STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

DELTA DENTAL PLAN OF NEW HAMPSHIRE: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL PLAN OF NEW HAMPSHIRE (EIN 02-0273013)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-11-15
IRS object ID
202133199349300928
Schema version
2020v4.1
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)
Return2021-11-15T06:43:34-06:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010494526PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BAKER NEWMAN & NOYES LLCBusinessNameLine1Txt

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 Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN020273013EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Delta Dental Plan of New Hampshire IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlDELTBusinessNameControlTxt
Phone6032231000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1One Delta Drive PO Box 2002AddressLine1Txt
CityConcordCityNm
State AbbreviationNHStateAbbreviationCd
ZIP033022002ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonThomas RaffioPersonNm
Person TitlePresident & CEOPersonTitleTxt
Phone6032231000PhoneNum
Signature2021-11-10SignatureDt
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 PersonE Drew CheneyPreparerPersonNm
PTINP00182972PTIN
Phone8002447444PhoneNum
Preparation2021-11-10PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerThomas RaffioPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1One Delta Drive PO Box 2002AddressLine1Txt
CityConcordCityNm
State AbbreviationNHStateAbbreviationCd
ZIP033022002ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$338,737,482GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website Addresswww.nedelta.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1961FormationYr
Legal Domicile StateNHLegalDomicileStateCd
Activity Or MissionProvide programs of dental careActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee183TotalEmployeeCnt
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$381,047,984PYProgramServiceRevenueAmt
CY Program Service Revenue$332,744,477CYProgramServiceRevenueAmt
PY Investment Income-$675,676PYInvestmentIncomeAmt
CY Investment Income$2,180,536CYInvestmentIncomeAmt
PY Other Revenue-$49,742PYOtherRevenueAmt
CY Other Revenue-$39,399CYOtherRevenueAmt
PY Total Revenue$380,322,566PYTotalRevenueAmt
CY Total Revenue$334,885,614CYTotalRevenueAmt
PY Grants And Similar Paid$137,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$565,393CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$339,988,883PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$286,545,709CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$20,477,900PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$19,440,183CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$19,785,210PYOtherExpensesAmt
CY Other Expenses$24,526,115CYOtherExpensesAmt
PY Total Expenses$380,388,993PYTotalExpensesAmt
CY Total Expenses$331,077,400CYTotalExpensesAmt
PY Revenues Less Expenses-$66,427PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,808,214CYRevenuesLessExpensesAmt
Total Assets BOY$75,216,563TotalAssetsBOYAmt
Total Assets EOY$82,249,112TotalAssetsEOYAmt
Total Liabilities BOY$14,917,915TotalLiabilitiesBOYAmt
Total Liabilities EOY$15,240,353TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$60,298,648NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$67,008,759NetAssetsOrFundBalancesEOYAmt
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$300,381,424ExpenseAmt
Grant$0GrantAmt
Revenue$332,644,477RevenueAmt
DescDelta Dental Plan of New Hampshire 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. Delta Dental Plan of New Hampshire processed approximately 667,300 claims in 2020. There are approximately 363,300 members in New Hampshire included in the various plans. Customers' 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$565,393ExpenseAmt
Grant$565,393GrantAmt
Revenue$0RevenueAmt
DescDelta Dental Plan of New Hampshire 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$300,946,817TotalProgramServiceExpensesAmt
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
IRP Document17944IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee183EmployeeCnt
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 Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
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 CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNHStatesWhereCopyOfReturnIsFldCd
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 (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
Thomas Raffio
President & CEO80.00Yes (X)$982,967$0$31,593
Erica Bodwell
VP, General Counsel50.00$386,475$0$37,783Yes (X)
Joseph Errante
VP, Professional Relations47.00$337,783$0$31,111Yes (X)
William H Lambrukos
Sr. VP Operations40.00$291,182$0$30,343Yes (X)
Jodie L Hittle
VP, Marketing50.00$282,712$0$25,335Yes (X)
Constance Roy Czyzowski
VP, Human Resources50.00$270,830$0$20,089Yes (X)
Francis Boucher
Treasurer & Sr VP Finance48.00Yes (X)$270,241$0$22,056
Sara M Brehm
Secretary50.00Yes (X)$120,696$0$16,610
David Staples DDS
Chair & Director3.00Yes (X)$31,027$0$0Yes (X)
Christiane Rothwangl DDS
Director3.00$11,160$0$0Yes (X)
James St Jean
Director3.00$10,420$0$0Yes (X)
Richard Bolduc DMD
Vice Chair & Director3.00Yes (X)$9,920$0$0Yes (X)
Matthew Cookson
Director3.00$9,800$0$0Yes (X)
Jean-Paul Rabbath DMD
Director3.00$8,560$0$0Yes (X)
Karen Carew CPA CFE
Director3.00$8,060$0$0Yes (X)
Jason Golden
Director3.00$7,440$0$0Yes (X)
Keith Levesque DMD
Director3.00$6,820$0$0Yes (X)
James Larrick
Director3.00$6,200$0$0Yes (X)
Nader Moavenian DDS
Director3.00$6,200$0$0Yes (X)
Rachel Forbes DMD
Director3.00$4,340$0$0Yes (X)
Tracy Claybaugh
Director (start 4/2020)3.00$3,720$0$0Yes (X)
Joseph Carelli
Director (start 4/2020)3.00$3,100$0$0Yes (X)
Cydney Shapleigh
Director (start 4/2020)3.00$3,100$0$0Yes (X)
Lisa Braiterman
Director (end 4/2020)3.00$1,240$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,073,993TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$214,920TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K59IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Softserve Inc
12800 University Drive Suite 41Fort MyersFL33907Contracted Services$1,265,360
Worldcom Exchange Inc
43 Northwestern DriveSalemNH03079Contracted Services$1,055,006
Wyssta Services Inc
PO Box 86Stevens PointWI54481Contracted Services$1,018,563
Combined Services LLC
2 Delta DriveConcordNH03302Insurance broker commissions$823,132
Elixirr LLC
605 Guadalajara CircleIrvingTX75062Professional consulting$451,079
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K23CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Admin service contract fees524292$267,662,906$267,662,906
Premium revenue524114$64,981,571$64,981,571
Management fee - CSLLC524298$100,000$100,000
FieldValueIRS element (for citing)
Total Program Service Revenue$332,744,477TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,097,196TotalRevenueColumnAmt
Exclusion$1,097,196ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$221,463RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$260,862RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$39,399RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$39,399TotalRevenueColumnAmt
Exclusion-$39,399ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$4,674,346SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$3,591,006SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$1,083,340SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,083,340TotalRevenueColumnAmt
Exclusion$1,083,340ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$334,885,614TotalRevenueColumnAmt
Related Or Exempt Func Income$332,644,477RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$100,000UnrelatedBusinessRevenueAmt
Exclusion$2,141,137ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$565,393TotalAmt
Program Services$565,393ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$286,545,709TotalAmt
Program Services$286,545,709ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,575,270TotalAmt
Program Services$567,097ProgramServicesAmt
Management And General$1,008,173ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$13,643,691TotalAmt
Program Services$6,033,179ProgramServicesAmt
Management And General$7,610,512ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$413,025TotalAmt
Program Services$167,688ProgramServicesAmt
Management And General$245,337ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,737,904TotalAmt
Program Services$1,122,541ProgramServicesAmt
Management And General$1,615,363ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,070,293TotalAmt
Program Services$451,663ProgramServicesAmt
Management And General$618,630ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$357,322TotalAmt
Management And General$357,322ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$112,322TotalAmt
Management And General$112,322ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$134,698TotalAmt
Management And General$134,698ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,819,339TotalAmt
Program Services$54,580ProgramServicesAmt
Management And General$1,764,759ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,658,075TotalAmt
Program Services$961,684ProgramServicesAmt
Management And General$696,391ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$2,339,170TotalAmt
Program Services$977,773ProgramServicesAmt
Management And General$1,361,397ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$790,016TotalAmt
Program Services$346,027ProgramServicesAmt
Management And General$443,989ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$28,381TotalAmt
Program Services$3,917ProgramServicesAmt
Management And General$24,464ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$119,606TotalAmt
Program Services$9,927ProgramServicesAmt
Management And General$109,679ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$6,180TotalAmt
Program Services$2,713ProgramServicesAmt
Management And General$3,467ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,524,157TotalAmt
Program Services$669,105ProgramServicesAmt
Management And General$855,052ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$239,302TotalAmt
Program Services$98,353ProgramServicesAmt
Management And General$140,949ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Strategic initiatives$9,914,094$2,369,468$7,544,626
Brokers' commissions$4,285,699$4,285,699
Premium taxes$1,197,754$1,197,754

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$331,077,400TotalAmt
Program Services$300,946,817ProgramServicesAmt
Management And General$30,130,583ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$8,004,343BOYAmt
EOY$9,308,228EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$524,960BOYAmt
EOY$135,682EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$6,265,105BOYAmt
EOY$4,907,791EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$863,751BOYAmt
EOY$863,374EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$30,270,536LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$21,821,496LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$7,414,346BOYAmt
EOY$8,449,040EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$49,510,592BOYAmt
EOY$54,775,961EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$675,713BOYAmt
EOY$446,914EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$1,815,128BOYAmt
EOY$3,212,101EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$142,625BOYAmt
EOY$150,021EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$75,216,563BOYAmt
EOY$82,249,112EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$8,118,201BOYAmt
EOY$7,483,783EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,050,000BOYAmt
EOY$840,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,749,714BOYAmt
EOY$6,916,570EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,917,915BOYAmt
EOY$15,240,353EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$60,298,648BOYAmt
EOY$67,008,759EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$60,298,648BOYAmt
EOY$67,008,759EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$75,216,563BOYAmt
EOY$82,249,112EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,808,214ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$2,445,949NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$455,948OtherChangesInNetAssetsAmt
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$9,500PoliticalExpendituresAmt
Expended527 Activities$9,500Expended527ActivitiesAmt
Internal Funds Contributed$0InternalFundsContributedAmt
Total Exempt Function Expend$9,500TotalExemptFunctionExpendAmt
Form1120 POL FiledYes (1)Form1120POLFiledInd

Section527 Political Org Section527PoliticalOrgGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPaid Internal FundsPaidInternalFundsAmt
Committee To Elect Donna Soucy
91 Alexander DriveManchesterNH03109460562207$1,000
Friends of Chris Sununu
PO Box 957ExeterNH03833454901693$1,000
Morse for State Senate
14 Old Farm RoadSalemNH03079273071602$1,000
Friends of Jeb Bradley for State Senate
645 South Main StreetWolfeboroNH03894264422111$500
Committee to Elect House Republicans
75 South Main Street Unit 7 Box 1ConcordNH03301463192141$500
Committee to Elect House Democrats
105 N State StreetConcordNH03301141906794$500
NH Senate Republicans PAC
PO Box 3512ManchesterNH03105463728365$750
NH Senate Democratic Caucus
105 North State StreetConcordNH03301020473096$750
Friends of Cindy Rosenwald
101 Wellington StreetNashuaNH03064830627490$500
Tom Sherman for State Senate
296 Harbor RoadRyeNH03870812841560$500
Sununu Inaugural
31 Chestnut Street 312ExeterNH03833814606499$2,500

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I-A, Line 1:FormAndLineReferenceDesc
ExplanationEleven campaign donations totalling $9,500 were made in New Hampshire.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,133,345OtherCostOrOtherBasisAmt
Book Value$1,133,345BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,002,065OtherCostOrOtherBasisAmt
Depreciation$6,938,985DepreciationAmt
Book Value$3,063,080BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$387,895OtherCostOrOtherBasisAmt
Depreciation$387,105DepreciationAmt
Book Value$790BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$18,569,168OtherCostOrOtherBasisAmt
Depreciation$14,354,780DepreciationAmt
Book Value$4,214,388BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$178,063OtherCostOrOtherBasisAmt
Depreciation$140,626DepreciationAmt
Book Value$37,437BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$8,449,040TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Unearned revenue$3,143,601
Accrued refunds$745,169
Other advances$3,027,800
FieldValueIRS element (for citing)
Total Liability$6,916,570TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$93,217,138TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$2,445,949NetUnrealizedGainsInvstAmt
Revenue Not Reported$2,445,949RevenueNotReportedAmt
Revenue Subtotal$90,771,189RevenueSubtotalAmt
Investment Expenses Not Incld$134,698InvestmentExpensesNotIncldAmt
Other Revenues Not Included$243,979,727OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$244,114,425RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$334,885,614TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$88,222,264TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$88,222,264ExpensesSubtotalAmt
Investment Expenses Not Incld2$134,698InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$242,720,438OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$242,855,136ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$331,077,400TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X, Line 2:The 2020 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 2d - Other Adjustments:Change in nonadmitted assets
Part XI, Line 4b - Other Adjustments:Dental claims paid under admin service contracts 242,720,438. Change in nonadmitted assets 1,259,289.
Part XII, Line 4b - Other Adjustments:Dental claims paid under admin service contracts 242,720,438.
Schedule D, Part XI, Line 2dThe 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 New Hampshire Department 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$565,393CashGrantAmt
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
ExplanationDelta Dental Plan of New Hampshire, Inc. (DDPNH) 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. DDPNH's elective contributions to the Foundation in 2020 totaled $565,393.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
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 PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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
President & CEO$578,726$0$132,518$0$271,723$0$8,400$0$23,193$0$1,014,560$0$0$0
Erica Bodwell
VP, General Counsel$263,072$0$98,130$0$25,273$0$8,400$0$29,383$0$424,258$0$0$0
Joseph Errante
VP, Professional Relations$278,434$0$59,349$0$0$0$8,351$0$22,760$0$368,894$0$0$0
William H Lambrukos
Sr. VP Operations$237,236$0$46,686$0$7,260$0$7,817$0$22,526$0$321,525$0$0$0
Jodie L Hittle
VP, Marketing$212,677$0$41,259$0$28,776$0$6,920$0$18,415$0$308,047$0$0$0
Constance Roy Czyzowski
VP, Human Resources$214,667$0$45,523$0$10,640$0$6,759$0$13,330$0$290,919$0$0$0
Francis Boucher
Treasurer & Sr VP Finance$220,955$0$42,954$0$6,332$0$7,165$0$14,891$0$292,297$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 1aDelta Dental Plan of New Hampshire provides for the spouses of Senior VPs to attend one business trip per year. The Plan also provides for the CEO and his spouse to travel and attend business trips together as required or appropriate.
Part I, Line 7The Organization has a team bonus program for all employees. Each individual's bonus is based on a combination of the individual's performance, the Organization's performance compared to the predetermined goals, and the individual's job level within the Organization.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (7 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Nader Moavenian DDS
Director$1,499,000The Directors listed here have ownership interests in dental practices that receive insurance reimbursements from Delta Dental Plan of New Hampshire in the ordinary course of their business. All transactions are at arm's length and for fair value.0
Richard Bolduc DDS
Vice Chair & Director$334,249Please see above.0
Rachel Forbes DMD
Director$327,822Please see above.0
David Staples DDS
Chair & Director$325,109Please see above.0
Keith Levesque DMD
Director$259,123Please see above.0
Jean-Paul Rabbath DMD
Director$219,458Please see above.0
Christiane Rothwangl DDS
Director$186,801Please see above0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6The membership of Delta Dental Plan of New Hampshire, Inc. consists of the New Hampshire dentists participating in the company's networks which are used by individuals covered under one of the Company's dental benefit plans.
Form 990, Part VI, Section A, line 7bMembership approval is required for all Bylaw changes.
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 B, line 15CEO's Compensation: Every year, the Board Tri-State Compensation Committee goes through a rigorous evaluation and carefully researches information on which it bases its recommendations for the compensation for the President & CEO. This includes the engagement of independent compensation consultants and advisors. The independent Tri-State Compensation Committee comprises the Chairs of the Boards for the Delta Dental Plans of Maine, Vermont, and New Hampshire and the Executive Committee of the DDPNH Board. In reviewing the compensation and benefits, the Committee considered various sources of comparability data and the analysis of comparability data and market conditions presented by the independent compensation consultant. In February 2019, the Tri-State Compensation Committee reviewed and approved the CEO's proposed compensation, effective April 1, 2019, for the Treasurer and Secretary based on comparability data provided to the Committee.
Form 990, Part VI, Section C, line 19Upon request, Delta Dental Plan of New Hampshire, Inc. makes its governing documents, conflict of interest policy, or financial statements available to the public.
Form 990, Part XI, line 9:Unrealized gains/(losses) on bonds 455,948.
Form 990, Part XII, Line 2c:The Finance/Audit Committee oversees the audit process for Delta Dental Plan of New Hampshire, Inc. The audit process for the financial statements did not change from the prior year. Independent accountants performed the audit in both 2019 and 2020.
Form 990, Part XI, Line 9The 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 New Hampshire Department of Insurance. This is one of the reconciling items to meet the reporting requirements for the Form 990.