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DELTA DENTAL PLAN OF NEW HAMPSHIRE: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL PLAN OF NEW HAMPSHIRE (EIN 02-0273013)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-07
IRS object ID
201703119349302350
Schema version
2016v3.0
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)
Return2017-11-07T12:55:42-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

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 Begin2016-01-01TaxPeriodBeginDt

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
Signature2017-10-27SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonE Drew CheneyPreparerPersonNm
PTINP00182972PTIN
Phone8002447444PhoneNum
Preparation2017-10-27PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address208.105.168.164IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-10-27IPDt
IP Tm10:33:18IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdCCFCCF25870C8311BDDC6739800371DE19EE9571AtSubmissionCreationDeviceId
At Submission Filing Device IdCD9BA379DF6EC1A0D15BAC40CC9AB00D59855B06AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2018-03-14 21:41:22ZBuildTS

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$340,755,894GrossReceiptsAmt
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 Independent9VotingMembersIndependentCnt
Total Employee198TotalEmployeeCnt
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$315,558,587PYProgramServiceRevenueAmt
CY Program Service Revenue$327,048,629CYProgramServiceRevenueAmt
PY Investment Income$933,016PYInvestmentIncomeAmt
CY Investment Income$901,217CYInvestmentIncomeAmt
PY Other Revenue$4,519PYOtherRevenueAmt
CY Other Revenue-$4,326CYOtherRevenueAmt
PY Total Revenue$316,496,122PYTotalRevenueAmt
CY Total Revenue$327,945,520CYTotalRevenueAmt
PY Grants And Similar Paid$234,796PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$224,680CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$280,383,113PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$290,387,545CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$16,728,317PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$17,731,994CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$15,439,474PYOtherExpensesAmt
CY Other Expenses$16,233,380CYOtherExpensesAmt
PY Total Expenses$312,785,700PYTotalExpensesAmt
CY Total Expenses$324,577,599CYTotalExpensesAmt
PY Revenues Less Expenses$3,710,422PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,367,921CYRevenuesLessExpensesAmt
Total Assets BOY$61,776,573TotalAssetsBOYAmt
Total Assets EOY$65,126,420TotalAssetsEOYAmt
Total Liabilities BOY$14,760,741TotalLiabilitiesBOYAmt
Total Liabilities EOY$14,778,813TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$47,015,832NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$50,347,607NetAssetsOrFundBalancesEOYAmt
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$301,446,058ExpenseAmt
Revenue$326,948,629RevenueAmt
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 775,000 claims in 2015. There are approximately 349,000 members in New Hampshire 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$224,680ExpenseAmt
Grant$224,680GrantAmt
DescDelta Dental Plan of New Hampshire is one of three members of the Northeast Delta Dental Foundation. The company contributes .025% 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$301,670,738TotalProgramServiceExpensesAmt
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 InvstYes (1)ReportProgramRelatedInvstInd
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
IRP Document15949IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee198EmployeeCnt
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 Members15GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
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 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 WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Mary Ann Aldrich RN
Director3.00Yes (X)$11,220$0$0
Richard Bolduc DDS
Director3.00Yes (X)$7,980$0$0
Lisa Braiterman
Director3.00Yes (X)$6,523$0$0
Dennis Hannon DDS
Director3.00Yes (X)$10,680$0$0
Francis H LaBranche Jr DDS
Director (part year)3.00Yes (X)$4,320$0$0
Michael L'Ecuyer
Director3.00Yes (X)$9,060$0$0
Keith Levesque DMD part year
Director3.00Yes (X)$3,660$0$0
Nader Moavenian DDS
Director3.00Yes (X)$6,360$0$0
Jean-Paul Rabbath DMD
Director3.00Yes (X)$9,060$0$0
Christiane Rothwangl DDS
Director3.00Yes (X)$8,520$0$0
Nick S Soggu
Director3.00Yes (X)$11,220$0$0
David Staples DDS
Director3.00Yes (X)$9,060$0$0
Seth P Wall
Director3.00Yes (X)$10,680$0$0
Susan H Woods
Director3.00Yes (X)$10,680$0$0
Kathryn L Yerkes
Vice Chair & Director3.00Yes (X)$13,380$0$0Yes (X)
J Michael Degnan
Chair & Director3.00Yes (X)$29,158$0$0Yes (X)
Thomas Raffio
President & CEO80.00$805,520$0$104,765Yes (X)
Francis Boucher
Treasurer & Sr. VP Financ48.00$227,753$0$30,672Yes (X)
Sara M Brehm
Secretary50.00$101,115$0$19,021Yes (X)
Erica Bodwell
VP, General Counsel50.00$203,827$0$25,208Yes (X)
William A Lambrukos
Sr. VP Operations40.00$222,662$0$44,504Yes (X)
Shannon Mills
VP, Professional Relations50.00$217,248$0$20,969Yes (X)
Jodie L Hittle
VP, Marketing50.00$219,810$0$44,148Yes (X)
Mike Bourbeau
VP, Information Systems47.00$209,094$0$19,336Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,368,590TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$308,623TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K34IndivRcvdGreaterThan100KCnt
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
Encara Inc
4818 Starkey RoadRoanokeVA24018Contracted services$887,270
Combined Services LLC
2 Delta DriveConcordNH03302Insurance broker commissions$881,497
Cronin Gervino & Warlick Inc
171 Londonderry TurnpikeHooksettNH03106Insurance broker commissions$339,439
New England Employee Benefits
15 Chenell DriveConcordNH03301Insurance broker commissions$333,952
Shi International Corp
PO Box 952121DallasTX75395Consulting services$251,246
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K12CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Admin Service Contract Fees524292$262,585,917$262,585,917
Premium Revenue524114$64,362,712$64,362,712
Management Fee - CSLLC524298$100,000$100,000
FieldValueIRS element (for citing)
Total Program Service Revenue$327,048,629TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$798,852TotalRevenueColumnAmt
Exclusion$798,852ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$240,405RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$244,731RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$4,326RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$4,326TotalRevenueColumnAmt
Exclusion-$4,326ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$12,668,008SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$12,565,643SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$102,365SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$102,365TotalRevenueColumnAmt
Exclusion$102,365ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$327,945,520TotalRevenueColumnAmt
Related Or Exempt Func Income$326,948,629RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$100,000UnrelatedBusinessRevenueAmt
Exclusion$896,891ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$224,680TotalAmt
Program Services$224,680ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$290,387,545TotalAmt
Program Services$290,387,545ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,450,407TotalAmt
Program Services$523,597ProgramServicesAmt
Management And General$926,810ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$12,275,700TotalAmt
Program Services$5,410,160ProgramServicesAmt
Management And General$6,865,540ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$329,233TotalAmt
Program Services$133,998ProgramServicesAmt
Management And General$195,235ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,777,986TotalAmt
Program Services$1,144,530ProgramServicesAmt
Management And General$1,633,456ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$898,668TotalAmt
Program Services$379,542ProgramServicesAmt
Management And General$519,126ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$30,228TotalAmt
Management And General$30,228ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$77,172TotalAmt
Management And General$77,172ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$115,156TotalAmt
Management And General$115,156ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,722,219TotalAmt
Program Services$52,359ProgramServicesAmt
Management And General$1,669,860ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,584,412TotalAmt
Program Services$920,992ProgramServicesAmt
Management And General$663,420ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,394,309TotalAmt
Program Services$583,537ProgramServicesAmt
Management And General$810,772ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$814,020TotalAmt
Program Services$357,762ProgramServicesAmt
Management And General$456,258ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$70,575TotalAmt
Program Services$9,758ProgramServicesAmt
Management And General$60,817ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$482,322TotalAmt
Program Services$40,350ProgramServicesAmt
Management And General$441,972ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$4,593TotalAmt
Program Services$2,019ProgramServicesAmt
Management And General$2,574ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,648,493TotalAmt
Program Services$724,513ProgramServicesAmt
Management And General$923,980ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$201,983TotalAmt
Program Services$83,065ProgramServicesAmt
Management And General$118,918ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Brokers' Commissions$3,885,772$0$3,885,772
Premium Taxes$1,094,908$0$1,094,908
Strategic Initiatives$238,967$0$238,967

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,868,251TotalAmt
Program Services$692,331ProgramServicesAmt
Management And General$2,175,920ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$324,577,599TotalAmt
Program Services$301,670,738ProgramServicesAmt
Management And General$22,906,861ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$10,170,160BOYAmt
EOY$10,421,963EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$315,392BOYAmt
EOY$58,471EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,611,809BOYAmt
EOY$5,032,241EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$866,669BOYAmt
EOY$845,134EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$24,138,973LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$16,501,440LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$8,593,656BOYAmt
EOY$7,637,533EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$35,631,116BOYAmt
EOY$37,344,303EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$167,451BOYAmt
EOY$256,071EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$1,317,698BOYAmt
EOY$3,425,005EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$102,622BOYAmt
EOY$105,699EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$61,776,573BOYAmt
EOY$65,126,420EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,695,463BOYAmt
EOY$8,121,065EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,890,000BOYAmt
EOY$1,680,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,175,278BOYAmt
EOY$4,977,748EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,760,741BOYAmt
EOY$14,778,813EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$47,015,832BOYAmt
EOY$50,347,607EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$47,015,832BOYAmt
EOY$50,347,607EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$61,776,573BOYAmt
EOY$65,126,420EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,367,921ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$158,003NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$194,149OtherChangesInNetAssetsAmt
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$5,300PoliticalExpendituresAmt
Expended527 Activities$5,300Expended527ActivitiesAmt
Internal Funds Contributed$0InternalFundsContributedAmt
Total Exempt Function Expend$5,300TotalExemptFunctionExpendAmt
Form1120 POL FiledYes (1)Form1120POLFiledInd

Section527 Political Org Section527PoliticalOrgGrp (21 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPaid Internal FundsPaidInternalFundsAmt
Friends of Feltes Committee
PO Box 623ConcordNH03302471093993$400
Pappas for NH
PO Box 313ManchesterNH02104454838661$200
Donna Soucy for Senate
91 Alexander StreetManchesterNH02104460562203$200
Committee to Elect Lou D'Allesandro
332 St James AvenueManchesterNH03102020519208$200
Chuck Morse for State Senate
14 Old Farm RoadSalemNH03079273071602$400
Friends of Jeb Bradley
645 S Main StreetWolfeboroNH03894264422111$400
Supporters of Molly Kelly
PO Box 1475KeeneNH03431208805201$200
Friends of Sharon Carson
19 Tokanel RoadLondonderryNH03053800628169$200
Martha Fuller Clark for State Senate
501 Islington Street Ste EPortsmouthNH03801005427475$200
Woodburn for Senate
524 Faraway RoadDaltonNH03594002583240$400
Committee to Elect David Watters
19 Maple StreetDoverNH03810262910228$200
Hosmer for Senate
8 Summit AvenueLaconiaNH03246273600949$200
Friends of Andy Sanborn
71 Eagle DriveBedfordNH03110002428739$250
Bette Lasky for State Senate
15 Masefield RoadNashuaNH03062021382071$200
Friends of Regina Birdsell
24 Larson DriveHampsteadNH03841272345889$200
Garvey for NH Senate
PO Box 935New LondonNH03257811084028$200
Friends of Scott McGilvray
PO Box 16208HooksettNH03106812647784$200
Volinsky for Executive Coucil
488 Shaker RoadConcordNH03301475489903$200
Mel Myler
PO Box 82ContoocookNH03229455610319$200
Dick Hinch
14 Ichabod DriveMerrimackNH03054812979588$200
Lee Nyquist
PO Box 3New BostonNH03070461385760$450

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I-A, Line 1:FormAndLineReferenceDesc
ExplanationTwenty-three campaign donations totalling $5,300 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$9,344,865OtherCostOrOtherBasisAmt
Depreciation$5,395,829DepreciationAmt
Book Value$3,949,036BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$387,895OtherCostOrOtherBasisAmt
Depreciation$384,999DepreciationAmt
Book Value$2,896BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,105,214OtherCostOrOtherBasisAmt
Depreciation$10,656,648DepreciationAmt
Book Value$2,448,566BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$167,654OtherCostOrOtherBasisAmt
Depreciation$63,964DepreciationAmt
Book Value$103,690BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$7,637,533TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

FieldValueIRS element (for citing)
DescInvestment in Red Tree Holdings (1/3 interest)Desc
Book Value$3,425,005BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Program Rltd$3,425,005TotalBookValueProgramRltdAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Unearned Revenue$1,859,939
Accrued Refunds$594,009
Other Advances$2,523,800
FieldValueIRS element (for citing)
Total Liability$4,977,748TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$87,474,244TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$158,003NetUnrealizedGainsInvstAmt
Other Revenue$725,224OtherRevenueAmt
Revenue Not Reported$883,227RevenueNotReportedAmt
Revenue Subtotal$86,591,017RevenueSubtotalAmt
Investment Expenses Not Incld$115,156InvestmentExpensesNotIncldAmt
Other Revenues Not Included$241,239,347OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$241,354,503RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$327,945,520TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$83,223,096TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$83,223,096ExpensesSubtotalAmt
Investment Expenses Not Incld2$115,156InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$241,239,347OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$241,354,503ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$324,577,599TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X, Line 2:The 2016 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 725,224.
Part XI, Line 4b - Other Adjustments:Dental claims paid under admin service contracts 241,239,347.
Part XII, Line 4b - Other Adjustments:Dental claims paid under admin service contracts 241,239,347.
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$224,680CashGrantAmt
Purpose Of GrantGeneral support to promote oral healthPurposeOfGrantTxt

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 0.025% of the budgeted gross billings, plus 5% of the actual increase in unrestricted net assets from operations each year. DDPNH's elective contributions to the Foundation in 2016 totaled $224,680.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 PlanYes (1)SupplementalNonqualRtrPlanInd
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$522,200$0$220,107$0$63,213$0$75,814$0$28,951$0$910,285$0$0$0
Francis Boucher
Treasurer & Sr. VP Financ$190,942$0$26,196$0$10,615$0$17,832$0$12,840$0$258,425$0$0$0
Erica Bodwell
VP, General Counsel$199,314$0$0$0$4,513$0$0$0$25,208$0$229,035$0$0$0
William A Lambrukos
Sr. VP Operations$184,352$0$26,360$0$11,950$0$19,221$0$25,283$0$267,166$0$0$0
Shannon Mills
VP, Professional Relations$188,339$0$20,617$0$8,292$0$17,308$0$3,661$0$238,217$0$0$0
Jodie L Hittle
VP, Marketing$180,254$0$24,730$0$14,826$0$18,915$0$25,233$0$263,958$0$0$0
Mike Bourbeau
VP, Information Systems$168,077$0$22,327$0$18,690$0$15,806$0$3,530$0$228,430$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 1aSpousal travel for one business trip per year.
Part I, Line 4bThomas Raffio (President & CEO) - 2016 total contributions to nonqualified deferred compensation plans = $52,220 to 457(f) plan.
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 (6 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Nader Moavenian DDS
Director$656,068The 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
David Staples DDS
Director$387,479Please see above.0
Jean-Paul Rabbath DMD
Director$238,269Please see above.0
Richard Bolduc DDS
Director$256,546Please see above.0
Christiane Rothwangl DDS
Director$271,809Please see above.0
Keith Levesque DMD
Director$229,699Please see above.0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 2016, the Tri-State Compensation Committee reviewed and approved the CEO's proposed compensation, effective April 1, 2016, 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 losses on bonds -194,149.
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 2015 and 2016.
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.