2020-11-12T20:16:03-06:00 2019-12-31 205325889 ACCUITY LLP 999 BISHOP STREET STE 1900 HONOLULU HI 96813 990 2019-01-01 990309519 ALOHACARE ALOH 8089731650 1357 KAPIOLANI BLVD NO 1250 HONOLULU HI 96814 DAVID R FIELD CFO 8089731650 2020-11-10 1 MANOJ SAMARANAYAKE P01450116 8085313400 72.130.220.18 2020-11-10 18:07:15 HS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 728C3D58C026F3372B916E3E5285344D13BDC82C 2019 2022-01-07 14:23:13Z DAVID R FIELD 1357 KAPIOLANI BLVD NO 1250 HONOLULU HI 96814 389987776 0 X WWW.ALOHACAREHAWAII.ORG X 1994 HI ALOHACARE IS A HAWAII CORPORATION THAT CONTRACTS WITH THE STATE OF HI, DEPT OF HUMAN SERVICES MED-QUEST DIVISION TO PROVIDE MANAGED HEALTH CARE IN ACCORDANCE WITH THE STATE OF HI HEALTH QUEST DEMONSTRATION, AND WITH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) TO PROVIDE MANAGED HEALTH CARE THROUGH A MEDICARE ADVANTAGE HEALTH/PRESCRIPTION DRUG PLAN AND A MEDICARE ADVANTAGE HEALTH/PRESCRIPTION DRUG SPECIAL NEEDS PLAN. ALOHACARE ALSO PARTICIPATES IN AND HELPS TO FUND HEALTH RELATED ACTIVITIES TO IMPROVE THE QUALITY OF HEALTH OF THE PEOPLE OF HAWAII. ALOHACARE OPERATES FOR CHARITABLE, EDUCATIONAL, RECREATIONAL PURPOSES, WITHIN THE MEANING OF SECTION 501(C)(4) OF THE IRS CODE OF 1986 AS AMENDED. 16 2 340 0 0 0 0 0 372240265 387004611 2243817 2913253 63387 68530 374547469 389986394 4630457 1430702 0 0 24274386 25835236 0 0 0 343066695 391602323 371971538 418868261 2575931 -28881867 165933475 153281702 76529954 91785596 89403521 61496106 X ALOHACARE IS A HAWAII CORPORATION THAT CONTRACTS WITH THE STATE OF HAWAII, DEPARTMENT OF HUMAN SERVICES MED-QUEST DIVISION TO PROVIDE MANAGED HEALTH CARE IN ACCORDANCE WITH THE STATE OF HAWAII HEALTH QUEST DEMONSTRATION, AND WITH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) TO PROVIDE MANAGED HEALTH CARE THROUGH A MEDICARE ADVANTAGE HEALTH/PRESCRIPTION DRUG PLAN AND A MEDICARE ADVANTAGE HEALTH/PRESCRIPTION DRUG SPECIAL NEEDS PLAN. ALOHACARE ALSO PARTICIPATES IN AND HELPS TO FUND HEALTH RELATED ACTIVITIES TO IMPROVE THE QUALITY OF HEALTH OF THE PEOPLE OF HAWAII. ALOHACARE OPERATES FOR CHARITABLE, EDUCATIONAL AND RECREATIONAL PURPOSES WITHIN THE MEANING OF SECTION 501(C)(4) OF THE IRS CODE OF 1986 AS AMENDED. 0 0 388409909 1430702 387004611 HEALTH CARE PROGRAMS, GENERAL/OTHER: PROVIDE MANAGED HEALTH CARE SERVICES TO APPROXIMATELY 62,529 QUALIFIED MEDICAID MEMBERS, AND 1,880 MEDICARE MEMBERS WHO ARE RESIDENTS OF HAWAII. 388409909 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1958 0 1 340 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 2 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 HI X ALOHACARE - CO JADE CARREL 8089731650 1357 KAPIOLANI BLVD SUITE 1250 HONOLULU HI 96814 ALAN TERADA BOARD MEMBER 1.00 X 0 0 0 HELEN KEKALIA BOARD MEMBER 1.00 X 0 0 0 CHRISTIAN KIMO ALAMEDA BOARD MEMBER 1.00 X 0 0 0 DEBORAH ZYSMAN BOARD MEMBER 1.00 X 0 0 0 GIDGET RUSCETTA BOARD MEMBER 1.00 X 0 0 0 CHRISTINA LEE BOARD MEMBER 1.00 X 0 0 0 CHERYL VASCONCELLOS BOARD MEMBER 1.00 X 0 0 0 PHYLLIS DENDLE BOARD MEMBER 1.00 X 0 0 0 MARY ONEHA BOARD MEMBER 1.00 X 0 0 0 DIANA SHAW BOARD MEMBER 1.00 X 0 0 0 DAVID DERAUF PRESIDENT 1.00 X 0 0 0 EMMANUEL KINTU SECRETARY 1.00 X 0 0 0 IRENE CARPENTER VICE PRESIDENT 1.00 X 0 0 0 RICHARD BETTINI IMMEDIATE PAST PRESIDENT 1.00 X 0 0 0 BETTY JANE OTT TREASURER 1.00 X 0 0 0 RICHARD TAAFFE VICE PRESIDENT 1.00 X 0 0 0 LAURA ESSLINGER CHIEF EXECUTIVE OFFICER 40.00 X 541997 0 29217 DR GARY OKAMOTO CHIEF MEDICAL DIRECTOR 40.00 X 479314 0 24491 TODD MORGAN CHIEF INFORMATION OFFICER 40.00 X 362186 0 30382 FRANCOISE CULLEY-TROTMAN CHIEF COMPLIANCE OFFICER 40.00 X 360334 0 14884 BRUCE LANE CHIEF FINANCIAL OFFICER 40.00 X 397451 0 28570 PAULA ARCENA VP EXTERNAL AFFAIRS 40.00 X 234164 0 18170 PATRICK BRENNAN SENIOR DIRECTOR OF PLAN OP 40.00 X 329367 0 23489 STELLA CATALAN SENIOR DIRECTOR OF CLINICA 40.00 X 256584 0 14745 VICKI BORRELL SENIOR DIRECTOR, CARE MODE 40.00 X 197979 0 0 JORGE GARCIA SENIOR DIRECTOR OF HEALTH 40.00 X 225130 0 12706 MICHAEL KIDONAKIS DIRECTOR OF ANALYTICS AND 40.00 X 198768 0 16550 RYAN MAU DIRECTOR OF BUSINESS SUPPO 40.00 X 155277 0 18508 HANH BANNISTER PHARMACY DIRECTOR 40.00 X 236754 0 18478 NILA PATEL DIRECTOR OF APPLICATION DE 40.00 X 186559 0 18106 SHERRIE SMALLEY MEDICAL DIRECTOR 40.00 X 317732 0 16070 JOHN MCCOMAS FORMER CHIEF EXECUTIVE OFF 40.00 X 141250 0 0 TAMMY DEROSA FORMER CONTROLLER 40.00 X 131267 0 9883 4752113 0 294249 17 1 1 0 ZELIS CLAIMS INTEGRITY LLC 2 CROSSROADS DR BEDMINSTER NJ 07921 COST CONTAINMENT 1227020 HEALTH CATALYST 3165 MILLROCK DR STE 400 SALT LATE CITY UT 84121 SUBSCRIPTION SERVICES 902045 CHANGE HEALTHCARE PO BOX 572490 MURRAY UT 841572490 HEDIS SOFTWARE 388607 INOVALON INC 4321 COLLINGTON ROAD BOWIE MD 20716 HEDIS REVIEW 272127 AGK CONSULTING LLC 7930 ACADEMY TRAIL NE ALBUQUERQUE NM 87109 CONSULTING SERVICES 151056 5 CAPITATION 624100 387004611 387004611 387004611 2909272 2909272 5363 1382 3981 3981 3981 OTHER REVENUE 624100 68530 68530 68530 389986394 387004611 0 2981783 X 1383637 1383637 47065 47065 5046362 5046362 15860103 32558 15827545 584689 584689 2748789 2748789 1595293 1595293 402773 402773 312195 312195 66205018 66205018 439323 439323 54150 54150 1768654 1768654 229101 229101 33930 33930 587550 587550 308368 308368 OTHER EXPENSES - PROGR 320741631 320741631 OTHER EXPENSES - MANAGE 519630 519630 418868261 388409909 30458352 0 84339794 45866212 25629791 41064247 759099 949991 6336921 3882224 1040634 2454697 54164157 62946555 165933475 153281702 36379105 41832379 40150849 49953217 76529954 91785596 X 89403521 61496106 89403521 61496106 165933475 153281702 -28881867 974452 0 X X 0 1 X 1 0 633483 12856 620627 5703438 3869368 1834070 2454697 PAYABLE TO RISK POOLS 1851395 ACCRUED MEDICAL CLAIMS 48101822 49953217 346738236 -470443 -470443 347208679 42777715 42777715 389986394 376090546 0 376090546 42777715 42777715 418868261 PART XI, LINE 4B - OTHER ADJUSTMENTS: PASS THROUGH REVENUE NETTED WITH EXPENSE 43,135,059. GRANT EXPENSE FROM G&A RECLASSED TO OTHER EXPENSES -357,344. PART XII, LINE 4B - OTHER ADJUSTMENTS: PASS THROUGH EXPENSE NETTED WITH REVENUE 43,135,059. GRANT EXPENSE FROM G&A RECLASSED TO OTHER EXPENSES -357,344. 1 ARLENE MEYERS MD 302 CALIFORNIA AVENUE WAHIAWA HI 96786 990205389 5350 QI INCENTIVE BAY CLINIC INC 450 KILAUEA AVE SUITE 105 HILO HI 96720 990222784 501 ( C) 3 94402 QI INCENTIVE BAY CLINIC INC 450 KILAUEA AVE SUITE 105 HILO HI 96720 990222784 501 ( C) 3 1942 2019 TRAVEL GRANT LEELEN PARK CHARLIE SONIDO MD INC 94-837 WAIPAHU ST WAIPAHU HI 96797 990258833 8500 QI INCENTIVE COMMUNITY CLINIC OF MAUI PO BOX 31000 HONOLULU HI 96849 990303304 501 ( C) 3 23393 QI INCENTIVE EDWIN P HERD MD 76-6225 KUAKINI HWY C-101 KAILUAKONA HI 96740 830917504 26665 2018 ACCESS CARE GRANT FEED THE HUNGER FOUNDATION 100 MONTGOMERY ST SAN FRANCISCO CA 94129 262975093 501 ( C) 3 10000 2018 ACCESS CARE GRANT HAMAKUA-KOHALA COMMUNITY HEALTH CENTER 45-539 PLUMERIA ST HONOKAA HI 96727 990115515 501 ( C) 3 7861 QI INCENTIVE HAMAKUA-KOHALA COMMUNITY HEALTH CENTER 45-539 PLUMERIA ST HONOKAA HI 96727 990115515 501 ( C) 3 1842 2019 GRANT S CARIAGA-ALFONSO KALIHI PALAMA HEALTH CENTER 915 NORTH KING ST HONOLULU HI 96817 990161221 501 ( C) 3 89350 QI INCENTIVE KAPIOLANI MEDICAL CLINIC MAILCODE 60152 BOX 1300 HONOLULU HI 96807 990177350 501 ( C) 3 13200 QI INCENTIVE KAUAI MEDICAL CLINIC MAIL CODE 61113 HONOLULU HI 96820 990326099 501 ( C) 3 25780 QI INCENTIVE KOKUA KALIHI VALLEY 2239 NORTH SCHOOL STREET HONOLULU HI 96819 990149797 501 ( C) 3 56474 QI INCENTIVE KOKUA KALIHI VALLEY 2239 NORTH SCHOOL STREET HONOLULU HI 96819 990149797 501 ( C) 3 9000 ALOHCARE ACCESS CARE GRANT KOKUA KALIHI VALLEY 2239 NORTH SCHOOL STREET HONOLULU HI 96819 990149797 501 ( C) 3 146 2019 TRAVEL GRANT KAUI ONEKEA KOOLAULOA COMMUNITY HEALTH & WELLNESS CENTER PO BOX 395 KAHUKU HI 96731 731681833 501 ( C) 3 12445 QI INCENTIVE MANGO FOUNDATION GROUP 45-516 HUAPALA ST HONOKAA HI 96727 455582062 501 ( C) 3 75000 WAIWAI OLA GRANT MAUI MEDICAL GROUP 2180 MAIN ST WAILUKU HI 96793 990176859 37070 QI INCENTIVE MOLOKAI GENERAL HOSPITAL PO BOX 408 KAUNAKAKAI HI 96748 990251372 501 ( C) 3 8000 2018 ACCESS CARE GRANT MOLOKAI OHANA HEATHCARE INC PO BOX 2040 KAUNAKAKAI HI 96748 510437659 501 ( C) 3 7550 QI INCENTIVE PACIFIC MEDICAL ADMINSITRATIVE GROUP 1600 KAPIOLANI BLVD STE 220 HONLULU HI 96814 990262366 465000 WAIWAI OLA GRANT AWARD PANIOLO PEDIATRICS AND FAMILY MEDICINE INC P O BOX 6149 KAMUELA HI 96743 473826435 6450 QI INCENTIVE QUEEN'S MEDICAL CENTER PO BOX 30160 HONOLULU HI 96820 990073524 501 ( C) 3 11850 QI INCENTIVE UNIVERSITY CLINICAL EDUCATION & RESEARCH ASSOCIATES 550 S BERETANIA STREET SUITE 510 HONOLULU HI 96813 990307152 501 ( C) 3 137038 WAIWAI OLA GRANT UNIVERSITY CLINICAL EDUCATION & RESEARCH ASSOCIATES 550 S BERETANIA STREET SUITE 510 HONOLULU HI 96813 990307152 501 ( C) 3 15880 QI INCENTIVE WAIANAE COAST COMPREHENSIVE HEALTH CENTER 86-260 FARRINGTON HWY WAIANAE HI 96792 990148164 501 ( C) 3 199815 QI INCENTIVE WAIKIKI HEALTH CENTER 935 MAKAHIKI WAY HONOLULU HI 96826 990159253 501 ( C) 3 7112 QI INCENTIVE WAIKIKI HEALTH CENTER 935 MAKAHIKI WAY HONOLULU HI 96826 990159253 501 ( C) 3 5340 QI INCENTIVE WAIMANALO HEALTH CENTER 41-1347 KALANIANAOLE HWY WAIMANALO HI 96795 990273205 501 ( C) 3 27982 QI INCENTIVE WESLEY J SUGAI MD 75-5591 PALANI RD SUITE 3001 KAILUA KONA HI 96740 990290505 6550 QI INCENTIVE WEST HAWAII COMMUNITY HEALTH CENTER 75-5751 KUAKINI HWY STE 203 KAILUAKONA HI 96740 200495394 501 ( C) 3 32437 QI INCENTIVE WEST HAWAII COMMUNITY HEALTH CENTER 75-5751 KUAKINI HWY STE 203 KAILUAKONA HI 96740 200495394 501 ( C) 3 1278 2019 TRAVEL GRANT DR STEVE PIN 18 7 QI INCENTIVE 53 47065 PART I, LINE 2: ALOHACARE AWARDS QUALITY INCENTIVE PAYMENTS TO DIFFERENT ORGANIZATIONS IN THE COMMUNITY. THE QUALITY INCENTIVE PAYMENTS ARE AWARDED BASED ON DIFFERENT CRITERIA, INCLUDING PREVENTION AND/OR TREATMENT OF HEALTH RELATED ISSUES, HEALTHCARE NEEDS, AND THE OVERALL IMPROVEMENT OF HEALTH IN THE HAWAII COMMUNITY. X 1 1 X X X 0 0 0 0 0 0 0 0 0 LAURA ESSLINGER CHIEF EXECUTIVE OFFICER 443706 0 92291 0 6000 0 15222 0 13995 0 571214 0 0 0 DR GARY OKAMOTO CHIEF MEDICAL DIRECTOR 385341 0 73870 0 20103 0 12879 0 11612 0 503805 0 0 0 TODD MORGAN CHIEF INFORMATION OFFICER 293783 0 48300 0 20103 0 13832 0 16550 0 392568 0 0 0 FRANCOISE CULLEY-TROTMAN CHIEF COMPLIANCE OFFICER 269737 0 73862 0 16735 0 0 0 14884 0 375218 0 0 0 BRUCE LANE CHIEF FINANCIAL OFFICER 314951 0 72500 0 10000 0 14169 0 14401 0 426021 0 0 0 PAULA ARCENA VP EXTERNAL AFFAIRS 224061 0 0 0 10103 0 7620 0 10550 0 252334 0 0 0 PATRICK BRENNAN SENIOR DIRECTOR OF PLAN OP 270952 0 29726 0 28689 0 10408 0 13081 0 352856 0 0 0 STELLA CATALAN SENIOR DIRECTOR OF CLINICA 211382 0 16513 0 28689 0 8528 0 6217 0 271329 0 0 0 VICKI BORRELL SENIOR DIRECTOR, CARE MODE 172356 0 15589 0 10034 0 0 0 0 0 197979 0 0 0 JORGE GARCIA SENIOR DIRECTOR OF HEALTH 197959 0 18484 0 8687 0 6488 0 6218 0 237836 0 0 0 MICHAEL KIDONAKIS DIRECTOR OF ANALYTICS AND 186575 0 6915 0 5278 0 0 0 16550 0 215318 0 0 0 RYAN MAU DIRECTOR OF BUSINESS SUPPO 137420 0 17857 0 0 0 6513 0 11995 0 173785 0 0 0 HANH BANNISTER PHARMACY DIRECTOR 216754 0 20000 0 0 0 7927 0 10551 0 255232 0 0 0 NILA PATEL DIRECTOR OF APPLICATION DE 168702 0 17857 0 0 0 6444 0 11662 0 204665 0 0 0 SHERRIE SMALLEY MEDICAL DIRECTOR 303827 0 13905 0 0 0 10422 0 5648 0 333802 0 0 0 JOHN MCCOMAS FORMER CHIEF EXECUTIVE OFF 141250 0 0 0 0 0 0 0 0 0 141250 0 0 0 TAMMY DEROSA FORMER CONTROLLER 117036 0 14231 0 0 0 5220 0 4663 0 141150 0 0 0 PART I, LINE 1A DISCRETIONARY SPENDING IS APPROVED BY BOARD OF DIRECTORS AS DOCUMENTED IN THE EMPLOYMENT CONTRACT. DAVID DERAUF KOKUA KALIHI VALLEY EXEC DIR DIRECTOR & PRESIDENT OF ALOHACARE'S BOD 1325565 SERVICES RENDERED 0 RICHARD BETTINI WAIANAE COAST COMP HEALTH CENTER CEO DIRECTOR & IMMEDIATE PAST PRESIDENT OF ALOHACARE'S BOD 13003480 SERVICES RENDERED 0 IRENE CARPENTER HAMAKUA HEALTH CENTER DIRECTOR & VP OF ALOHACARE'S BOD 437718 SERVICES RENDERED 0 RICHARD TAAFFE WEST HAWAII COMMUNITY HEALTH CENTER DIRECTOR & VP OF ALOHACARE'S BOD 1466283 SERVICES RENDERED 0 BETTY JANE OTT MALAMA I KE OLA HEALTH CENTER DIRECTOR & TREASURER OF ALOHACARE'S BOD 2455517 SERVICES RENDERED 0 EMMANUEL KINTU KALIHI PALAMA HEALTH CENTER EXEC DIR DIRECTOR & SECRETARY OF ALOHACARE'S BOD 2370179 SERVICES RENDERED 0 MARY ONEHA & CHRISTINA LEE WAIMANALO HEALTH CENTER EXEC DIR DIRECTOR OF ALOHACARE'S BOD 689380 SERVICES RENDERED 0 QUEENS HEALTH SYSTEMS & ALAN TERADAMGRQUEEN EMMA CLINICS VACANT BOD POSITION & DIRECTOR OF ALOHACARE'S BOD 63225313 SERVICES RENDERED 0 CHRISTIAN KIMO ALAMEDA BAY CLINIC INC DIRECTOR OF ALOHACARE'S BOD 1772276 SERVICES RENDERED 0 PHYLLIS DENDLE WAIKIKI HEALTH CENTER EXEC DIR DIRECTOR OF ALOHACARE'S BOD 1263185 SERVICES RENDERED 0 HELEN KEKALIA MOLOKAI COMMUNITY HEALTH CENTER DIRECTOR OF ALOHACARE'S BOD 621850 SERVICES RENDERED 0 GIDGET RUSCETTA PALI MOMI MEDICAL CENTER DIRECTOR OF ALOHACARE'S BOD 6960004 SERVICES RENDERED 0 KOOLAULOA COMMUNITY HEALTH CENTER VACANT BOD POSITION 557683 SERVICES RENDERED 0 CHERYL VACONCELLOS HANA COMMUNITY HEALTH CENTER DIRECTOR OF ALOHACARE'S BOD 379350 SERVICES RENDERED 0 DIANA SHAW LANAI COMMUNITY HEALTH CENTER DIRECTOR OF ALOHACARE'S BOD 315729 SERVICES RENDERED 0 FORM 990, PART VI, SECTION A, LINE 1 THE BOARD OF DIRECTORS, BY RESOLUTION ADOPTED BY A MAJORITY OF THE FULL BOARD OF DIRECTORS, MAY DESIGNATE FROM AMONG ITS MEMBERS AN EXECUTIVE COMMITTEE, A GOVERNANCE COMMITTEE, AN AUDIT COMMITTEE, AND A COMPLIANCE COMMITTEE, TOGETHER WITH ONE OR MORE OTHER COMMITTEES, EACH OF WHICH SHALL HAVE AND MAY EXERCISE ALL THE AUTHORITY GRANTED BY THE BOARD OF DIRECTORS, EXCEPT AS LIMITED BY LAW OR THE ARTICLES OF INCORPORATION. FORM 990, PART VI, SECTION B, LINE 11B BOTH THE CEO & CFO OF ALOHACARE REVIEW FORM 990 PRIOR TO OBTAINING APPROVAL FROM ALOHACARE'S FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS OR TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM ANNUALLY, AND NOTIFY ALOHACARE SHOULD ANY CONFLICTS ARISE DURING THE YEAR. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS HOLDS MEETINGS TO DETERMINE FAIR COMPENSATION OF ALOHACARE'S CEO. THE CEO DETERMINES FAIR COMPENSATION OF ALOHACARE'S KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST BY ALOHACARE. FORM 990, PART IX, LINE 11G OTHER FEES - PROGRAM SERVICES: PROGRAM SERVICE EXPENSES 66,205,018. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 66,205,018. FORM 990, PART XI, LINE 2C ALOHACARE HAS A COMMITTEE THAT IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. SCHEDULE L, PART III GRANTS ARE AWARDED ON AN OBJECTIVE AND NONDISCRIMINATORY BASIS BASED ON PRE-ESTABLISHED CRITERIA AND REVEIWED BY A SELECTION COMMITTEE, AS DESCRIBED IN REGULATIONS SECTION 53.4945-4(B).