| Return Reference | Explanation |
|---|---|
| Form 990, Part V, Line 15: | Thomas Raffio is the President & CEO of Delta Dental Plan of New Hampshire, Inc. Mr. Raffio also serves in a similar capacity for the Delta Dental Plan of Vermont and the Maine Dental Services Corporation. These three entities are otherwise independent of and unrelated to each other as defined under IRS Form 990 Instructions. While Delta Dental Plan of New Hampshire technically files and processes Thomas Raffio's compensation, a portion of this compensation is paid in return for services rendered to the two other aforementioned unrelated organizations. However, in accordance with IRS Instructions, the complete amount of compensation paid to Mr. Raffio by Delta Dental Plan of New Hampshire has been disclosed on this Form 990, reported as compensation and benefits paid by the filing organization. During the period covered by this Form 990, Mr. Raffio received total compensation in excess $1,000,000 and is reported in detail on this Form 990, Part VII and Schedule J. While Mr. Raffio received compensation exceeding $1,000,000 in total, the compensation paid to Mr. Raffio was in return for services rendered on behalf of each of the three unrelated entities; compensation paid to Mr. Raffio in return for services rendered to any one of the entities, taken individually, was less than $1,000,000. These entities in aggregate do not constitute a group of related applicable tax-exempt organizations as defined under Section 4960. As a portion of the compensation paid to Mr. Raffio was in return for services rendered to each of the unrelated tax-exempt organizations, and no single entity's allocated compensation was more than $1,000,000, neither Delta Dental Plan of New Hampshire, nor either of the two other unrelated organizations, are subject to the Section 4960 excise tax on executive compensation exceeding $1,000,000. Accordingly, this Form 990, Part V, Line 15, has been answered "no, and the Organization has not filed Form 4720. |
| Form 990, Part VI, Section A, line 6 | The membership of Delta Dental Plan of New Hampshire, Inc. consists of the New Hampshire dentists participating in the company's networks which are used by individuals covered under one of the Company's dental benefit plans. |
| Form 990, Part VI, Section A, line 7b | Membership approval is required for all Bylaw changes. |
| Form 990, Part VI, Section B, line 11b | The 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 12c | 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 15 | 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 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 2023, the Tri-State Compensation Committee reviewed and approved the CEO's proposed compensation, effective April 1, 2023, for the Treasurer and Secretary based on comparability data provided to the Committee. |
| Form 990, Part VI, Section C, line 19 | 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 XI, line 9: | Unrealized gains/(losses) on bonds -1,114,078. |
| 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 2022 and 2023. |
| Form 990, Part XI, Line 9 | The 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. |
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