2018-11-15T16:49:28-06:00 2017-12-31 205325889 ACCUITY LLP 999 BISHOP STREET STE 1900 HONOLULU HI 96813 990 2017-01-01 990309519 ALOHACARE ALOH 8089731650 1357 KAPIOLANI BLVD NO 1250 HONOLULU HI 96814 BRUCE LANE CFO 8089731650 2018-11-13 1 KENT K TSUKAMOTO P00089337 8085313400 72.253.96.98 2018-11-13 19:45:45 HS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 E1B8C69178C1034648735D05824C21F2E015F984 2017 2019-02-21 02:37:17Z BRUCE LANE 1357 KAPIOLANI BLVD NO 1250 HONOLULU HI 96814 384382122 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. 15 2 301 0 0 0 0 0 322559458 383485545 277072 719979 24114 44597 322860644 384250121 930172 570130 0 0 17850188 20340416 0 0 0 288562765 344450047 307343125 365360593 15517519 18889528 142238433 168712281 74227005 81811325 68011428 86900956 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 341752332 570130 383485545 HEALTH CARE PROGRAMS, GENERAL/OTHER: PROVIDE MANAGED HEALTH CARE SERVICES TO APPROXIMATELY 69,769 QUALIFIED MEDICAID MEMBERS, AND 1,404 MEDICARE MEMBERS WHO ARE RESIDENTS OF HAWAII. 341752332 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 1885 0 1 301 1 0 0 0 0 0 0 0 0 0 0 X 15 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 BRUCE LANE 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 HAROLD WALLACE 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 CHRISTINA VASCONCELLOS BOARD MEMBER 1.00 X 0 0 0 SHEILA BECKHAM BOARD MEMBER 1.00 X 0 0 0 MARY ONEHA 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 425291 0 25787 DR GARY OKAMOTO CHIEF MEDICAL DIRECTOR 40.00 X 333507 0 14591 TODD MORGAN CHIEF INFORMATION OFFICER 40.00 X 212702 0 20718 PAULA ARCENA CHIEF CUSTOMER OFFICER 40.00 X 190838 0 14736 FRANCOISE CULLEY-TROTMAN CHIEF COMPLIANCE OFFICER 40.00 X 136984 0 6545 PATRICK BRENNAN SENIOR DIRECTOR OF PLAN OPERATIONS 40.00 X 258902 0 18459 STELLA CATALAN SENIOR DIRECTOR OF CLINICAL OPS 40.00 X 221406 0 9144 NILA PATEL DIRECTOR OF APPLICATION DEVELOPMENT 40.00 X 145258 0 12031 MAKIKO SAWADA MEDICAL DIRECTOR 40.00 X 175046 0 6722 MAMIVAR AQUINO SENIOR DIRECTOR OF HEALTH SERVICES 40.00 X 175154 0 2985 JOHN MCCOMAS FORMER CHIEF EXECUTIVE OFFICER 40.00 X 411505 0 4930 CINDY NEELEY FORMER CHIEF FINANCIAL OFFICER 40.00 X 227447 0 10357 2914040 0 147005 12 1 1 0 TATUM PO BOX 847872 DALLAS TX 75284 CONSULTING 499179 MILLIMAN 1301 FIFTH AVENUE SUITE 3800 SEATTLE WA 98101 ACTUARIAL 269105 MEDICONNECTNET PO BOX 673377 DETROIT MI 482673377 MEDICAL RECORD RETRIEVAL 249091 PRICEWATERHOUSE PO BOX 514038 LOS ANGELES CA 900514038 ACTUARIAL 174536 MEDISENSE CONSULTING 41-1347 KALANIANAOLE WAIMANALO HI 96795 CONSULTING 133233 5 CAPITATION 624100 376907644 376907644 REINSURANCE 624100 6577901 6577901 383485545 851980 851980 132001 -132001 -132001 -132001 OTHER REVENUE 624100 44597 44597 44597 384250121 383485545 0 764576 X 456838 456838 113292 113292 3061045 3061045 13616934 8467758 5149176 389453 389453 1971502 1971502 1301482 1301482 682599 682599 418604 418604 215070679 215070679 580265 580265 110978 110978 1152675 1152675 228933 228933 54411 54411 541938 541938 313699 313699 OTHER EXPENSES - PROGR 117643765 117643765 OTHER EXPENSES - MANAGE 7651501 7651501 365360593 341752332 23608261 0 66046254 100854191 29794580 17334590 295476 368811 8587404 7650607 889375 936797 45212748 49217892 142238433 168712281 22132358 28312711 52094647 53498614 74227005 81811325 X 68011428 86900956 68011428 86900956 142238433 168712281 18889528 0 X X 0 1 X 1 0 191889 182643 9246 8395515 7467964 927551 936797 PAYABLE TO RISK POOLS 9277972 ACCRUED MEDICAL CLAIMS 44220642 53498614 377736680 64460 64460 377672220 6577901 6577901 384250121 358781847 0 358781847 6578746 6578746 365360593 PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION OF REINSURANCE REVENUES 6,577,901. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION OF REINSURANCE REVENUES 6,577,901. BROKER FEES 845. 1 AHARO 86-260 FARRINGTON HWY WAIANAE HI 96792 472848796 39300 QI INCENTIVE ALII HEALTH CENTER 78-6831 ALII DRIVE KAILUA KONA HI 96740 260318372 501 ( C) 3 6028 QI INCENTIVE ARNOLD SEID MD WAHIAWA MEDICAL CENTER WAIHIAWA HI 96786 990225570 5172 QI INCENTIVE AZARA HEALTHCARE 70 BLANCHARD RD SUITE 401 BURLINGTON MA 01803 452609523 10471 ACCESS GRANT BAY CLINIC INC 450 KILAUEA AVE SUITE 105 HILO HI 96720 990222784 501 ( C) 3 40000 ACCESS AND AVAILABILITY GRANT KALIHI PALAMA HEALTH CENTER 915 NORTH KING ST HONOLULU HI 96817 990161221 501 ( C) 3 16000 QI INCENTIVE KAUAI MEDICAL CLINIC MAIL CODE 61113 HONOLULU HI 96820 990326099 501 ( C) 3 12612 QI INCENTIVE LANAI COMMUNITY HEALTH CENTER PO BOX 630142 LANAI CITY HI 96763 202509287 501 ( C) 3 6500 ACCESS GRANT MARIA ILAR MD COMMUNITY HEALTH CLINIC LLC WAIPAHU HI 96797 990326183 6764 QI INCENTIVE MAUI MEDICAL GROUP 2180 MAIN ST WAILUKU HI 96793 990176859 35704 QI INCENTIVE MEDISENSE CONSULTANTS LLC 41-1347 KALANIANAOLE HWY WAIMANALO HI 96798 453700422 34894 TRAINING AND IMPLEMENTATION MOLOKAI GENERAL HOSPITAL 280 HOME OLU PLACE KAUNAKAKAI HI 96748 990251372 501 ( C) 3 11484 QI INCENTIVE NOA E ALULI MD PO BOX 1100 KAUNAKAKAI HI 96748 990333142 9504 QI INCENTIVE QUEEN EMMA CLINIC PO BOX 30160 HONOLULU HI 968200160 990073524 501 ( C) 3 15312 QI INCENTIVE QUEEN'S HEALTH CARE CENTER - KAPOLEI PO BOX 30210 HONOLULU HI 96820 990239756 6644 QI INCENTIVE RUSSELL S KELLY MD LLC 91-2139 FORT WEAVER RD 300 EWA BEACH HI 96706 205215599 8020 QI INCENTIVE UNIVERSITY CLINICAL EDUCATION & RESEARCH ASSOCIATES 550 S BERETANIA STREET SUITE 510 HONOLULU HI 96813 990307152 501 ( C) 3 10256 QI INCENTIVE WEST HAWAII COMMUNITY HEALTH CENTER 75-5751 KUAKINI HWY STE 203 KAILUAKONA HI 96740 200495394 501 ( C) 3 6500 QI INCENTIVE 9 9 QI INCENTIVE 112 113292 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 1 0 0 0 0 0 0 0 LAURA ESSLINGER CHIEF EXECUTIVE OFFICER 425291 0 0 0 0 0 14404 0 11383 0 451078 0 0 0 DR GARY OKAMOTO CHIEF MEDICAL DIRECTOR 277803 0 55704 0 0 0 8147 0 6444 0 348098 0 0 0 TODD MORGAN CHIEF INFORMATION OFFICER 174642 0 38060 0 0 0 9498 0 11220 0 233420 0 0 0 PAULA ARCENA CHIEF CUSTOMER OFFICER 160046 0 30792 0 0 0 7240 0 7496 0 205574 0 0 0 PATRICK BRENNAN SENIOR DIRECTOR OF PLAN OPERATIONS 183799 0 60000 0 15103 0 7241 0 11218 0 277361 0 0 0 STELLA CATALAN SENIOR DIRECTOR OF CLINICAL OPS 156303 0 50000 0 15103 0 4800 0 4344 0 230550 0 0 0 NILA PATEL DIRECTOR OF APPLICATION DEVELOPMENT 121146 0 24112 0 0 0 4535 0 7496 0 157289 0 0 0 MAKIKO SAWADA MEDICAL DIRECTOR 175046 0 0 0 0 0 6722 0 0 0 181768 0 0 0 MAMIVAR AQUINO SENIOR DIRECTOR OF HEALTH SERVICES 168487 0 6667 0 0 0 1838 0 1147 0 178139 0 0 0 JOHN MCCOMAS FORMER CHIEF EXECUTIVE OFFICER 411505 0 0 0 0 0 3895 0 1035 0 416435 0 0 0 CINDY NEELEY FORMER CHIEF FINANCIAL OFFICER 152447 0 75000 0 0 0 8107 0 2250 0 237804 0 0 0 PART I, LINE 1A DISCRETIONARY SPENDING IS APPROVED BY BOARD OF DIRECTORS AS DOCUMENTED IN THE EMPLOYMENT CONTRACT. PART I, LINE 4B PATRICK BRENNAN $15,103 STELLA CATALAN $15,103 DAVID DERAUF KOKUA KALIHI VALLEY EXEC DIR DIRECTOR & PRESIDENT OF ALOHACARE'S BOD 1244233 SERVICES RENDERED 0 RICHARD BETTINI WAIANAE COAST COMP HEALTH CENTER CEO DIRECTOR & IMMEDIATE PAST PRESIDENT OF ALOHACARE'S BOD 11286252 SERVICES RENDERED 0 IRENE CARPENTER HAMAKUA HEALTH CENTER DIRECTOR & VP OF ALOHACARE'S BOD 309299 SERVICES RENDERED 0 RICHARD TAAFFE WEST HAWAII COMMUNITY HEALTH CENTER DIRECTOR & VP OF ALOHACARE'S BOD 1529080 SERVICES RENDERED 0 BETTY JANE OTT MALAMA I KE OLA HEALTH CENTER DIRECTOR & TREASURER OF ALOHACARE'S BOD 1754047 SERVICES RENDERED 0 EMMANUEL KINTU KALIHI PALAMA HEALTH CENTER EXEC DIR DIRECTOR & SECRETARY OF ALOHACARE'S BOD 2427490 SERVICES RENDERED 0 MARY ONEHA & CHRISTINA LEE WAIMANALO HEALTH CENTER EXEC DIR DIRECTOR OF ALOHACARE'S BOD 877457 SERVICES RENDERED 0 QUEENS HEALTH SYSTEMS & ALAN TERADAMGRQUEEN EMMA CLINICS VACANT BOD POSITION & DIRECTOR OF ALOHACARE'S BOD 49107777 SERVICES RENDERED 0 HAROLD WALLACE BAY CLINIC INC DIRECTOR OF ALOHACARE'S BOD 1626816 SERVICES RENDERED 0 SHEILA BECKHAM WAIKIKI HEALTH CENTER EXEC DIR DIRECTOR OF ALOHACARE'S BOD 1243629 SERVICES RENDERED 0 HELEN KEKALIA MOLOKAI COMMUNITY HEALTH CENTER DIRECTOR OF ALOHACARE'S BOD 483226 SERVICES RENDERED 0 KOOLAULOA COMMUNITY HEALTH CENTER VACANT BOD POSITION 454107 SERVICES RENDERED 0 HANA COMMUNITY HEALTH CENTER VACANT BOD POSITION 155257 SERVICES RENDERED 0 GIDGET RUSCETTA PALI MOMI MEDICAL CENTER DIRECTOR OF ALOHACARE'S BOD 5370146 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 215,070,679. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 215,070,679. 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).