Maine Dental Service Corporation

“The membership of Maine Dental Service Corporation consists of the Board of Directors, all of the individuals covered under the Company's dental benefit plans, and the Maine dentists participating in the Company's dental networks which are used by the individuals covered under one of the Company's dental benefit plans.”

“The Board of Trustees are elected at the Maine Dental Service Corporation's Annual Membership meeting, which requires a quorum of 25 members to conduct business.”

“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.”

“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.”

“Upon request, Maine Dental Services Corporation makes its governing documents, conflict of interest policy, or financial statements available to the public.”

“Thomas Raffio, CEO and Laurie Bienefeld, Vice President of Finance, received all of their compensation from Delta Dental Plan of New Hampshire, which is an unrelated organization per IRS definitions; while definitionally unrelated, Delta Dental Plan of New Hampshire does coordinate and work closely with the Maine Dental Service Corporation to fulfill their respective exempt missions. In accordance with the IRS Instructions for the Form 990, compensation or payments from an unrelated organization to an individual for services rendered to the filing organization in that person's capacity as an officer, director, trustee, or employee of the filing organization, then the filing organization must report such amounts as compensation from the filing organization. Therefore, the compensation paid to these individuals has been reported on this Form 990, Part VII, Section A, under Column (D), though the Maine Dental Service Corporation did not, in fact, directly pay or compensate these individuals; these individuals were paid by Delta Dental Plan of New Hampshire in part for services rendered for the benefit and on behalf of Maine Dental Service Corporation. Additionally, due to the close working relationship between the two organizations, neither the filing organization nor Delta Dental Plan of New Hampshire is able to make a determination of how much of each named individuals' compensation relates to time and resources expended on either the filing organization or Delta Dental Plan of New Hampshire. For this reason and to promote transparency and compliance with this tax return, the filing organization has elected to report 100% of the named individuals' applicable calendar year compensation as received by the Delta Dental Plan of New Hampshire on this Form 990, Part VII, and Schedule J, in accordance with the definitions and calculations as detailed in the IRS Form 990 Instructions.”

“Please see narrative for Part III, Line 4c.”

“The seven employees included here are actually employed and paid by Delta Dental Plan of New Hampshire. These employees are assigned to provide sales and marketing services to Maine Dental Services Corporation. Maine Dental Services Corporation reimburses Delta Dental Plan of New Hampshire for these employees' payroll and employee benefit expenses.”

“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 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.”

“The Finance/Audit Committee oversees the audit process for Maine Dental Service Corporation. The audit process for the financial statements did not change from the prior year. Independent accountants performed the audit in both 2023 and 2024.”

“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 using accounting practices prescribed or permitted by the Vermont Department of Financial Regulation. This is one of the reconciling items to meet the reporting requirements for the Form 990.”