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DELTA DENTAL PLAN OF NEW HAMPSHIRE: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL PLAN OF NEW HAMPSHIRE (EIN 02-0273013)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-11
IRS object ID
201623169349300822
Schema version
2015v2.1
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)
Return2016-11-11T09:05:17-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

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 Begin2015-01-01TaxPeriodBeginDt

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
Signature2016-11-01SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonE Drew CheneyPreparerPersonNm
PTINP00182972PTIN
Phone8002447444PhoneNum
Preparation2016-11-01PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

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$326,501,479GrossReceiptsAmt
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 Employee186TotalEmployeeCnt
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$306,262,527PYProgramServiceRevenueAmt
CY Program Service Revenue$315,558,587CYProgramServiceRevenueAmt
PY Investment Income$991,092PYInvestmentIncomeAmt
CY Investment Income$933,016CYInvestmentIncomeAmt
PY Other Revenue-$11,554PYOtherRevenueAmt
CY Other Revenue$4,519CYOtherRevenueAmt
PY Total Revenue$307,242,065PYTotalRevenueAmt
CY Total Revenue$316,496,122CYTotalRevenueAmt
PY Grants And Similar Paid$104,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$234,796CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$273,452,600PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$280,383,113CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$15,732,831PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$16,728,317CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$16,674,482PYOtherExpensesAmt
CY Other Expenses$15,439,474CYOtherExpensesAmt
PY Total Expenses$305,963,913PYTotalExpensesAmt
CY Total Expenses$312,785,700CYTotalExpensesAmt
PY Revenues Less Expenses$1,278,152PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,710,422CYRevenuesLessExpensesAmt
Total Assets BOY$58,031,348TotalAssetsBOYAmt
Total Assets EOY$61,776,573TotalAssetsEOYAmt
Total Liabilities BOY$13,952,006TotalLiabilitiesBOYAmt
Total Liabilities EOY$14,760,741TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$44,079,342NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$47,015,832NetAssetsOrFundBalancesEOYAmt
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$290,848,362ExpenseAmt
Grant$0GrantAmt
Revenue$315,458,587RevenueAmt
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 752,000 claims in 2015. There are approximately 340,000 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$234,796ExpenseAmt
Grant$234,796GrantAmt
Revenue$0RevenueAmt
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$291,083,158TotalProgramServiceExpensesAmt
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
IRP Document15646IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee186EmployeeCnt
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 (25 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)$8,208$0$0
Richard Bolduc
Director3.00Yes (X)$9,756$0$0
Dennis Hannon DDS
Director3.00Yes (X)$8,708$0$0
Jeffrey S Kipperman CPA
Director (part year)3.00Yes (X)$1,032$0$0
Michael L'Ecuyer
Director3.00Yes (X)$7,196$0$0
Jean-Paul Rabbath DMD
Director3.00Yes (X)$7,692$0$0
Christiane Rothwangl DDS
Director3.00Yes (X)$6,144$0$0
Nick S Soggu
Director3.00Yes (X)$8,192$0$0
Seth P Wall
Director3.00Yes (X)$8,724$0$0
Susan H Woods
Director3.00Yes (X)$11,820$0$0
Kathryn L Yerkes
Director3.00Yes (X)$8,708$0$0
Lisa Braiterman
Director (part year)3.00Yes (X)$6,660$0$0
Nadar Moavenian DDS
Director (part year)3.00Yes (X)$4,596$0$0
David Staples DDS
Director (part year)3.00Yes (X)$6,144$0$0
J Michael Degnan
Chair & Director3.00Yes (X)$26,971$0$0Yes (X)
Francis H LaBranche Jr DDS
Vice Chair & Director3.00Yes (X)$13,884$0$0Yes (X)
Thomas Raffio
President & CEO80.00$814,932$0$164,575Yes (X)
Francis Boucher
Treasurer & Sr. VP Financ48.00$206,715$0$29,226Yes (X)
Sara M Brehm
Secretary50.00$96,734$0$18,216Yes (X)
Peter Leberman Esq
VP & Gen. Counsel, Asst Sec'y55.00$255,908$0$29,203Yes (X)
William A Lambrukos
Sr. VP Operations40.00$215,686$0$42,877Yes (X)
Shannon Mills
VP, Professional Relations50.00$210,906$0$19,813Yes (X)
Jodie L Hittle
VP, Marketing50.00$214,533$0$42,286Yes (X)
Mike Bourbeau
VP, Information Systems47.00$194,126$0$19,188Yes (X)
Constance Roy-Czyzowski
VP, Human Resources50.00$197,715$0$27,389Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,551,690TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$392,773TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K29IndivRcvdGreaterThan100KCnt
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
Combined Services LLC
2 Delta DriveConcordNH03302Insurance broker commissions$871,650
Iovations Inc
26 Ray AvenueBurlingtonMA01803Consulting services$664,390
Encara Inc
4818 Starkey RoadRoanokeVA24018Contracted services$637,729
New England Employee Benefits
15 Chenell DriveConcordNH03301Insurance broker commissions$331,309
Cronin Gervino & Warlick Inc
171 Londonderry TurnpikeHooksettNH03106Insurance broker commissions$310,266
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K10CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Admin Service Contract Fees524292$253,109,769$253,109,769
Premium Revenue524114$62,348,818$62,348,818
Management Fee - CSLLC524298$100,000$100,000
FieldValueIRS element (for citing)
Total Program Service Revenue$315,558,587TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$795,888TotalRevenueColumnAmt
Exclusion$795,888ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$253,724RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$249,205RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$4,519RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,519TotalRevenueColumnAmt
Exclusion$4,519ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$9,893,280SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$9,756,152SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$137,128SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$137,128TotalRevenueColumnAmt
Exclusion$137,128ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$316,496,122TotalRevenueColumnAmt
Related Or Exempt Func Income$315,458,587RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$100,000UnrelatedBusinessRevenueAmt
Exclusion$937,535ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$234,796TotalAmt
Program Services$234,796ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$280,383,113TotalAmt
Program Services$280,383,113ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,742,472TotalAmt
Program Services$629,211ProgramServicesAmt
Management And General$1,113,261ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$11,147,594TotalAmt
Program Services$4,958,065ProgramServicesAmt
Management And General$6,189,529ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$318,533TotalAmt
Program Services$133,723ProgramServicesAmt
Management And General$184,810ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,663,084TotalAmt
Program Services$1,099,343ProgramServicesAmt
Management And General$1,563,741ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$856,634TotalAmt
Program Services$362,490ProgramServicesAmt
Management And General$494,144ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$58,410TotalAmt
Management And General$58,410ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$61,148TotalAmt
Management And General$61,148ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$113,053TotalAmt
Management And General$113,053ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,674,849TotalAmt
Program Services$50,919ProgramServicesAmt
Management And General$1,623,930ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,635,161TotalAmt
Program Services$950,492ProgramServicesAmt
Management And General$684,669ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$940,312TotalAmt
Program Services$393,533ProgramServicesAmt
Management And General$546,779ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$803,263TotalAmt
Program Services$353,998ProgramServicesAmt
Management And General$449,265ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$71,940TotalAmt
Program Services$9,947ProgramServicesAmt
Management And General$61,993ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$409,742TotalAmt
Program Services$34,278ProgramServicesAmt
Management And General$375,464ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$6,350TotalAmt
Program Services$2,798ProgramServicesAmt
Management And General$3,552ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,611,146TotalAmt
Program Services$710,032ProgramServicesAmt
Management And General$901,114ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$169,899TotalAmt
Program Services$69,092ProgramServicesAmt
Management And General$100,807ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmt
Brokers' Commissions$3,803,149$3,803,149
Premium Taxes$1,020,903$1,020,903
Strategic Initiatives$129,769$129,769

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,930,380TotalAmt
Program Services$707,328ProgramServicesAmt
Management And General$2,223,052ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$312,785,700TotalAmt
Program Services$291,083,158ProgramServicesAmt
Management And General$21,702,542ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$7,077,901BOYAmt
EOY$10,170,160EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$281,815BOYAmt
EOY$315,392EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,284,580BOYAmt
EOY$4,611,809EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$559,213BOYAmt
EOY$866,669EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$23,559,792LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$14,966,136LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$8,725,424BOYAmt
EOY$8,593,656EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$35,416,621BOYAmt
EOY$35,631,116EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$271,853BOYAmt
EOY$167,451EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$1,327,013BOYAmt
EOY$1,317,698EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$86,928BOYAmt
EOY$102,622EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$58,031,348BOYAmt
EOY$61,776,573EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,239,116BOYAmt
EOY$7,695,463EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,100,000BOYAmt
EOY$1,890,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,612,890BOYAmt
EOY$5,175,278EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$13,952,006BOYAmt
EOY$14,760,741EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$44,079,342BOYAmt
EOY$47,015,832EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$44,079,342BOYAmt
EOY$47,015,832EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$58,031,348BOYAmt
EOY$61,776,573EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,710,422ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$454,634NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$319,298OtherChangesInNetAssetsAmt
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$6,800PoliticalExpendituresAmt
Expended527 Activities$6,800Expended527ActivitiesAmt
Internal Funds Contributed$0InternalFundsContributedAmt
Total Exempt Function Expend$6,800TotalExemptFunctionExpendAmt
Form1120 POL FiledYes (1)Form1120POLFiledInd

Section527 Political Org Section527PoliticalOrgGrp (21 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPaid Internal FundsPaidInternalFundsAmt
Governor Maggie Hassan Inaugural Committee
PO Box 1464ManchesterNH03101461402057$1,000
Friends of Feltes Committee
PO Box 623ConcordNH03302471093993$100
NH Senate Democratic Caucus
105 North State StreetConcordNH03301020473096$250
Van Ostern for NH
PO Box 193ConcordNH033020193453128573$250
Committee to Elect House Democrats
PO Box 1292ConcordNH03301020162350$250
Pappas for NH
PO Box 313ManchesterNH02104454838661$250
Donna Soucy for Senate
91 Alexander StreetManchesterNH02104460562203$100
Jerry Little for State Senate
75 Woodbury RoadWeareNH03281465457460$100
Friends of Jeanie Forrester
78 Tracy WayMeredithNH03253271874774$100
Committee to Elect Lou D'Allesandro
332 St James AvenueManchesterNH03102020519208$100
Chuck Morse for State Sentate
14 Old Farm RoadSalemNH03079273071602$500
Friends of Jeb Bradley
645 S Main StreetWolfeboroNH03894264422111$250
Supporters of Molly Kelly
PO Box 1475KeeneNH03431208805201$250
Boutin for State Senate
1465 Hooksett Road 80HooksettNH03106005563604$100
Friends of Sharon Carson
19 Tokanel RoadLondonderryNH03053800628169$100
Committee to Elect House Republicans
75 South Main Street Unit 7 Box 1ConcordNH03301463192141$250
Martha Fuller Clark for State Senate
501 Islington Street Ste EPortsmouthNH03801$100
Senate Republican Majority PAC
PO Box 656ConcordNH03301463728365$500
Friends of Chris Sununu
PO Box 957ExeterNH03833454901693$250
Ted Gatsas for Mayor
20 Market Street PO Box 6655ManchesterNH031086655270405959$1,000
Joyce Craig for Mayor
396 N Bend DrManchesterNH03104472901050$1,000

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I-A, Line 1:FormAndLineReferenceDesc
ExplanationTwenty one campaign donations totalling $6,800 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$9,286,089OtherCostOrOtherBasisAmt
Depreciation$5,032,739DepreciationAmt
Book Value$4,253,350BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$384,735OtherCostOrOtherBasisAmt
Depreciation$384,735DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,617,465OtherCostOrOtherBasisAmt
Depreciation$9,428,735DepreciationAmt
Book Value$3,188,730BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$138,158OtherCostOrOtherBasisAmt
Depreciation$119,927DepreciationAmt
Book Value$18,231BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$8,593,656TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Unearned Revenue$2,063,297
Accrued Refunds$711,981
Other Advances$2,400,000
FieldValueIRS element (for citing)
Total Liability$5,175,278TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$82,765,412TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$454,634NetUnrealizedGainsInvstAmt
Other Revenue-$329,190OtherRevenueAmt
Revenue Not Reported-$783,824RevenueNotReportedAmt
Revenue Subtotal$83,549,236RevenueSubtotalAmt
Investment Expenses Not Incld$113,053InvestmentExpensesNotIncldAmt
Other Revenues Not Included$232,833,833OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$232,946,886RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$316,496,122TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$79,838,814TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$79,838,814ExpensesSubtotalAmt
Investment Expenses Not Incld2$113,053InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$232,833,833OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$232,946,886ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$312,785,700TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X, Line 2:The 2015 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. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position historically taken on various tax exposure items including unrelated business income or tax status. Assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. 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, does not have any significant unrelated business income and has taken no uncertain tax positions that require adjustment to or disclosure in the accompanying statutory financial statements. Tax years after December 31, 2011 are open for Internal Revenue Service or state examination.
Part XI, Line 2d - Other Adjustments:Change in nonadmitted assets -329,190.
Part XI, Line 4b - Other Adjustments:Dental claims paid under admin service contracts 232,833,833.
Part XII, Line 4b - Other Adjustments:Dental claims paid under admin service contracts 232,833,833.
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$234,796CashGrantAmt
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 0.025% 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 2015 totaled $234,796.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 (8 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$226,636$0$66,096$0$127,527$0$37,048$0$979,507$0$0$0
Francis Boucher
Treasurer & Sr. VP Financ$183,195$0$23,082$0$438$0$15,470$0$13,756$0$235,941$0$0$0
Peter Leberman Esq
VP & Gen. Counsel, Asst Sec'y$200,676$0$39,947$0$15,285$0$7,795$0$21,408$0$285,111$0$0$0
William A Lambrukos
Sr. VP Operations$179,781$0$24,834$0$11,071$0$17,726$0$25,151$0$258,563$0$0$0
Shannon Mills
VP, Professional Relations$175,860$0$24,292$0$10,754$0$16,202$0$3,611$0$230,719$0$0$0
Jodie L Hittle
VP, Marketing$172,016$0$24,443$0$18,074$0$15,201$0$27,085$0$256,819$0$0$0
Mike Bourbeau
VP, Information Systems$158,244$0$21,504$0$14,378$0$14,773$0$4,415$0$213,314$0$0$0
Constance Roy-Czyzowski
VP, Human Resources$162,157$0$27,379$0$8,179$0$15,613$0$11,776$0$225,104$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) - 2015 total contributions to nonqualified deferred compensation plans = $104,440 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$587,398The 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$380,767Please see above.0
Jean-Paul Rabbath DMD
Director$237,095Please see above.0
Richard Bolduc DDS
Director$235,441Please see above.0
Francis H LaBranche DDS
Director$196,554Please see above.0
Christiane Rothwangl DDS
Director$303,577Please see above.0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, line 11The 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 2015, the Tri-State Compensation Committee reviewed and approved the CEO's proposed compensation, effective April 1, 2015, 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 -319,298.
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 2014 and 2015.
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.