2023-11-07T17:44:20-06:00 2022-12-31 010494526 Baker Newman & Noyes 650 Elm Street Suite 302 Manchester NH 03101 990 2022-01-01 020489150 Northeast Delta Dental Foundation NORT 6032231000 PO Box 2002 Concord NH 033022002 THOMAS RAFFIO President & CEO 6032231000 2023-11-07 1 THOMAS RAFFIO 999009999 0 Connor Smart P02285543 6036262200 2023-11-07 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z Thomas Raffio PO Box 2002 Concord NH 033022002 1532949 0 X www.nedelta.com X 1996 NH Promote dental health and education in northern New England 10 10 0 15 0 0 1985060 1278064 0 0 422609 239179 0 0 2407669 1517243 666779 503999 0 0 0 0 0 0 0 11448 13347 678227 517346 1729442 999897 10988991 10442324 213817 213817 10775174 10228507 To promote dental health and education in northern New England. 0 0 326695 326695 Dental Equipment and Supplies: Cash donations to 34 nonprofit dental clinics to purchase dental equipment and supplies to serve patients who cannot afford dental care. 140804 140804 Oral Health Education Programs and Public Policy Development: Cash donations to 13 organizations to sponsor oral health education programs. Donations of printed materials and supplies to schools, nonprofit dental clinics, and other organizations to provide oral health education programs. 36500 36500 In-School Programs for Children: Cash donations to 6 organizations to sponsor in-school education programs on fluoride rinse or sealants for children. 503999 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 0 0 0 NH X Jennifer McGrath 6032231000 c/o One Delta Drive Concord NH 033022002 X Grace Odimayo DMD Director 0.50 X 0 0 0 David B Solomon DDS Director 0.50 X 0 0 0 David B Staples DDS Director 0.50 X 0 0 0 Jeffrey R Walawender DDS Director 0.50 X 0 0 0 Terence A Wardrop Director 0.50 X 0 0 0 Jason Williams Director 0.50 X 0 0 0 Thomas Raffio President & Director 2.00 X X 0 0 0 Melvine J Severance III Chair & Director 0.50 X X 0 0 0 Jennifer L McGrath Treasurer 6.00 X 0 0 0 Siobhan Hutchison Secretary 1.00 X 0 0 0 0 0 0 0 0 0 0 0 19854 1258210 1278064 239179 239179 12598 19854 15706 -3108 -3108 3108 0 3108 3108 1517243 0 0 239179 503999 503999 2900 2900 10337 10337 Bank Service Charges 110 110 517346 503999 13347 0 832939 1031008 1640700 904100 8515352 8507216 10988991 10442324 213817 213817 213817 213817 X 10725174 10178507 50000 50000 10775174 10228507 10988991 10442324 999897 -1546564 0 X 0 0 0 X 650200 500475 1715901 1988648 1288438 6143662 650200 500475 1715901 1988648 1288438 6143662 5345005 798657 133540 167542 126514 422609 239179 1089384 7233046 0.11040 0.11240 X The Organization meets the Facts and Circumstances Test for the following reasons:1.) Through its activities, the Organization regularly and continuously benefits many thousands of members of the general public;2.) The Organization encourages donations from the general public through the website of Northeast Delta Dental (a group of nonprofit organizations) and through other means; and3.) The Organization's Board does not represent any narrow interests and is committed to representing all of the citizens of Northern New England who are most in need of dental care assistance. Part II, Section A, Line 1 Line 1 includes $22,040 as a very conservative estimate of the amount of annual in-kind non-cash contributions which are not included on the organization's books received over the past five years. The 2022 estimate for in-kind non-cash contributions is $5,187. Any net retained fundraising contributions were support from the general public. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10206100 904100 -1307385 341433 9461382 7948027 1640700 1097782 480409 10206100 6473499 1218500 533990 277962 7948027 5618830 150000 954181 249512 6473499 5923124 403200 -489552 217942 5618830 0.99500 0.00000 0.00500 0 0 0 Part V, Line 4: To help ensure that the Foundation can continue to promote dental health and education in Northern New England. Golf Tournament 32452 19854 12598 7100 7202 1404 32452 19854 12598 7100 7202 1404 15706 -3108 1 Building Community in New Hampshire 1045 Elm Street Suite 202 Manchester NH 03101 273435232 501(c)(3) 5158 0 Dental care fund for Congolese refugees Children's Oral Health Network of Maine PO Box 11 Yarmouth ME 04096 813309003 501(c)(3) 15000 0 Medical dental integration initiative and coordinator's salary Concord Hospital Trust 250 Pleasant Street Concord NH 03301 222594672 501(c)(3) 15000 0 Pledge support for dental center Crotched Mountain Foundation 1 Verney Drive Greenfield NH 03047 020222168 501(c)(3) 11200 0 Community care oral health care program Dismas Home of New Hampshire 102 Fourth Street Manchester NH 03102 472722572 501(c)(3) 10000 0 Dental care fund for clientele Easterseals New Hampshire 555 Auburn Street Manchester NH 03103 020272825 501(c)(3) 10000 0 Residential dental program Good Neighbor Health Clinic 70 N Main Street White River Junction VT 05001 030346949 501(c)(3) 5754 0 Red Logan Dental Clinic dental extern student housing stipends Greater Seacoast Community Health Foundation 100 Campus Drive Suite 12 Portsmouth NH 03801 020304203 501(c)(3) 10000 0 Support for oral care of the patients Harbor Homes (Harbor Care Health and Wellness Center) 77 Northeastern Boulevard Nashua NH 03062 020304203 501(c)(3) 10000 0 Support for care of dental centers patients Mid-State Health Center 101 Boulder Point Drive Suite 1 Plymouth NH 03864 020487172 501(c)(3) 38300 0 Mobile dental van National Foundation of Dentistry for the Handicapped PO Box 3487 Concord NH 033023487 900292580 501(c)(3) 20000 0 Dental Lifeline Network of NH; donated dental services program support National Foundation of Dentistry for the Handicapped 1800 15th Street Suite 100 Denver CO 80202 364779648 501(c)(3) 15000 0 Dental Lifeline Network of VT; donated dental services program support National Foundation of Dentistry for the Handicapped PO Box 2282 Augusta ME 043382282 841533658 501(c)(3) 12500 0 Dental Lifeline Network of ME; donated dental services program support North American Family Institute (NFI) 40 Park Lane Contoocook NH 03229 043161042 501(c)(3) 10000 0 Dental health flex fund One Sky Community Service 755 Banfield Road Portsmouth NH 03801 020368955 501(c)(3) 6000 0 Support for dental portion of readiness fund for clientele St Croix Regional Family Health Center 136 Mill Street Priceton ME 04668 010467073 501(c)(3) 12000 0 Tooth restoration and treatment system Sullivan County Oral Health Collaborative 1 Tremont Street Claremont NH 03743 680662886 501(c)(3) 10000 0 Dental equipment Sunrise Opportunities PO Box 311 Machias ME 04654 010407276 501(c)(3) 15000 0 School-based oral health program The Opportunity Alliance 50 Lydia Lane South Portland ME 04106 010274725 501(c)(3) 10000 0 Virtual dental health groups The Root Cellar (fiscal agent for Mainely Teeth) 166 Regan Lane Portland ME 04103 220990667 501(c)(3) 10000 0 Mobile dental clinic waiting list University of NH Foundation 56 Old Suncook Road Suite 2 Concord NH 03301 020437506 501(c)(3) 7500 0 Leadership Series for individuals with disabilities and their family members University of Vermont Medical Center 128 Lakeside Avenue Suite 106 Brlington VT 05401 030219309 501(c)(3) 15000 0 General practice dental residency program Vermont State Dental Society 1 Kennedy Drive Suite L3 South Burlington VT 05403 222514423 501(c)(3) 20000 0 Dental auxiliary recruitment program Windham County Dental CenterUnited Way of Windham County - Fiscal Agent 1 Holstein Place Brattleboro VT 05301 853639751 501(c)(3) 10000 0 School to dentist referral program Community Health Centers of the Rutland Region 275 Route 30N Bomoseen VT 05732 221179701 501(c)(3) 25000 0 School-based dental program Community Health Services of Addison County (Open Door Clinic 100 Porter Drive Middlebury VT 05753 030359531 501(c)(3) 15000 0 Open wide oral health care initiative Upper Valley Haven 713 Hartford Avenue White River Junction VT 05001 030277908 501(c)(3) 10000 0 Dental care fund for clientele Trustees of Tufts College (Tufts University School of Dental Medicine) 20 Professors Row Medford MA 02155 042103634 501(c)(3) 50000 0 Dental students mentorship program 28 0 Part I, Line 2: Donation recipients are required to send a report annually detailing how the money was spent, using statistics of patients served, utilization of machinery, or other specifics. These reports are monitored by the Foundation Treasurer who tracks the receipt of the annual reports. Form 990, Part VI, Section A, line 6 The Foundation has three members: Delta Dental Plan of New Hampshire, Inc.; Delta Dental Plan of Vermont, Inc.; and Maine Dental Services Corporation. All three members are tax-exempt under Internal Revenue Code Section 501(c)(4). Form 990, Part VI, Section A, line 7a The members elect the Foundation's Board of Directors. Form 990, Part VI, Section A, line 7b In addition to electing the Board of Directors, the members have the power to remove directors, repeal or change bylaws by 2/3rd member vote (Board has primary authority to amend bylaws), and to dissolve the Corporation by 2/3rd member vote. 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 990 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 C, line 19 Upon request, Northeast Delta Dental Foundation makes its governing documents, conflict of interest policy, or financial statements available to the public.