2014-05-08T00:48:27-05:00 2013-06-30 261659234 CW ASSOCIATES CPAS 700 BISHOP STREET SUITE 1040 HONOLULU HI 96813 990 2012-07-01 453084351 HAWAII HEALTH CONNECTOR HAWA 8083124400 201 MERCHANT STREET NO 1810 HONOLULU HI 96813 TOM MATSUDA 8083124400 2014-05-07 1 MARK A HAYES P00085205 8085311040 2012 2015-11-30 17:44:51Z TOM MATSUDA 201 MERCHANT STREET NO 1810 HONOLULU HI 96813 34283557 0 X WWW.HAWAIIHEALTHCONNECTOR.ORG X 2011 HI SEE SCHEDULE O 15 15 20 15 0 0 1483633 34281554 0 0 0 0 0 2003 1483633 34283557 0 0 0 0 226274 2646314 0 0 0 1176700 12292274 1402974 14938588 80659 19344969 1046160 37730126 965501 18304498 80659 19425628 X TO HELP THE PEOPLE OF HAWAII LIVE HAPPIER & HEALTHIER LIVES BY MAKING QUALITY HEALTH INSURANCE ACCESSIBLE TO ALL, MAKING THE ACQUISITION OF HEALTH INSURANCE AFFORDABLE AND SIMPLER, AND BY IMPROVING THE INTEGRATION BETWEEN PUBLIC AND PRIVATE HEALTH INSURANCE PLANS. 0 0 11017896 2003 DURING THE FISCAL YEAR ENDED JUNE 30, 2013, THE CONNECTOR EXPENDED APPROXIMATELY $30 MILLION DOLLARS OF PROGRAM FUNDING FOR $19 MILLION OF LONG TERM ASSETS AND $11 MILLION OF PROGRAM EXPENSES IN ORDER TO DESIGN, DEVELOP AND BEGIN IMPLEMENTATION OF A HEALTH INSURANCE EXCHANGE (HIX) FOR HAWAII. THESE EXPENDITURES INCLUDE COSTS FOR INFORMATION TECHNOLOGY DEVELOPMENT, PURCHASE OF LICENSING RIGHTS, PROJECT MANAGEMENT, AND PERSONNEL AND ADMINISTRATIVE COSTS ASSOCIATED WITH THE DEVELOPMENT OF THE INFRASTRUCTURE FOR THE OPERATING COMPANY. THE CONNECTOR'S HIX BEGAN OPERATIONS IN OCTOBER 2013. THE CONNECTOR PLANS TO LEVERAGE THE INTEGRATED ELIGIBILITY SYSTEM THAT DHS IS BUILDING, WHICH WILL DETERMINE ELIGIBILITY FOR ALL INSURANCE AFFORDABILITY PROGRAMS. THIS APPROACH WILL CONSOLIDATE HEALTH INSURANCE SELECTION AND BE SUPPORTED BY EFFECTIVE COMMUNICATION AND REPORTING ACROSS THE CONNECTOR AND DHS.THROUGH THIS ONE-STOP WEB PORTAL, CONSUMERS MAY SUBMIT A SINGLE QUERY AND LEARN IF THEIR INCOME POTENTIALLY QUALIFIES THEM FOR MEDICAID OR WHETHER THEY ARE ELIGIBLE FOR PREMIUM SUBSIDIES TO PURCHASE HEALTH INSURANCE, AND BE GUIDED THROUGH A MARKETPLACE TO CHOOSE A HEALTH PLAN. 11017896 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 X 13 0 20 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 1 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X DIANE REICH CFO 8083124418 201 MERCHANT STREET NO 1810 HONOLULU HI 96813 HARDY SPOEHR 4.00 X X 0 0 0 SHERRY MENOR-MCNAMARA 4.00 X X 0 0 0 CLIFFORD ALAKAI 4.00 X X 0 0 0 GWEN K RULONA 4.00 X X 0 0 0 CLEMENTINA CERIA-ULEP 4.00 X 0 0 0 JOAN DANIELEY 4.00 X 0 0 0 JENNIFER DIESMAN 4.00 X 0 0 0 LORETTA FUDDY 4.00 X 0 0 0 MICHAEL GLEASON 4.00 X 0 0 0 ROBERT HIROKAWA 4.00 X 0 0 0 FAYE KURREN 4.00 X 0 0 0 KEALI'I LOPEZ 4.00 X 0 0 0 PATRICIA MCMANAMAN 4.00 X 0 0 0 CHRISTINE MAI'I SAKUDA 4.00 X 0 0 0 DWIGHT TAKAMINE 4.00 X 0 0 0 BETH GEISTING 4.00 X 0 0 0 CORAL T ANDREWS 40.00 X 153808 0 0 JAMES S DIXON 40.00 X 18460 0 0 KEVIN RANDALL HAUSE 40.00 X 92419 0 0 RICHARD R BUDAR 40.00 X 0 0 0 JENNIFER L SCHEMBER-LANG 40.00 X 0 0 0 DIANE REICH 40.00 X 0 0 0 RESTITUTO J CRUZ 40.00 X 61275 0 0 325962 0 0 1 0 1 0 GOODSILL ANDERSON QUINN & STIFEL FIRST HAWAIIAN CENTER SUITE 600 HONOLULU HI 96813 LEGAL SERVICES 1050548 PUBLIC CONSULTING GROUP PO BOX 845308 BOSTON MA 022845308 IT PROJECT MANAGEMENT SERVICES 361984 GREENBERG TRAURIG 2101 L ST NW SUITE 1000 WASHINGTON DC 20037 LEGAL SERVICES 204723 JULIE MAULDIN 360 H ST NE APT 626 WASHINGTON DC 20002 IT SERVICES 141600 4 34281554 34281554 OTHER REVENUE 900099 2003 2003 2003 34283557 2003 0 0 575682 285467 290215 1639141 1247247 391894 273147 187879 85268 158344 106685 51659 2196737 2196737 172565 172565 587932 587932 40151 28106 12045 7646060 7646060 208887 141332 67555 165835 165835 28103 28103 63444 44411 19033 PUBLIC RELATIONS/OUTREA 1029936 1029936 SUPPLIES/MAINT/REPAIRS 92446 64712 27734 OTHER EXPENSES 60178 42123 18055 14938588 11017896 3920692 0 24580 10444 955443 18309976 478 7949 11291 41306 562542 64484 43720 498058 1191 18846579 9457 15814 1046160 37730126 965501 18304498 965501 18304498 X 80659 19425628 80659 19425628 1046160 37730126 19344969 0 X 0 1 X 1 1 1 X 1483633 34281554 35765187 1483633 34281554 35765187 35765187 2003 2003 35767190 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2012 AMOUNT: $ 2,003. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 48883 8793 40090 513659 55691 457968 498058 X 34283557 0 34283557 0 34283557 14938588 0 14938588 0 14938588 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE UNCERTAIN TAX POSITIONS TO BE RECOGNIZED IN THE FINANCIAL STATEMENTS IF THEY ARE MORE LIKELY THAN NOT TO FAIL UPON REGULATORY EXAMINATION. MANAGEMENT HAS EVALUATED THE CONNECTOR'S TAX POSITIONS AS OF JUNE 30, 2013 AND 2012 AND FOR THE PERIODS THEN ENDED BY REVIEWING ITS INCOME TAX RETURNS AND CONFERRING WITH ITS TAX ADVISORS, AND DETERMINED THAT THE CONNECTOR HAD NO UNCERTAIN TAX POSITIONS REQUIRED TO BE REPORTED IN ACCORDANCE WITH SUCH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THE INCOME TAX RETURNS ARE OPEN FOR EXAMINATION BY TAXING AUTHORITIES UNTIL THEIR RESPECTIVE STATUTES OF LIMITATION EXPIRE. X X X X X 0 0 0 0 0 0 0 0 0 CORAL T ANDREWS 153808 0 0 0 0 0 0 0 0 0 153808 0 0 0 FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: HAWAII HEALTH CONNECTOR (THE "CONNECTOR") IS A NOT-FOR-PROFIT CORPORATION ESTABLISHED IN JULY 2011. THE CONNECTOR'S MISSION IS TO HELP THE PEOPLE OF HAWAII LIVE HAPPIER AND HEALTHIER LIVES BY MAKING QUALITY HEALTH INSURANCE ACCESSIBLE TO ALL, MAKING THE ACQUISITION OF HEALTH INSURANCE AFFORDABLE AND SIMPLER, AND BY IMPROVING THE INTEGRATION BETWEEN PUBLIC AND PRIVATE HEALTH PLANS. THE CONNECTOR WAS ESTABLISHED BY THE HAWAII STATE LEGISLATURE'S ENACTMENT OF ACT 205 ("ACT 205") TO BE HAWAII'S HEALTH INSURANCE EXCHANGE, AS MANDATED BY THE FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010 ("ACA"). THE CONNECTOR SEEKS TO PROVIDE THE PEOPLE OF HAWAII THE ABILITY TO PERUSE A WIDE RANGE OF HEALTH INSURANCE COVERAGE OPTIONS THROUGH A "ONE-STOP" MARKETPLACE EXPERIENCE WHERE INDIVIDUALS AND BUSINESSES CAN EFFICIENTLY AND CAREFULLY CONSIDER THE HEALTH INSURANCE CHOICES AVAILABLE TO THEM. THROUGH THIS SERVICE, THE CONNECTOR ULTIMATELY SEEKS TO IMPROVE PUBLIC ACCESS TO AFFORDABLE HEALTH CARE COVERAGE IN HAWAII. SECTION 1311 OF THE ACA REQUIRES EACH STATE TO ESTABLISH A HEALTH INSURANCE EXCHANGE FOR INDIVIDUAL AND SMALL EMPLOYER GROUP HEALTH INSURANCE PLAN PURCHASES. IN HAWAII, THE STATE LEGISLATURE DETERMINED IT TO BE IN THE BEST INTEREST OF THE STATE TO ESTABLISH ITS EXCHANGE AS A PRIVATE NONPROFIT ORGANIZATION, IN LIEU OF HOUSING IT WITHIN A STATE AGENCY OR ALLOWING THE FEDERAL GOVERNMENT TO ESTABLISH AN EXCHANGE IN HAWAII, THEREBY LESSENING THE BURDEN OF THE FEDERAL AND STATE GOVERNMENTS. THE CONNECTOR'S APPLICATION FOR TAX-EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE WAS APPROVED BY THE INTERNAL REVENUE SERVICE IN FEBRUARY 2014, AND IS EFFECTIVE AS OF AUGUST 25, 2011. FORM 990, PART V, LINE 2A, DESCRIPTION OF EMPLOYEES: THE CONNECTOR HAS A CO-EMPLOYMENT ARRANGEMENT WITH BISHOP & CO., WHO IS THE OUTSOURCED HUMAN RESOURCE/PAYROLL PROVIDER AND THE EMPLOYER OF RECORD. THE CONNECTOR IS THE WORKSITE EMPLOYER. FORM 990, PART VI, SECTION A, LINE 4 THE CONNECTOR ADOPTED AMENDED BYLAWS ON JANUARY 18, 2013 AND SIGNIFICANT CHANGES WERE MADE TO THE FOLLOWING: COMPOSITION OF THE BOARD OF DIRECTORS, MEETINGS OF THE BOARD OF DIRECTORS, ATTENDANCE AT MEETINGS, OFFICERS AND MANAGEMENT, COMMITTEES OF THE BOARD, CONFLICT OF INTEREST, AND FINANCIAL MATTERS. THE CONNECTOR ADOPTED AMENDED ARTICLES ON APRIL 12, 2013 AND SIGNIFICANT CHANGES WERE MADE TO THE FOLLOWING: CORPORATE PURPOSES, CORPORATE POWERS, DURATION OF CORPORATION, MEMBERSHIP, DIRECTORS AND OFFICERS, LIABILITY OF OFFICERS AND DIRECTORS, CORPORATE LIABILITY, CORPORATE DISSOLUTION, BYLAWS, AND AMENDMENTS. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OF THE BOARD SHALL BE APPOINTED BY THE GOVERNOR OF THE STATE OF HAWAII AND WITH THE ADVICE AND CONSENT OF THE SENATE PURSUANT TO HAWAII REVISED STATUTES SECTION 26-34 AND ACT 205, 2010 SESSION LAWS ("ACT 205"). DIRECTORS OF STATE AGENCIES ENTITLED TO A SEAT ON THE BOARD PURSUANT TO ACT 205 MAY NAME A PERMITTED DESIGNEE TO THE BOARD TO SERVE IN HIS OR HER PLACE AS PROVIDED BY ACT 205, AS WELL AS ANY SUCCESSOR DESIGNEE IN THE CASE OF A VACANCY RESULTING FROM THE RESIGNATION, DEATH, DISABILITY OR TERMINATION OF EMPLOYMENT BY SUCH DIRECTOR'S RESPECTIVE STATE AGENCY BY DELIVERING WRITTEN NOTICE THEREOF TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 11 THE CFO REVIEWS THE FORM 990 WITH THE IN-HOUSE LEGAL COUNSEL AND EXECUTIVE DIRECTOR PRIOR TO SIGNING. THE FORM 990 IS ALSO PROVIDED TO ALL BOARD MEMBERS FOR REVIEW AND APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONNECTOR'S BOARD ADOPTED A CONFLICT OF INTEREST POLICY ON MAY 11, 2012. DIRECTORS, OFFICERS AND EMPLOYEES OF THE ORGANIZATION MUST DISCLOSE TO THE INDEPENDENT DIRECTORS OF THE BOARD ALL FACTS THAT ARE MATERIAL TO WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IF IT IS DETERMINED THAT AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST EXISTS, SUCH INTERESTED PERSON SHALL BE SO NOTIFIED, AND SHALL RECUSE HIM OR HERSELF FROM PARTICIPATING IN THE DISCUSSION, VOTE, OR OTHER PART OF THE DECISION-MAKING PROCESS INVOLVING AN OFFICIAL ACTION ON THE MATTER IN WHICH THE INTERESTED PERSON HAS A FINANCIAL INVOLVEMENT OR CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 DURING FY 2013, THE CONNECTOR ESTABLISHED A HUMAN RESOURCES COMMITTEE (HRC) WHICH ENCOMPASSES MEMBERS OF THE CONNECTOR BOD. THE HRC ESTABLISHED SALARY RANGES BASED ON GRADE BANDS FOR THE MANAGEMENT AND EMPLOYEES OF THE CONNECTOR BASED UPON COMPENSATION STUDIES PREPARED BY A THIRD-PARTY ORGANIZATION. THIS PROCESS WAS USED FOR ALL PERSONNEL INCLUDING OFFICERS, MANAGEMENT AND OTHER POSITIONS. THE CONNECTOR'S COMPENSATION STUDY WAS COMPILED BY AN INDEPENDENT CONSULTANT USING DATA FROM HAWAII COMPENSATION SURVEYS, THE ECONOMIC RESEARCH INSTITUTE EXECUTIVE COMPENSATION DATABASE, PUBLISHED NON-PROFIT COMPENSATION REPORTS AND OTHER NATIONAL PUBLISHED HUMAN RESOURCE CONSULTING DATABASES. THE HRC REVIEWS AND APPROVES THE COMPENSATION AND THIS PROCESS IS DOCUMENTED IN THE MINUTES. IT WAS LAST UNDERTAKEN IN JANUARY 2013 FOR EXECUTIVE AND MANAGEMENT AND IN DECEMBER 2013 FOR OTHER EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AS WELL AS MINUTES OF MEETINGS, ARE AVAILABLE FOR PUBLIC VIEWING ON THE ORGANIZATION'S WEBSITE AT HTTP://WWW.HAWAIIHEALTHCONNECTOR.COM/CONNECTOR-DOCUMENTS-2/.