2012-11-14T18:59:17-06:00 2011-12-31 205325889 ACCUITY LLP 999 BISHOP STREET STE 1900 HONOLULU HI 96813 990 2011-01-01 990309519 ALOHACARE ALOH 8089731650 1357 KAPIOLANI BLVD NO 1250 HONOLULU HI 96814 JOHN MCCOMAS 8089731650 2012-11-13 1 ACCUITY LLP P00037058 8085313400 2011 2016-02-24 21:20:13Z JOHN E MCCOMAS 1357 KAPIOLANI BLVD NO 1250 HONOLULU HI 96814 231297552 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. 17 6 265 0 0 0 0 0 217051099 229441375 205267 285588 877651 1570589 218134017 231297552 1175003 1317642 0 0 11485102 11716201 0 0 0 196471491 222538488 209131596 235572331 9002421 -4274779 130336787 128617607 48365025 50920624 81971762 77696983 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 221461437 1317642 229441375 HEALTH CARE PROGRAMS, GENERAL/OTHER: PROVIDE MANAGED HEALTH CARE SERVICES TO APPROXIMATELY 80,204 QUALIFIED MEDICAID MEMBERS, AND 2,010 MEDICARE MEMBERS WHO ARE RESIDENTS OF HAWAII. 221461437 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 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1524 0 1 265 1 0 0 0 0 0 0 0 0 0 0 X 17 6 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 DAWN HOFMANN 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 MAY AKAMINE 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 TONY GUERRERO 1.00 X 0 0 0 CINDY NEELEY 40.00 X 204541 0 13876 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 226620 0 24738 PAUL STRAUSS 1.00 X 0 0 0 RICHARD BETTINI 1.00 X 0 0 0 SHARON TISZA 40.00 X 178313 0 17070 SHERI STACHER 40.00 X 15016 0 1424 SUSAN HUNT 1.00 X 0 0 0 PATRICK BRENNAN 40.00 X 163500 0 18697 EVELYN CHOCK 40.00 X 114232 0 15899 FRANCIS APPEL 40.00 X 118848 0 12979 KARINA BUCKNER 40.00 X 106331 0 4687 RANE SHOJI 40.00 X 103988 0 8402 STELLA CATALAN 40.00 X 139067 0 11260 VICTOR RODRIGUEZ 40.00 X 221274 0 7552 MARIE WAGNER 40.00 X 118176 0 8192 1709906 0 144776 11 1 1 0 INSURANCE BENEFITS SERVICES 1585 KAPIOLANI BLVD SUITE 1020 HONOLULU HI 96814 BROKER FEES 253749 FLEXTECH 445 BUTTERNUT DRIVE HOLLAND MI 49424 CONSULTING 243298 MILLIMAN 1301 FIFTH AVENUE SUITE 3800 SEATTLE WA 98101 ACTUARIAL 227995 INFO OPTIONS PO BOX 235876 HONOLULU HI 96823 CONSULTING 178778 ERICKSON CONSULTING 11118 WHISPER MEADOW SAN ANTONIO TX 78230 CONSULTING 131249 5 CAPITATION 624100 223869674 223869674 REINSURANCE 624100 5571701 5571701 229441375 285588 285588 OTHER REVENUE 624100 1374705 1374705 MEDICARE REBATES 624100 195884 195884 1570589 231297552 229441375 0 1856177 1317642 1317642 1854682 1854682 7619179 4959619 2659560 191811 191811 1186513 1186513 864016 864016 67748 67748 115026 115026 180769917 180769917 512018 512018 124587 124587 629047 629047 112211 112211 28448 28448 385435 385435 174914 174914 OTHER PROFESSIONAL SERV 29669975 29669975 CAPITATION 4035166 4035166 OTHER PROFESSIONAL FEES 2039998 2039998 LICENCES & FEES 703458 703458 3170540 709118 2461422 235572331 221461437 14110894 0 98885194 67168328 5629394 10709737 337953 317167 5126761 4550694 701669 576067 24782577 49846308 130336787 128617607 7573653 9217187 40791372 41703437 48365025 50920624 X 81971762 77696983 81971762 77696983 130336787 128617607 -4274779 0 X X 0 1 1 X 0 179050 143639 35411 4947711 4407055 540656 576067 PAYABLE TO RISK POOLS 7630159 ACCRUED MEDICAL CLAIMS 34073278 41703437 231297552 235572331 -4274779 -4274779 225706188 0 225706188 5591364 5591364 231297552 229979846 -1121 -1121 229980967 5591364 5591364 235572331 PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION OF REINSURANCE REVENUES 5,591,364. PART XIII, LINE 2D - OTHER ADJUSTMENTS: BROKER FEES -20,786. INVESTMENTS 19,665. PART XIII, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION OF REINSURANCE REVENUES 5,591,364. 1 ALII HEALTH CENTER 75-5759 KUAKINI HWY SUITE 208 KAILUAKONA HI 96740 260318372 501(C)(3) 75000 GRANTS - CHC DEVELOPMENT ALOHA UNITED WAY PO BOX 3100 HONOLULU HI 96849 990073494 501(C)(3) 250 DONATION BAY CLINIC INC 224 HAILI ST SUITE B HILO HI 96720 990222784 501(C)(3) 188354 QUALITY PROGRAM GRANT CHILDREN'S MIRACLE NETWORK PO BOX 31191 HONOLULU HI 96820 990177350 501(C)(3) 20000 DONATION COMMUNITY CLINIC OF MAUI 48 LONO STREET KAHULUI HI 96732 990303304 501(C)(3) 74354 QUALITY PROGRAM GRANT HAMAKUA HEALTH CENTER 45-549 PLUMERIA STREET HAMAKUA HI 96827 990115515 501(C)(3) 45000 QUALITY PROGRAM GRANT HANA COMMUNITY HEALTH CENTER PO BOX 807 HANA HI 96713 990326154 501(C)(3) 16000 DONATION KALIHI PALAMA HEALTH CENTER 915 NORTH KING STREET HONOLULU HI 96819 990161221 501(C)(3) 222920 QUALITY PROGRAM GRANT KOKUA KALIHI VALLEY 2239 NORTH SCHOOL STREET KIHEI HI 96819 990149797 501(C)(3) 62681 QUALITY PROGRAM GRANT KOKUA MAU PO BOX 62155 HONOLULU HI 96819 990339201 501(C)(3) 1000 DONATION KOOLAULOA COMMUNITY HEALTH & WELLNESS CENTER PO BOX 395 KAHUKU HI 96731 731681833 501(C)(3) 54000 QUALITY PROGRAM GRANT LANAI COMMUNITY HEALTH CENTER PO BOX 630142 LANAI CITY HI 96763 202509287 501(C)(3) 46350 GRANTS - CHC DEVELOPMENT MAUI ADULT DAY CARE CENTER 11 MAHAOLU STREET SUITE B KAHULUI HI 96732 990216306 501(C)(3) 784 DONATION MOLOKAI COMMUNITY HEALTH CENTER 28 KAMOI ST SUITE 600 KAUNAKAKAI HI 96748 510439659 501(C)(3) 70000 QUALITY PROGRAM GRANT OCEAN VIEW FAMILY HEALTH CLINIC PO BOX 7009 OCEAN VIEW ESTATES HI 96737 680623208 501(C)(3) 18000 GRANTS - CDC DEVELOPMENT QUEEN EMMA CLINIC PO BOX 30160 HONOLULU HI 96820 990073524 501(C)(3) 58990 QUALITY PROGRAM GRANT UH SCHOOL OF PUBLIC HEALTH ALUMNI ASSOCIATION PO BOX 314 HALEIWA HI 96712 990272310 501(C)(3) 250 DONATION WAIANAE COAST COMPREHENSIVE HEALTH CENTER 86-260 FARRINGTON HWY WAIANAE HI 96792 990148164 501(C)(3) 199200 QUALITY PROGRAM GRANT WAIKIKI HEALTH CENTER 758 KAPAHULU AVE A-319 HONOLULU HI 96816 990159253 501(C)(3) 37500 QUALITY PROGRAM GRANT WAIMANALO HEALTH CENTER 41-1347 KALANIANAOLE HWY A WAIMANALO HI 96795 990273205 501(C)(3) 45000 QUALITY PROGRAM GRANT WEST HAWAII COMMUNITY HEALTH CENTER 75-5751 KUAKINI HWY SUITE 203 KAILUAKONA HI 96740 200495394 501(C)(3) 82009 QUALITY PROGRAM GRANT 21 0 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 1 0 0 0 0 0 0 0 0 CINDY NEELEY 191789 0 2500 0 10252 0 8158 0 5718 0 218417 0 0 0 JOHN MCCOMAS 224332 0 0 0 2288 0 9100 0 15638 0 251358 0 0 0 SHARON TISZA 178313 0 0 0 0 0 4382 0 12688 0 195383 0 0 0 PATRICK BRENNAN 150748 0 2500 0 10252 0 6622 0 12075 0 182197 0 0 0 STELLA CATALAN 126282 0 2500 0 10285 0 5542 0 5718 0 150327 0 0 0 VICTOR RODRIGUEZ 146274 0 0 0 75000 0 0 0 7552 0 228826 0 0 0 MARIE WAGNER 118176 0 0 0 0 0 0 0 8192 0 126368 0 0 0 PART I, LINE 1A DISCRETIONARY SPENDING IS APPROVED BY BOARD OF DIRECTORS AS DOCUMENTED IN THE EMPLOYMENT CONTRACT. PART I, LINE 4A VICTOR RODRIGUEZ $75,000; RICHARD BANNER $25,000 PAUL STRAUSS BAY CLINIC CEO DIRECTOR OF ALOHACARE'S BOD GRANT & SERVICES RENDERED (EST. $1.9 MILLION) DANA ALONZO-HOWETH COMMUNITY CLINIC OF MAUI EXEC DIR DIRECTOR & PRESIDENT OF ALOHACARE'S BOD GRANT & SERVICES RENDERED (EST. $1.9 MILLION) EMMANUEL KINTU KALIHI PALAMA HEALTH CENTER EXEC DIR DIRECTOR & TREASURER OF ALOHACARE'S BOD GRANT & SERVICES RENDERED (EST. $3.3 MILLION) DAVID DERAUF KOKUA KALIHI VALLEY EXEC DIR DIRECTOR OF ALOHACARE'S BOD GRANT & SERVICES RENDERED (EST. $1.1 MILLION) RICH BETTINI WAIANAE COAST COMP HEALTH CENTER CEO DIRECTOR & VICE PRESIDENT OF ALOHACARE'S BOD GRANT & SERVICES RENDERED (EST. $11.0 MILLION) DESIREE PUHI MOLOKAI OHANA HEALTH CENTER EXEC DIR DIRECTOR OF ALOHACARE'S BOD GRANT & SERVICES RENDERED (EST. $820,000) MAY AKAMINE WAIMANALO HEALTH CENTER EXEC DIR DIRECTOR OF ALOHACARE'S BOD GRANT & SERVICES RENDERED (EST. $515,000) SHEILA BECKHAM WAIKIKI HEALTH CENTER EXEC DIR DIRECTOR OF ALOHACARE'S BOD GRANT & SERVICES RENDERED (EST. $730,000) JANET ONAPA QUEENS HEALTH SYSTEMS MED DIR DIRECTOR OF ALOHACARE'S BOD GRANT & SERVICES RENDERED (EST. $24 MILLION) 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. 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).