the budgeted gross billings, plus 10% of the actual increase in unrestricted net assets from operations each year. MDSC's total contributions to the Foundation in 2021 totaled $600,400.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Thomas Raffio
DDPNH President & CEO$0$575,726$0$267,223$0$44,191$0$17,324$0$21,970$0$926,434$0$0
Francis Boucher
DDPNH Sr. Vice President$0$219,329$0$45,834$0$4,602$0$16,228$0$21,447$0$307,440$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule J, Part II:FormAndLineReferenceDesc
ExplanationThomas Raffio, CEO, and Francis Boucher, Senior Vice President, received all of their compensation from Delta Dental Plan of New Hampshire, which is an unrelated organization per Schedule R definitions.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (6 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Laura Oakes DMD
Director$914,960The Directors listed here have ownership interests in dental practices that receive insurance reimbursements from Delta Dental in the ordinary course of their business. All transactions are at arm's length and for fair value.0
Kyra Chadbourne DDS
Vice Chair & Director$365,062Please see above.0
Katherine Heer DMD
Director$211,449Please see above.0
Michael Goldberg DMD
Director$116,275Please see above.0
Burton Rankie DDC
Director$110,297Please see above0
Bradford Rand DDS
Director$574,916Please see above0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part V, Line 2aThe six employees included here are actually employed and paid by Delta Dental Plan of New Hampshire. These employees are assigned to provide sales and marketing services to Maine Dental Services Corporation. Maine Dental Services Corporation reimburses Delta Dental Plan of New Hampshire for these employees' payroll and employee benefit expenses.
Form 990, Part VI, Section A, line 6The membership of Maine Dental Service Corporation consists of the Board of Directors, all of the individuals covered under the Company's dental benefit plans, and the Maine dentists participating in the Company's dental networks which are used by the individuals covered under one of the Company's dental benefit plans.
Form 990, Part VI, Section A, line 7aThe Board of Trustees are elected at the Maine Dental Service Corporation's Annual Membership meeting, which requires a quorum of 25 members to conduct business.
Form 990, Part VI, Section B, line 11bThe Form 990 is reviewed in detail by key finance employees of Northeast Delta Dental. A final draft is presented to the Board before the Form is filed.
Form 990, Part VI, Section B, line 12cA copy of the conflict of interest policy is distributed annually to all officers, directors, and the management team. All are required to report any conflicts and sign, date, and return the policy, whether or not a conflict exists, to confirm compliance. General Counsel reviews the returned policies and reports the results to the entire Board of Directors. Board members are asked to provide updates of any changes that may occur between their annual conflict of interest filings.
Form 990, Part VI, Section C, line 19Upon request, Maine Dental Services Corporation makes its governing documents, conflict of interest policy, or financial statements available to the public.
Form 990, Part XII, Line 2c:The Finance/Audit Committee oversees the audit process for Maine Dental Service Corporation. The audit process for the financial statements did not change from the prior year. Independent accountants performed the audit in both 2020 and 2021.