STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

MAINE DENTAL SERVICE CORPORATION: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
MAINE DENTAL SERVICE CORPORATION (EIN 01-0286541)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-12
IRS object ID
201813169349302106
Schema version
2017v2.3
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)
Return2018-11-12T07:43:01-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

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 Begin2017-01-01TaxPeriodBeginDt

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
Signature2018-11-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonE Drew CheneyPreparerPersonNm
PTINP00182972PTIN
Phone8002447444PhoneNum
Preparation2018-11-08PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address208.105.168.164IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-11-08IPDt
IP Tm09:58:17IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdA664E523594A7D029D88D3AD4966DBCC0261F172AtSubmissionCreationDeviceId
At Submission Filing Device IdE7C342458DF4D4AB2E77FA21342842838D49B854AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

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$130,863,718GrossReceiptsAmt
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 Body14VotingMembersGoverningBodyCnt
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$113,967,940PYProgramServiceRevenueAmt
CY Program Service Revenue$122,171,132CYProgramServiceRevenueAmt
PY Investment Income$791,963PYInvestmentIncomeAmt
CY Investment Income$2,560,305CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$114,759,903PYTotalRevenueAmt
CY Total Revenue$124,731,437CYTotalRevenueAmt
PY Grants And Similar Paid$813,216PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$379,300CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$96,544,772PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$103,563,094CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$754,673PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$848,560CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$13,165,177PYOtherExpensesAmt
CY Other Expenses$13,887,080CYOtherExpensesAmt
PY Total Expenses$111,277,838PYTotalExpensesAmt
CY Total Expenses$118,678,034CYTotalExpensesAmt
PY Revenues Less Expenses$3,482,065PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$6,053,403CYRevenuesLessExpensesAmt
Total Assets BOY$53,941,597TotalAssetsBOYAmt
Total Assets EOY$59,662,302TotalAssetsEOYAmt
Total Liabilities BOY$6,771,099TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,153,366TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$47,170,498NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$53,508,936NetAssetsOrFundBalancesEOYAmt
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$107,752,451ExpenseAmt
Revenue$122,071,132RevenueAmt
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 630,700 claims in 2017. There are approximately 331,300 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$379,300ExpenseAmt
Grant$379,300GrantAmt
DescMaine Dental Service Corporation Inc. is one of three members of the Northeast Delta Dental Foundation. The company contributes .05% of annual budgeted revenue, as well as 5% 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$108,131,751TotalProgramServiceExpensesAmt
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
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
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 With Officer EntYes (1)BusinessRlnWithOfficerEntInd
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 Document216IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
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
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
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 (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
Beverly Altenburg
Director3.00Yes (X)$8,672$0$0
Charles E Brown DDS
Director (part year)3.00Yes (X)$3,892$0$0
Jeffrey B Doss DDS
Director3.00Yes (X)$9,784$0$0
Michael P Goldberg DMD
Director3.00Yes (X)$9,284$0$0
Demitroula Kouzounas DMD
Director3.00Yes (X)$8,172$0$0
Daniel D Thayer
Director (part year)3.00Yes (X)$6,504$0$0
Jayne Giles
Director3.00Yes (X)$9,398$0$0
Burton Rankie DDS
Director3.00Yes (X)$5,948$0$0
Jeffrey Walawender DDS
Director3.00Yes (X)$8,172$0$0
Jason Lenardson
Director3.00Yes (X)$7,060$0$0
Donald Oakes
Vice Chair & Director3.00Yes (X)$16,512$0$0Yes (X)
Kara Chadbourne DDS
Director3.00Yes (X)$8,172$0$0
Scott Normandeau
Director (part year)3.00Yes (X)$2,780$0$0
Katherin O'Grady
Director (part year)3.00Yes (X)$2,224$0$0
Michael A Bevilacqua
Treasurer & Director3.00Yes (X)$8,116$0$0Yes (X)
Cheryl Bascomb
Director (part year)3.00Yes (X)$5,948$0$0
Michael W Pardue
Chair & Director3.00Yes (X)$25,707$0$0Yes (X)
Thomas Raffio
DDPNH President & CEO10.00$0$763,808$163,407Yes (X)
Francis Boucher
DDPNH Sr. Vice President10.00$0$224,830$32,872Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$146,345TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$988,638TotReportableCompRltdOrgAmt
Total Other Compensation$196,279TotalOtherCompensationAmt
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
Encara Inc
4818 Starkey RoadRoanokeVA24018Contracted Services$615,319
Combined Services LLC
2 Delta DriveConcordNH03301Insurance broker commissions$354,971
Business Ins Agency DBA Cross Ins
116 Community Dr PO Box 469AugustaME04332Insurance broker commissions$285,800
Towers Watson Delaware IncCommission
Lockbox 28852New YorkNY10087Insurance broker commissions$254,539
Wyssta Services Inc
PO Box 86Stevenes PointWI54481Contracted Services$206,274
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K10CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Premium Revenue524114$71,040,879$71,040,879
Admin Service Contract Fees524292$51,030,253$51,030,253
Management Fee - CSLLC524298$100,000$100,000
FieldValueIRS element (for citing)
Total Program Service Revenue$122,171,132TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$941,553TotalRevenueColumnAmt
Exclusion$941,553ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$7,751,033SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$6,132,281SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$1,618,752SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,618,752TotalRevenueColumnAmt
Exclusion$1,618,752ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$124,731,437TotalRevenueColumnAmt
Related Or Exempt Func Income$122,071,132RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$100,000UnrelatedBusinessRevenueAmt
Exclusion$2,560,305ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$379,300TotalAmt
Program Services$379,300ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$103,563,094TotalAmt
Program Services$103,563,094ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$146,346TotalAmt
Management And General$146,346ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$529,857TotalAmt
Management And General$529,857ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$33,446TotalAmt
Management And General$33,446ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$101,614TotalAmt
Management And General$101,614ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$37,297TotalAmt
Management And General$37,297ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$18,159TotalAmt
Management And General$18,159ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$31,586TotalAmt
Management And General$31,586ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$107,775TotalAmt
Management And General$107,775ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$24,000TotalAmt
Management And General$24,000ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$733,077TotalAmt
Management And General$733,077ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$61,212TotalAmt
Management And General$61,212ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$62,471TotalAmt
Management And General$62,471ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$27,447TotalAmt
Management And General$27,447ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$47,406TotalAmt
Management And General$47,406ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,441TotalAmt
Management And General$2,441ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$15,867TotalAmt
Management And General$15,867ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Administration - Delta$9,521,265$4,189,357$5,331,908
Brokers' Commissions$2,959,682$2,959,682
Dues & Subscriptions$223,965$223,965

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$50,727TotalAmt
Management And General$50,727ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$118,678,034TotalAmt
Program Services$108,131,751ProgramServicesAmt
Management And General$10,546,283ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$8,087,668BOYAmt
EOY$5,818,587EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$529,853BOYAmt
EOY$623,878EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,211,919BOYAmt
EOY$3,466,582EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,956BOYAmt
EOY$2,956EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$173,703LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$164,034LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$12,111BOYAmt
EOY$9,669EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$38,487,652BOYAmt
EOY$46,829,252EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$122,760BOYAmt
EOY$74,991EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$3,425,005BOYAmt
EOY$2,795,078EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$61,673BOYAmt
EOY$41,309EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$53,941,597BOYAmt
EOY$59,662,302EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,593,408BOYAmt
EOY$3,669,312EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$183,300BOYAmt
EOY$318,600EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,994,391BOYAmt
EOY$2,165,454EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,771,099BOYAmt
EOY$6,153,366EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$47,170,498BOYAmt
EOY$53,508,936EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$47,170,498BOYAmt
EOY$53,508,936EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$53,941,597BOYAmt
EOY$59,662,302EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$6,053,403ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$285,035NetUnrlzdGainsLossesInvstAmt
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
Volunteer Hours0VolunteerHoursCnt
Expended527 Activities$4,000Expended527ActivitiesAmt
Internal Funds Contributed$0InternalFundsContributedAmt
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
Maine House Republican Majority Fund
PO Box 5629AugustaME04332274312959$1,000
Maine House Democratic Campaign Committee
PO Box 2021AugustaME04338222695883$1,000
Maine 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$17,892DepreciationAmt
Book Value$3,224BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$132,614OtherCostOrOtherBasisAmt
Depreciation$126,169DepreciationAmt
Book Value$6,445BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$19,973OtherCostOrOtherBasisAmt
Depreciation$19,973DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$9,669TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Accrued refunds$604,951
Unearned revenue$1,024,603
Advances - admin service contracts$535,900
FieldValueIRS element (for citing)
Total Liability$2,165,454TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$77,741,147TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$285,034NetUnrealizedGainsInvstAmt
Other Revenue-$19,671OtherRevenueAmt
Revenue Not Reported$265,363RevenueNotReportedAmt
Revenue Subtotal$77,475,784RevenueSubtotalAmt
Investment Expenses Not Incld$107,775InvestmentExpensesNotIncldAmt
Other Revenues Not Included$47,147,878OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$47,255,653RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$124,731,437TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$71,422,381TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$71,422,381ExpensesSubtotalAmt
Investment Expenses Not Incld2$107,775InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$47,147,878OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$47,255,653ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$118,678,034TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X, Line 2:The 2017 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 -19,671.
Part XI, Line 4b - Other Adjustments:Dental claims paid under admin service contracts 47,147,878.
Part XII, Line 4b - Other Adjustments:Dental claims paid under admin service contracts 47,147,878.
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 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$379,300CashGrantAmt
Purpose Of GrantGeneral support to promote oral healthPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

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 0.05% of the budgeted gross billings, plus 5% of the actual increase in unrestricted net assets from operations each year. MDSC's total contributions to the Foundation in 2017 totaled $379,300.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$522,200$0$188,514$0$53,094$0$127,171$0$36,236$0$927,215$0$0
Francis Boucher
DDPNH Sr. Vice President$0$195,300$0$21,072$0$8,458$0$19,048$0$13,824$0$257,702$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 (5 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Charles E Brown DDS
Director (part year)$120,957The 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
Jeffrey B Doss DDS
Director$799,710Please see above.0
Demitroula Kouzounas DMD
Director$929,657Please see above.0
Michael Goldberg DMD
Director$164,002Please see above.0
Kyra Chadbourne DDS
Director$155,701Please see above.0

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 2016 and 2017.