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DELTA DENTAL PLAN OF NEW HAMPSHIRE: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
DELTA DENTAL PLAN OF NEW HAMPSHIRE (EIN 02-0273013)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-14
IRS object ID
201103189349305270
Schema version
2010v3.4
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)
Timestamp2011-11-14T14:35:23-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BAKER NEWMAN & NOYES LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1650 ELM STREET SUITE 302AddressLine1
CityMANCHESTERCity
StateNHState
ZIP Code03101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN020273013EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1DELTA DENTAL PLAN OF NEW HAMPSHIRE INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlDELTNameControl
Phone6032231000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE DELTA DRIVE PO BOX 2002AddressLine1
CityCONCORDCity
StateNHState
ZIP Code033022002ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTHOMAS RAFFIOName
TitlePRESIDENT & CEOTitle
Phone6032231000Phone
Date Signed2011-11-14DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameE DREW CHENEYName
Phone8002447444Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTHOMAS RAFFIONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1ONE DELTA DRIVE PO BOX 2002AddressLine1
CityCONCORDCity
StateNHState
ZIP Code033022002ZIPCode
FieldValueIRS element (for citing)
Gross Receipts280951054GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.NEDELTA.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1961YearFormation
State Legal DomicileNHStateLegalDomicile
Activity Or Mission DescriptionPROVIDE PROGRAMS OF DENTAL CAREActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees213TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI98445TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year263918821ProgramServiceRevenuePriorYear
Program Service Revenue CY276896834ProgramServiceRevenueCY
Investment Income Prior Year1535129InvestmentIncomePriorYear
Investment Income Current Year1025807InvestmentIncomeCurrentYear
Other Revenue Prior Year-63075OtherRevenuePriorYear
Other Revenue Current Year101943OtherRevenueCurrentYear
Total Revenue Prior Year265390875TotalRevenuePriorYear
Total Revenue Current Year278024584TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year197200GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY290100GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year237425903BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY249379499BenefitsPaidToMembersCY
Salaries Etc Prior Year13215847SalariesEtcPriorYear
Salaries Etc Current Year13579236SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year13319423OtherExpensePriorYear
Other Expenses Current Year13774490OtherExpensesCurrentYear
Total Expenses Prior Year264158373TotalExpensesPriorYear
Total Expenses Current Year277023325TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1232502RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1001259RevenuesLessExpensesCY
Total Assets BOY42893534TotalAssetsBOY
Total Assets EOY45317776TotalAssetsEOY
Total Liabilities BOY10651863TotalLiabilitiesBOY
Total Liabilities EOY10760156TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY32241671NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY34557620NetAssetsOrFundBalancesEOY
Mission DescriptionIT IS OUR MISSION TO BE THE LEADING FORCE IN THE DENTAL PREPAYMENT MARKET BY OFFERING QUALITY, VERSATILE AND AFFORDABLE DENTAL PROGRAMS TO BENEFIT OUR PURCHASERS, SUBSCRIBERS, AND PARTICIPATING MEMBER DENTISTS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense258057720Expense
Revenue276896834Revenue
DescriptionPROGRAM SERVICES INCLUDE THE PROCESSING AND PAYMENT OF CLAIMS FOR DENTAL PROGRAMS FOR VARIOUS ORGANIZATIONS, CORPORATIONS, INDIVIDUALS , AND OTHER BUSINESS ENTERPRISES. THERE, ARE APPROXIMATELY 734,400 MEMBERS INCLUDED IN THE VARIOUS PLANS AND APPROXIMATELY 1,521,400 CLAIMS WERE PROCESSED IN 2010.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense290100Expense
Grants290100Grants
DescriptionGRANT MADE TO THE NORTHEAST DELTA DENTAL FOUNDATION ($190,100).DONATION OF $100,000 TO THE UNIVERSITY OF NEW ENGLAND TO BUILD A NEW DENTAL SCHOOL.Description
FieldValueIRS element (for citing)
Total Program Service Expense258347820TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109615402NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees213NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1FRANK BOUCHERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6032231000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE DELTA DRIVE PO BOX 2002AddressLine1
CityCONCORDCity
StateNHState
ZIP Code03302ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
PETER A WELNAK DDS
CHAIR & DIRECTOR5.00XX2363400
GERALDINE STONE DONAHUE
VICE CHAIR & DIRECTOR (PART YEAR)3.00XX285800
TERENCE A WARDROP
VICE CHAIR & DIRECTOR (PART YEAR)3.00XX536300
MARY ANN ALDRICH RN
DIRECTOR (PART YEAR)3.00X395600
MICHAEL DEGNAN
DIRECTOR3.00X489500
DENNIS HANNON DDS
DIRECTOR (PART YEAR)3.00X302000
MARK A HORVATH DDS
DIRECTOR (PART YEAR)3.00X140400
DOUGLAS J KATZ DMD
DIRECTOR3.00X489500
SHEILA A KENNEDY DDS MPH
DIRECTOR3.00X699400
JEFFREY S KIPPERMAN CPA
DIRECTOR3.00X766200
FRANCIS H LABRANCHE DDS
DIRECTOR3.00X536300
JEFFREY W RODDEN DDS
DIRECTOR3.00X536300
NICK S SOGGU
DIRECTOR3.00X536300
KATHRYN L YERTZE
DIRECTOR3.00X583100
ELIZABETH SPINDEL DMD
DIRECTOR3.00X307300
SETH P WALL
DIRECTOR3.00X442700
SUSAN H WOODS
DIRECTOR3.00X583100
HELEN T BIGLIN
TREASURER & SR. VP FINANCE40.00X182420031522
BARBARA A MCLAUGHLIN
SECRETARY (PART YEAR)40.00X143239026980
SARA BREHM
SECRETARY (PART YEAR)40.00X6438705534
THOMAS RAFFIO
PRESIDENT & CEO60.00X7060670149478
WILLIAM H LAMBRUKOS
SENIOR VP OPERATIONS40.00175119034902X
SHANNON MILLS
VP PROFESSIONAL RELATIONS40.00169239031746X
CONSTANCE ROY-CZYZOWSKI
VP HUMAN RESOURCES40.00159147037529X
KENNETH L ROBINSON
GENERAL COUNSEL40.00156290031893X
MICHAEL D BOURBEAU
VP INFORMATION SYSTEMS40.00152618012696X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2008458TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation362280TotalOtherCompensation
Number Individuals GT100 K16NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
COMBINED SERVICES LLC
15 NORTH MAIN STREET SUITE 300CONCORDNH03301INSURANCE BROKER COMMISSIONS893415
NEW ENGLAND EMPLOYEE BENEFITS
15 CHENELL DRIVECONCORDNH03301INSURANCE BROKER COMMISSIONS388194
CRONIN GERVINO & WARLICK INC
171 LONDONDERRY TURNPIKEHOOKSETTNH03106INSURANCE BROKER COMMISSIONS167077
BAKER NEWMAN & NOYES LLC
PO BOX 507PORTLANDME04112AUDITING, CONSULTING, TAX160751
SHEEHAN PHINNEY BAS & GREEN
1000 ELM STREET PO BOX 3701MANCHESTERNH03105LEGAL124731
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
ADMIN SERVICE CONTRACT524292216790346216790346
PREMIUM REVENUE5241146010648860106488
FieldValueIRS element (for citing)
Total Program Service Revenue276896834TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column985563TotalRevenueColumn
Exclusion$985,563ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real241350Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real237852Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real3498Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column3498TotalRevenueColumn
Exclusion$3,498ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2727232Securities
Other1630Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities2683872Securities
Other4746Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities43360Securities
Other-3116Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column40244TotalRevenueColumn
Exclusion$40,244ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenue
MANAGEMENT FEE - CSLLC561000100000100000
EQUITY LOSS - NEW ENGL524292-1555-1555
FieldValueIRS element (for citing)
Total Other Revenue98445TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column278024584TotalRevenueColumn
Related Or Exempt Function Income276896834RelatedOrExemptFunctionIncome
Unrelated Business Revenue98445UnrelatedBusinessRevenue
Exclusion$1,029,305ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total290100Total
Program Services290100ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total249379499Total
Program Services249379499ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1409559Total
Management And General1409559ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total8813575Total
Program Services3526935ProgramServices
Management And General5286640ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total131808Total
Program Services117284ProgramServices
Management And General14524ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2490812Total
Program Services1130615ProgramServices
Management And General1360197ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total733482Total
Program Services313583ProgramServices
Management And General419899ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total80813Total
Management And General80813ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total263687Total
Management And General263687ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total58070Total
Management And General58070ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total424481Total
Program Services140358ProgramServices
Management And General284123ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1316048Total
Management And General1316048ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2455964Total
Program Services1581641ProgramServices
Management And General874323ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total782304Total
Program Services348125ProgramServices
Management And General434179ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total77973Total
Program Services13255ProgramServices
Management And General64718ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total337563Total
Program Services21942ProgramServices
Management And General315621ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total6184Total
Program Services2751ProgramServices
Management And General3433ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1376369Total
Program Services600433ProgramServices
Management And General775936ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total97508Total
Program Services31606ProgramServices
Management And General65902ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
BROKERS' COMMISSIONS36099333609933
PREMIUM TAXES944478944478
EQUIPMENT/SOFTWARE MAIN631055359655271400
DATA PROCESSING50196763067438900
STRATEGIC INITIATIVES5096350963

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total759130Total
Program Services139393ProgramServices
Management And General619737ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total277023325Total
Program Services258347820ProgramServices
Management And General18675505ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2437903BOY
EOY3045675EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY116341BOY
EOY35368EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3811803BOY
EOY4156301EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY201440BOY
EOY140714EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis17733722LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec9317843LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY9214831BOY
EOY8415879EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY25589753BOY
EOY28051137EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY1410112BOY
EOY1352030EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY111351BOY
EOY120672EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY42893534BOY
EOY45317776EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4547964BOY
EOY4810531EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY63500BOY
EOY100700EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY2100000BOY
EOY1890000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3940399BOY
EOY3958925EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY10651863BOY
EOY10760156EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY32241671BOY
EOY34557620EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32241671BOY
EOY34557620EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY42893534BOY
EOY45317776EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1001259ReconcilationRevenueExpenses
Reconcilation Other Changes1314690ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1133345OtherCostOrOtherBasis
Book Value1133345BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis8115110OtherCostOrOtherBasis
Depreciation3385321Depreciation
Book Value4729789BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis384735OtherCostOrOtherBasis
Depreciation384735Depreciation
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis7877357OtherCostOrOtherBasis
Depreciation5364955Depreciation
Book Value2512402BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis223175OtherCostOrOtherBasis
Depreciation182832Depreciation
Book Value40343BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings8415879TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
UNEARNED REVENUE$1,262,624
ACCRUED REFUNDS$732,084
OTHER ADVANCES$1,964,217
FieldValueIRS element (for citing)
Total Of Amounts3958925TotalOfAmounts
Total Revenue278024584TotalRevenue
Total Expenses277023325TotalExpenses
Excess Or Deficit For Year1001259ExcessOrDeficitForYear
Net Unrealized GL On Investments1314690NetUnrealizedGLOnInvestments
Total Adjustments1314690TotalAdjustments
Excess Or Deficit Per FS2315949ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt78809718TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1314690NetUnrealizedGainsInvestments
Revenue Not Rptd F9901314690RevenueNotRptdF990
Revenue Subtotal77495028RevenueSubtotal
Investment Expenses Not Included58070InvestmentExpensesNotIncluded
Other Revenues Not Included200471486OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt200529556RevenueNotRptdOnFinStmt
Total Revenue Per Form990278024584TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt76493769TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal76493769ExpensesSubtotal
Investment Expenses Not Included258070InvestmentExpensesNotIncluded2
Other Expenses Not Included200471486OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt200529556ExpensesNotRptdOnFinStmt
Total Expenses Per Form990277023325TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:PER THE AUDITED FINANCIAL STATEMENTS: DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. (THE CORPORATION)'S MANAGEMENT HAS DETERMINED THAT THE CORPORATION HAS NOT TAKEN, NOR EXPECTS TO TAKE, ANY UNCERTAIN TAX POSITIONS IN ANY INCOME TAX RETURN. TAX YEARS AFTER DECEMBER 31, 2006 ARE OPEN FOR INTERNAL REVENUE SERVICE OR STATE EXAMINATION.
PART XII, LINE 4B - OTHER ADJUSTMENTS:DENTAL CLAIMS PAID UNDER ADMIN SERVICE CONTRACTS 200,471,486.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:DENTAL CLAIMS PAID UNDER ADMIN SERVICE CONTRACTS 200,471,486.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
NORTHEAST DELTA DENTAL FOUNDATION
ONE DELTA DRIVE PO BOX 2002CONCORDNH03302020489150501(C)(3)190100GENERAL SUPPORT TO PROMOTE ORAL HEALTH
UNIVERSITY OF NEW ENGLAND
11 HILLS BEACH ROADBIDDEFORDME04005010211810501(C)(3)100000BUILDING A NEW DENTAL SCHOOL
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierOTHER INFORMATION:Identifier
Return ReferencePART IV:ReturnReference
ExplanationDELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. (DDPNH) 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. DDPNH'S ELECTIVE CONTRIBUTIONS TO THE FOUNDATION IN 2010 TOTALED $190,100. DDPNH CONTRIBUTED $100,000 TO THE UNIVERSITY OF NEW ENGLAND TO BUILD A NEW DENTAL SCHOOL.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
HELEN T BIGLIN
153461011466017493092460222760213942000
BARBARA A MCLAUGHLIN
107529018369017341054500215300170219000
THOMAS RAFFIO
522204012569305817001200510294270855545000
WILLIAM H LAMBRUKOS
15130509421014393093360255660210021000
SHANNON MILLS
1575640981101864094040223420200985000
CONSTANCE ROY-CZYZOWSKI
13957601207907492086620288670196676000
KENNETH L ROBINSON
13386809079013343075320243610188183000
MICHAEL D BOURBEAU
1313310817701311007799048970165314000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1ASPOUSAL TRAVEL FOR ONE BUSINESS TRIP PER YEAR.
PART I, LINE 4BTHOMAS RAFFIO (PRESIDENT & CEO) - 2010 REPORTABLE CONTRIBUTIONS TO NONQUALIFIED DEFERRED COMPENSATION PLANS = $104,400 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

Form990 Schedule L Part IV Form990ScheduleLPartIV (6 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
MARK A HORVATH DDS
DIRECTOR250414THE 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
ELIZABETH SPINDEL DMD
DIRECTOR3813000
PETER A WELNAK DDS
DIRECTOR2952550
DOUGLAS J KATZ DMD
DIRECTOR2112600
FRANCIS H LABRANCHE DDS
DIRECTOR2123170
JEFFREY RODDEN DDS
DIRECTOR1295300

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
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.
A 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 12C
CEO'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 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 2010, THE ORGANIZATION IMPLEMENTED A PROCESS OF TRI-STATE COMPENSATION COMMITTEE GENERAL OVERSIGHT AND REVIEW OF THE COMPENSATION OF THE OFFICERS OTHER THAN THE PRESIDENT & CEO. THE COMPENSATION OF THESE INDIVIDUALS HAS HISTORICALLY BEEN, AND CONTINUES TO BE, ESTABLISHED BY THE PRESIDENT & CEO, TAKING INTO ACCOUNT VARIOUS SOURCES OF COMPARABILITY DATA. IN FEBRUARY 2010, THE PRESIDENT & CEO'S RECOMMENDATIONS WERE REVIEWED BY THE COMMITTEE.FORM 990, PART VI, SECTION B, LINE 15A
UPON 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 VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 1,314,690.FORM 990, PART XI, LINE 5:
AUDIT REVIEW PROCESSTHE 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 2009 AND 2010.FORM 990, PART XII, LINE 2C