2013-11-15T15:12:33-06:00 2012-12-31 205325889 ACCUITY LLP 999 BISHOP STREET STE 1900 HONOLULU HI 96813 990 2012-01-01 990309519 ALOHACARE ALOH 8089731650 1357 KAPIOLANI BLVD NO 1250 HONOLULU HI 96814 JOHN MCCOMAS 8089731650 2013-11-13 1 ACCUITY LLP P00037058 8085313400 2012 2016-02-25 16:41:14Z JOHN E MCCOMAS 1357 KAPIOLANI BLVD NO 1250 HONOLULU HI 96814 236980676 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 5 233 0 0 0 0 0 229441375 236643872 285588 324517 1570589 12287 231297552 236980676 1317642 1157788 0 0 11716201 11939702 0 0 0 222538488 215152174 235572331 228249664 -4274779 8731012 128617607 134979215 50920624 48551220 77696983 86427995 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 213415207 1157788 236643872 HEALTH CARE PROGRAMS, GENERAL/OTHER: PROVIDE MANAGED HEALTH CARE SERVICES TO APPROXIMATELY 72,726 QUALIFIED MEDICAID MEMBERS, AND 1,827 MEDICARE MEMBERS WHO ARE RESIDENTS OF HAWAII. 213415207 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 1 0 0 0 0 0 0 0 0 0 0 0 1 1522 0 1 233 1 0 0 0 0 0 0 0 0 0 0 X 15 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 HI X ALOHACARE - CO CINDY NEELEY 8089736347 1357 KAPIOLANI BLVD SUITE 1250 HONOLULU HI 96814 BEN PETTUS 1.00 X 0 0 0 DAVID DERAUF 1.00 X 0 0 0 DESIREE PUHI 1.00 X 0 0 0 JANET ONAPA 1.00 X 0 0 0 MARTHA SMITH 1.00 X 0 0 0 PHILLIP KINNICUTT 1.00 X 0 0 0 RUSSELL SAITO 1.00 X 0 0 0 SHEILA BECKHAM 1.00 X 0 0 0 CHRISTINE RICHARDSON 1.00 X 0 0 0 MARY ONEHA 1.00 X 0 0 0 CINDY NEELEY 40.00 X 227033 0 14950 DANA HOWETH 1.00 X 0 0 0 DAVID BESS 1.00 X 0 0 0 EMMANUEL KINTU 1.00 X 0 0 0 JOHN MCCOMAS 40.00 X 231959 0 26094 PAUL STRAUSS 40.00 X 166643 0 13398 RICHARD BETTINI 1.00 X 0 0 0 SHERI STACHER 40.00 X 114583 0 15332 SUSAN HUNT 1.00 X 0 0 0 DR GARY OKAMOTO 40.00 X 57159 0 1275 PATRICK BRENNAN 40.00 X 170511 0 19566 DARRYL HUFF 40.00 X 120408 0 13894 EVELYN CHOCK 40.00 X 116244 0 16455 FRANCIS APPEL 40.00 X 124836 0 13212 DR SHARON TISZA 40.00 X 208446 0 20217 STELLA CATALAN 40.00 X 154491 0 12060 1692313 0 166453 10 0 1 0 MILLIMAN 1301 FIFTH AVENUE SUITE 3800 SEATTLE WA 98101 ACTUARIAL 467292 INSURANCE BENEFITS SERVICES 1585 KAPIOLANI BLVD STE 1020 HON HI 96814 BROKER FEES 169992 ACCUITY LLP 999 BISHOP STREET SUITE 1900 HONOLULU HI 96813 ACCOUNTING 102954 3 CAPITATION 624100 232657969 232657969 REINSURANCE 624100 3985903 3985903 236643872 323812 323812 705 0 705 705 705 OTHER REVENUE 624100 12287 12287 12287 236980676 236643872 0 336804 X 1139788 1139788 18000 18000 1858766 1858766 7821245 5349620 2471625 246445 246445 1148011 1148011 865235 865235 89683 89683 161168 161168 174080926 174080926 343473 343473 114890 114890 1014460 1014460 129012 129012 25454 25454 430040 430040 160976 160976 OTHER PROFESSIONAL SERV 27682913 27682913 CAPITATION 4418965 4418965 LICENCES & FEES 1581955 1581955 OTHER PROFESSIONAL FEES 1478790 1478790 3439469 724995 2714474 228249664 213415207 14834457 0 67168328 76225620 10709737 5322540 317167 313460 5689150 4980735 576067 708415 49846308 52409180 128617607 134979215 9217187 4605559 41703437 43945661 50920624 48551220 X 77696983 86427995 77696983 86427995 128617607 134979215 8731012 0 X X 0 1 X 1 0 179050 154355 24695 5510100 4826380 683720 708415 PAYABLE TO RISK POOLS 10339933 ACCRUED MEDICAL CLAIMS 33605728 43945661 232955212 0 232955212 4025464 4025464 236980676 224259533 35332 35332 224224201 4025463 4025463 228249664 PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION OF REINSURANCE REVENUES 3,985,903. UNREALIZED GAINS/LOSSES 39,559. ROUNDING 2. PART XII, LINE 2D - OTHER ADJUSTMENTS: BROKER FEES -4,227. INVESTMENTS 39,559. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION OF REINSURANCE REVENUES 3,985,903. UNREALIZED GAINS/LOSSES 39,559. ROUNDING 1. 1 ALII HEALTH CENTER 75-5759 KUAKINI HWY SUITE 208 KAILUAKONA HI 96740 260318372 501(C)(3) 25000 GRANTS - CHC DEVELOPMENT ALOHA HOUSE 1787 WILI PA LOOP SUITE 7 WAILUKU HI 96793 990173804 501(C)(3) 25000 GRANTS - CHC DEVELOPMENT AMERICAN CANCER SOCIETY 2370 NUUANU AVENUE HONOLULU HI 96817 990073489 501(C)(3) 1000 DONATION ASSN OF ASIAN PACIFIC COMMUNITY HEALTH ORG 300 FRANK H OGAWA PLAZA SUITE 620 OAKLAND CA 94612 943050247 501(C)(3) 10000 DONATION BAY CLINIC INC 224 HAILI ST SUITE B HILO HI 96720 990222784 501(C)(3) 154542 QUALITY PROGRAM GRANT/CHC DEVELOPMENT BREATH OF ALOHAMAITREYA INSTITUTE 1000 BISHOP STREET HONOLULU HI 96813 990229637 501(C)(3) 525 DONATION CHILDREN'S MIRACLE NETWORK PO BOX 31191 HONOLULU HI 96820 990177350 501(C)(3) 25000 DONATION COMMUNITY CLINIC OF MAUI 48 LONO STREET KAHULUI HI 96732 990303304 501(C)(3) 70251 QUALITY PROGRAM GRANT EASTER SEALS HAWAII 710 GREEN STREET HONOLULU HI 96813 990075235 501(C)(3) 3500 DONATION HAMAKUA HEALTH CENTER 45-549 PLUMERIA STREET HAMAKUA HI 96827 990115515 501(C)(3) 53000 QUALITY PROGRAM GRANT/CHC DEVELOPMENT HANA COMMUNITY HEALTH CENTER PO BOX 807 HANA HI 96713 990326154 501(C)(3) 14000 QUALITY PROGRAM GRANT HAWAII PUBLIC RADIO 45 KAHEKA STREET HONOLULU HI 96814 510191809 501(C)(3) 250 DONATION HO'OLA LAHUI HAWAII PO BOX 669 WAIMEA HI 96796 990250542 501(C)(3) 14000 QUALITY PROGRAM GRANT KALIHI PALAMA HEALTH CENTER 915 NORTH KING STREET HONOLULU HI 96819 990161221 501(C)(3) 91839 QUALITY PROGRAM GRANT KAPIOLANI COMMUNITY COLLEGEUH 4303 DIAMOND HEAD ROAD HONOLULU HI 96816 990085260 501(C)(3) 10000 DONATION KEVIN K KATO MD INC PO BOX 5058 KAHULUI HI 96732 200687791 25000 GRANTS - CHC DEVELOPMENT KOKUA KALIHI VALLEY 2239 NORTH SCHOOL STREET KIHEI HI 96819 990149797 501(C)(3) 37566 QUALITY PROGRAM GRANT KOOLAULOA COMMUNITY HEALTH & WELLNESS CENTER PO BOX 395 KAHUKU HI 96731 731681833 501(C)(3) 53000 QUALITY PROGRAM GRANT LANAI COMMUNITY HEALTH CENTER PO BOX 630142 LANAI CITY HI 96763 202509287 501(C)(3) 22500 QUALITY PROGRAM GRANT/CHC DEVELOPMENT MALAMA I KE OLA HEALTH CENTER - CC OF MAUI 1881 NANI STREET WAILUKU HI 96793 990303304 501(C)(3) 75000 GRANTS - CHC DEVELOPMENT MOLOKAI COMMUNITY HEALTH CENTER 28 KAMOI ST SUITE 600 KAUNAKAKAI HI 96748 510439659 501(C)(3) 48000 QUALITY PROGRAM GRANT/CHC DEVELOPMENT MOLOKAI GENERAL HOSPITAL PO BOX 408 KAUNAKAKAI HI 96748 990251372 501(C)(3) 25000 GRANTS - CHC DEVELOPMENT QUEEN EMMA CLINIC PO BOX 30160 HONOLULU HI 96820 990073524 501(C)(3) 30000 QUALITY PROGRAM GRANT QUEEN'S MEDICAL CENTER 1301 PUNCHBOWL STREET HONOLULU HI 96813 990073524 501(C)(3) 25000 GRANTS - CHC DEVELOPMENT ROBERT P MASTROIANNI MD INC 81 MAKAWAO AVENUE SUITE 100 MAKAWAO HI 96768 202107739 501(C)(3) 18000 GRANTS - CHC DEVELOPMENT STATE OF HI - DOI 846 POHUKINA STREET HONOLULU HI 96813 837 FMV DONATION OF STETHESCOPES DONATION OF STETHESCOPES WAIANAE COAST COMPREHENSIVE HEALTH CENTER 86-260 FARRINGTON HWY WAIANAE HI 96792 990148164 501(C)(3) 157846 QUALITY PROGRAM GRANT WAIKIKI HEALTH CENTER 758 KAPAHULU AVE A-319 HONOLULU HI 96816 990159253 501(C)(3) 30000 QUALITY PROGRAM GRANT WAIMANALO HEALTH CENTER 41-1347 KALANIANAOLE HWY A WAIMANALO HI 96795 990273205 501(C)(3) 28000 QUALITY PROGRAM GRANT WEST HAWAII COMMUNITY HEALTH CENTER 75-5751 KUAKINI HWY SUITE 203 KAILUAKONA HI 96740 200495394 501(C)(3) 65871 QUALITY PROGRAM GRANT/CHC DEVELOPMENT 28 2 GRANTS - CHC DEVELOPMENT 1 18000 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ALOHACARE AWARDS VARIOUS GRANTS TO DIFFERENT ORGANIZATIONS IN THE COMMUNITY. THE GRANTS 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 X 0 0 0 0 0 0 0 0 0 CINDY NEELEY 206990 0 10000 0 10043 0 9054 0 5896 0 241983 0 0 0 JOHN MCCOMAS 229299 0 0 0 2660 0 9307 0 16787 0 258053 0 0 0 PAUL STRAUSS 166643 0 0 0 0 0 6726 0 6672 0 180041 0 0 0 PATRICK BRENNAN 150468 0 10000 0 10043 0 6954 0 12612 0 190077 0 0 0 DR SHARON TISZA 204946 0 3500 0 0 0 8843 0 11374 0 228663 0 0 0 STELLA CATALAN 134448 0 10000 0 10043 0 6164 0 5896 0 166551 0 0 0 PART I, LINE 1A DISCRETIONARY SPENDING IS APPROVED BY BOARD OF DIRECTORS AS DOCUMENTED IN THE EMPLOYMENT CONTRACT. DANA ALONZO-HOWETH COMMUNITY CLINIC OF MAUI EXEC DIR DIRECTOR & PAST PRESIDENT OF ALOHACARE'S BOD 1900000 GRANT & SERVICES RENDERED GRANT & SERVICES CHRISTINE RICHARDSON HAMAKUA HEALTH CENTER DIRECTOR OF ALOHACARE'S BOD 445000 GRANT & SERVICES RENDERED GRANT & SERVICES EMMANUEL KINTU KALIHI PALAMA HEALTH CENTER EXEC DIR DIRECTOR & TREASURER OF ALOHACARE'S BOD 2900000 GRANT & SERVICES RENDERED GRANT & SERVICES DAVID DERAUF KOKUA KALIHI VALLEY EXEC DIR DIRECTOR OF ALOHACARE'S BOD 1100000 GRANT & SERVICES RENDERED GRANT & SERVICES RICH BETTINI WAIANAE COAST COMP HEALTH CENTER CEO DIRECTOR & SECRETARY OF ALOHACARE'S BOD 10700000 GRANT & SERVICES RENDERED GRANT & SERVICES DESIREE PUHI MOLOKAI OHANA HEALTH CENTER EXEC DIR DIRECTOR OF ALOHACARE'S BOD 800000 GRANT & SERVICES RENDERED GRANT & SERVICES MARY ONEHA WAIMANALO HEALTH CENTER EXEC DIR DIRECTOR OF ALOHACARE'S BOD 470000 GRANT & SERVICES RENDERED GRANT & SERVICES SHEILA BECKAHM WAIKIKI HEALTH CENTER EXEC DIR DIRECTOR OF ALOHACARE'S BOD 845000 GRANT & SERVICES RENDERED GRANT & SERVICES JANET ONAPA QUEENS HEALTH SYSTEMS MED DIR DIRECTOR OF ALOHACARE'S BOD 24500000 GRANT & SERVICES RENDERED GRANT & SERVICES BEN PETTUS KOOLAULOA COMMUNITY HEALTH CENTER DIRECTOR OF ALOHACARE'S BOD 440000 GRANT & SERVICES RENDERED GRANT & SERVICES BAY CLINIC INC VACANT BOD POSITION 2550000 GRANT & SERVICES RENDERED GRANT & SERVICES HANA COMMUNITY HEALTH CENTER VACANT BOD POSITION 176000 GRANT & SERVICES RENDERED GRANT & SERVICES 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 11 BOTH THE CEO & CFO OF ALOHACARE REVIEW FORM 990 PRIOR TO OBTAINING APPROVAL FROM ALOHACARE'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS OR TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO COMPELTE 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. OTHER FEES FORM 990, PART IX, LINE 11G OTHER FEES - PROGRAM SERVICES: PROGRAM SERVICE EXPENSES 174,080,926. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 174,080,926. 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).