2017-11-11T12:53:31-06:00 2016-12-31 205325889 ACCUITY LLP 999 BISHOP STREET STE 1900 HONOLULU HI 96813 990 2016-01-01 990309519 ALOHACARE ALOH 8089731650 1357 KAPIOLANI BLVD NO 1250 HONOLULU HI 96814 LAURA ESSLINGER CEO 8089731650 2017-11-10 1 KENT K TSUKAMOTO P00089337 8085313400 72.253.96.98 2017-11-10 08:49:55 HS P 1B4AB77F77468A1A1345A306DF907DFB530EC2BE 7D0FE1AFA0460A7566304F414B36F1975FF2EB04 2016 2018-03-14 21:41:22Z LAURA ESSLINGER 1357 KAPIOLANI BLVD NO 1250 HONOLULU HI 96814 322860644 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. 13 3 311 0 0 0 0 0 273275620 322559458 360126 277072 80 24114 273635826 322860644 1000526 930172 0 0 14108201 17850188 0 0 0 277651983 288562765 292760710 307343125 -19124884 15517519 114680263 142238433 62186354 74227005 52493909 68011428 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 287111754 930172 322559458 HEALTH CARE PROGRAMS, GENERAL/OTHER: PROVIDE MANAGED HEALTH CARE SERVICES TO APPROXIMATELY 70,735 QUALIFIED MEDICAID MEMBERS, AND 930 MEDICARE MEMBERS WHO ARE RESIDENTS OF HAWAII. 287111754 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 1756 0 1 311 1 0 0 0 0 0 0 0 0 0 0 X 13 3 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 LAURA ESSLINGER 8089731650 1357 KAPIOLANI BLVD SUITE 1250 HONOLULU HI 96814 ALAN TERADA BOARD MEMBER 1.00 X 0 0 0 ANDREA TRENNER BOARD MEMBER 1.00 X 0 0 0 DAVID DERAUF BOARD MEMBER 1.00 X 0 0 0 HAROLD WALLACE BOARD MEMBER 1.00 X 0 0 0 IRENE CARPENTER BOARD MEMBER 1.00 X 0 0 0 MARTHA SMITH BOARD MEMBER 1.00 X 0 0 0 PAULA YOSHIOKA BOARD MEMBER 1.00 X 0 0 0 PHIL KINNICUTT BOARD MEMBER 1.00 X 0 0 0 RICHARD KISHABA BOARD MEMBER 1.00 X 0 0 0 SHEILA BECKHAM BOARD MEMBER 1.00 X 0 0 0 EMMANUEL KINTU IMMEDIATE PAST PRESIDENT 1.00 X 0 0 0 DANA HOWETH PRESIDENT 1.00 X 0 0 0 RICHARD BETTINI VICE PRESIDENT 1.00 X 0 0 0 RICHARD TAAFFE VICE PRESIDENT 1.00 X 0 0 0 MARY ONEHA SECRETARY 1.00 X 0 0 0 CINDY NEELEY CHIEF FINANCIAL OFFICER 40.00 X 336584 0 15282 LAURA ESSLINGER CHIEF EXECUTIVE OFFICER 40.00 X 81178 0 991 DR GARY OKAMOTO CHIEF MEDICAL DIRECOR 40.00 X 322831 0 20132 TODD MORGAN CHIEF INFORMATION OFFICER 40.00 X 219137 0 19358 PAULA ARCENA CHIEF CUSTOMER OFFICER 40.00 X 177855 0 23159 PATRICK BRENNAN SENIOR DIRECTOR OF PLAN OPERATIONS 40.00 X 232891 0 19642 CRAWFORD ALLISON SENIOR DIRECTOR OF LTSS 40.00 X 176687 0 19234 STELLA CATALAN SENIOR DIRECTOR OF CLINICAL OPS 40.00 X 200306 0 12831 NILA PATEL APPLICATIONS DEVELOPMENT MANAGER 40.00 X 138697 0 12781 MAMIVIR AQUINO SR. DIRECTOR OF HEALTH SERVICES 40.00 X 178994 0 10851 JOHN MCCOMAS CHIEF EXECUTIVE OFFICER 40.00 X 226682 0 27546 2291842 0 181807 10 1 1 0 MEDICONNECTNET PO BOX 673377 DETROIT MI 482673377 MEDICAL RECORD RETRIEVAL 246106 MILLIMAN 1301 FIFTH AVENUE SUITE 3800 SEATTLE WA 98101 ACTUARIAL 168202 PRICEWATERHOUSE PO BOX 514038 LOS ANGELES CA 900514038 ACTUARIAL 142788 GORMAN HEALTH GROUP 5335 WISCONSIN AVE NW 340 WASHINGTON DC 20015 CONSULTING 130256 WITTKIEFFER 2015 SPRING ROAD SUITE 510 OAK BROOKE IL 60523 CONSULTING 125043 5 CAPITATION 624100 319260751 319260751 REINSURANCE 624100 3298707 3298707 322559458 277072 277072 OTHER REVENUE 624100 24114 24114 24114 322860644 322559458 0 301186 X 825866 825866 104306 104306 2748238 2748238 12063716 6606359 5457357 365582 365582 1571670 1571670 1100982 1100982 109627 109627 320969 320969 209556895 209556895 351915 351915 155089 155089 945105 945105 238498 238498 39818 39818 536898 536898 181340 181340 OTHER PROFESSIONAL SERV 62419192 62419192 CAPITATION 5130027 5130027 QUALITY PROGRAM SERVICE 2465492 2465492 OTHER PROFESSIONAL FEES 2022709 2022709 4089191 3617 4085574 307343125 287111754 20231371 0 43674912 66046254 25848031 29794580 284559 295476 7998043 7108668 995198 889375 43877563 45212748 114680263 142238433 24102638 22132358 38083716 52094647 62186354 74227005 X 52493909 68011428 52493909 68011428 114680263 142238433 15517519 0 X X 0 1 X 1 0 232790 195408 37382 7765253 6913260 851993 889375 PAYABLE TO RISK POOLS 10589443 ACCRUED MEDICAL CLAIMS 41505204 52094647 319630140 68203 68203 319561937 3298707 3298707 322860644 304043381 0 304043381 3299744 3299744 307343125 PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION OF REINSURANCE REVENUES 3,298,707. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION OF REINSURANCE REVENUES 3,298,707. BROKER FEES 1,037. 1 AHARO 86-260 FARRINGTON HWY WAIANAE HI 96792 472848796 227306 QI INCENTIVE ALII HEALTH CENTER 78-6831 ALII DRIVE KAILUA KONA HI 96740 260318372 501 ( C) 3 5189 QI INCENTIVE COMMUNITY CLINIC OF MAUI PO BOX 31000 HONOLULU HI 96849 990303304 501 ( C) 3 49575 QI INCENTIVE ELIZABETH ABINSAY MD 634 KALIHI ST SUITE 202 HONOLULU HI 96819 990320873 5269 QI INCENTIVE JOHN A BURNS SCHOOL OF MEDICINE 651 ILALO ST HONOLULU HI 96813 990085260 501 ( C) 3 10000 DONATION KALIHI PALAMA HEALTH CENTER 915 NORTH KING ST HONOLULU HI 96817 990161221 501 ( C) 3 63616 QI INCENTIVE KAPIOLANI MEDICAL CLINIC MAILCODE 60152 BOX 1300 HONOLULU HI 96807 990177350 501 ( C) 3 21613 QI INCENTIVE KAUAI MEDICAL CLINIC MAIL CODE 61113 HONOLULU HI 96820 990326099 501 ( C) 3 59959 QI INCENTIVE KIHEI WAILEA MEDICAL CENTER C/O TEAM PRAXIS HONOLULU HI 968200460 990350911 5431 QI INCENTIVE KOKUA KALIHI VALLEY 2239 NORTH SCHOOL STREET HONOLULU HI 96819 990149797 501 ( C) 3 58192 QI INCENTIVE KOOLAULOA COMMUNITY HEALTH & WELLNESS CENTER PO BOX 395 KAHUKU HI 96731 731681833 501 ( C) 3 9893 QI INCENTIVE LANAI COMMUNITY HEALTH CENTER PO BOX 630142 LANAI CITY HI 96763 202509287 501 ( C) 3 12931 $9,557 ACCESS AND AVAILABILITY GRANT & $3,374 QI INCENTIVE MANGO MEDICAL 64-1032 MAMALAHOA HWY KAMUELA HI 96743 452247272 5457 QI INCENTIVE MAUI MEDICAL GROUP 2180 MAIN ST WAILUKU HI 96793 990176859 48109 QI INCENTIVE MOLOKAI GENERAL HOSPITAL 280 HOME OLU PLACE KAUNAKAKAI HI 96748 990251372 501 ( C) 3 5361 QI INCENTIVE MOLOKAI OHANA HEALTH CARE INC PO BOX 2040 KAUNAKAKAI HI 96748 510437659 501 ( C) 3 13427 QI INCENTIVE NOA E ALULI MD PO BOX 1100 KAUNAKAKAI HI 96748 990333142 5961 QI INCENTIVE PANIOLO PEDIATRICS LLC P O BOX 6149 KAMUELA HI 96743 473826435 5654 QI INCENTIVE QUEEN EMMA CLINIC PO BOX 30160 HONOLULU HI 968200160 990073524 501 ( C) 3 8180 QI INCENTIVE STRAUB CLINIC & HOSPITAL (CLINIC) PO BOX 30180 HONOLULU HI 96820 912151670 501 ( C) 3 10731 QI INCENTIVE UNIVERSITY CLINICAL EDUCATION & RESEARCH ASSOCIATES 550 S BERETANIA STREET SUITE 510 HONOLULU HI 96813 990307152 501 ( C) 3 15594 QI INCENTIVE WAIKIKI HEALTH CENTER 935 MAKAHIKI WAY HONOLULU HI 96826 990159253 501 ( C) 3 27104 QI INCENTIVE WEST HAWAII COMMUNITY HEALTH CENTER 75-5751 KUAKINI HWY STE 203 KAILUAKONA HI 96740 200495394 501 ( C) 3 37068 QI INCENTIVE 16 7 QI INCENTIVE 110 104306 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 CINDY NEELEY CHIEF FINANCIAL OFFICER 241508 0 85038 0 10038 0 10492 0 4790 0 351866 0 0 0 DR GARY OKAMOTO CHIEF MEDICAL DIRECOR 267127 0 55704 0 0 0 13138 0 6994 0 342963 0 0 0 TODD MORGAN CHIEF INFORMATION OFFICER 181077 0 38060 0 0 0 7454 0 11904 0 238495 0 0 0 PAULA ARCENA CHIEF CUSTOMER OFFICER 147063 0 30792 0 0 0 15089 0 8070 0 201014 0 0 0 PATRICK BRENNAN SENIOR DIRECTOR OF PLAN OPERATIONS 162825 0 60033 0 10033 0 9507 0 10135 0 252533 0 0 0 CRAWFORD ALLISON SENIOR DIRECTOR OF LTSS 156687 0 20000 0 0 0 7330 0 11904 0 195921 0 0 0 STELLA CATALAN SENIOR DIRECTOR OF CLINICAL OPS 140240 0 50033 0 10033 0 8041 0 4790 0 213137 0 0 0 NILA PATEL APPLICATIONS DEVELOPMENT MANAGER 114585 0 24112 0 0 0 4711 0 8070 0 151478 0 0 0 MAMIVIR AQUINO SR. DIRECTOR OF HEALTH SERVICES 163796 0 15198 0 0 0 5855 0 4996 0 189845 0 0 0 JOHN MCCOMAS CHIEF EXECUTIVE OFFICER 226682 0 0 0 0 0 9098 0 18448 0 254228 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 CINDY NEELEY $10,038 PATRICK BRENNAN $10,033 STELLA CATALAN $10,033 PAULA YOSHIOKAQUEENS HEALTH SYSTEMS & ALAN TERADAMGRQUEEN EMMA CLINICS DIRECTOR OF ALOHACARE'S BOD 38637739 SERVICES RENDERED 0 DANA ALONZO-HOWETH COMMUNITY CLINIC OF MAUI EXEC DIR DIRECTOR & PRESIDENT OF ALOHACARE'S BOD 1710996 SERVICES RENDERED 0 IRENE CARPENTER HAMAKUA HEALTH CENTER DIRECTOR OF ALOHACARE'S BOD 322709 SERVICES RENDERED 0 EMMANUEL KINTU KALIHI PALAMA HEALTH CENTER EXEC DIR DIRECTOR & IMMEDIATE PAST PRESIDENT OF ALOHACARE'S BOD 2434032 SERVICES RENDERED 0 DAVID DERAUF KOKUA KALIHI VALLEY EXEC DIR DIRECTOR OF ALOHACARE'S BOD 1245666 SERVICES RENDERED 0 RICHARD BETTINI WAIANAE COAST COMP HEALTH CENTER CEO DIRECTOR & VP OF ALOHACARE'S BOD 11351280 SERVICES RENDERED 0 ANDREA TRENNER MOLOKAI OHANA HEALTH CENTER EXEC DIR DIRECTOR OF ALOHACARE'S BOD 485309 SERVICES RENDERED 0 MARY ONEHA WAIMANALO HEALTH CENTER EXEC DIR DIRECTOR & SECRETARY OF ALOHACARE'S BOD 896443 SERVICES RENDERED 0 SHEILA BECKHAM WAIKIKI HEALTH CENTER EXEC DIR DIRECTOR OF ALOHACARE'S BOD 1223001 SERVICES RENDERED 0 HAROLD WALLACE BAY CLINIC INC DIRECTOR OF ALOHACARE'S BOD 2221511 SERVICES RENDERED 0 RICHARD TAAFFE WEST HAWAII COMMUNITY HEALTH CENTER DIRECTOR & VP OF ALOHACARE'S BOD 1527360 SERVICES RENDERED 0 KOOLAULOA COMMUNITY HEALTH CENTER VACANT BOD POSITION 435421 SERVICES RENDERED 0 HANA COMMUNITY HEALTH CENTER VACANT BOD POSITION 160112 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 209,556,895. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 209,556,895. 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).