Form990
Click to see attachment
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Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 01-01-2021 , and ending 12-31-2021
BCheck if applicable:
CName of organization
ALOHACARE
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1357 KAPIOLANI BLVD G-101
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
HONOLULU, HI96814
D Employer identification number

99-0309519
E Telephone number

G Gross receipts $ 512,909,207
F Name and address of principal officer:
DAVID FIELD
1357 KAPIOLANI BLVD G-101
HONOLULU,HI96814
I
Tax-exempt status: ( 4 ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.ALOHACARE.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1994
M State of legal domicile: HI
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: 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 INTERNAL REVENUE CODE OF 1986 AS AMENDED.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 15
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 2
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 305
6 Total number of volunteers (estimate if necessary) ............. 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 447,304,115 506,660,216
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,716,552 1,592,619
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 81,236 123,926
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 449,101,903 508,376,761
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,667,216 2,053,124
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 26,573,901 26,620,257
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 419,894,803 472,405,889
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 448,135,920 501,079,270
19 Revenue less expenses. Subtract line 18 from line 12....... 965,983 7,297,491
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 145,058,426 178,821,617
21 Total liabilities (Part X, line 26)............. 81,214,166 107,152,026
22 Net assets or fund balances. Subtract line 21 from line 20..... 63,844,260 71,669,591
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
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Signature of officer Date
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Type or print name and title
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Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: 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 INTERNAL REVENUE CODE OF 1986 AS AMENDED.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 465,678,890 including grants of $ 2,053,124 ) (Revenue $ 506,660,216 )
HEALTH CARE PROGRAMS, GENERAL/OTHER: PROVIDE MANAGED HEALTH CARE SERVICES TO APPROXIMATELY 80,246 QUALIFIED MEDICAID MEMBERS, AND 2,684 MEDICARE MEMBERS WHO ARE RESIDENTS OF HAWAII.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet465,678,890
Form 990 (2021)
Form 990 (2021)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A.....................
1
 
No
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II.........
4
 
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part III..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XIIClick to see attachment......................
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
 
No
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................
34
 
No
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
1,983
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
305
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
15
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
2
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
Yes
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
HI
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletALOHACARE - CO DHARYL BONGBONGA1357 KAPIOLANI BLVD SUITE G-101   HONOLULU,HI96814 (808) 973-1650
Form 990 (2021)
Form 990 (2021)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) GERALD AKAKA......................................................................
BOARD MEMBER
 1.00
.................
  		X           0 0 0
(2) GIDGET RUSCETTA......................................................................
BOARD MEMBER
 1.00
.................
  		X           0 0 0
(3) PHYLLIS DENDLE......................................................................
BOARD MEMBER
 1.00
.................
  		X           0 0 0
(4) MARY ONEHA......................................................................
BOARD MEMBER
 1.00
.................
  		X           0 0 0
(5) HELEN KEKALIA......................................................................
BOARD MEMBER
 1.00
.................
  		X           0 0 0
(6) CHERYL VASCONCELLOS......................................................................
BOARD MEMBER
 1.00
.................
  		X           0 0 0
(7) DIANA SHAW......................................................................
BOARD MEMBER
 1.00
.................
  		X           0 0 0
(8) DEBORAH ZYSMAN......................................................................
BOARD MEMBER
 1.00
.................
  		X           0 0 0
(9) JAMES CHEN......................................................................
BOARD MEMBER
 1.00
.................
  		X           0 0 0
(10) CHRISTIAN KIMO ALAMEDA......................................................................
BOARD MEMBER
 1.00
.................
  		X           0 0 0
(11) FRANCOISE CULLEY-TROTMAN......................................................................
CHIEF EXECUTIVE OFFICER
 40.00
.................
  		    X       505,493 0 37,737
(12) DAVID FIELD......................................................................
CHIEF FINANCIAL OFFICER
 40.00
.................
  		    X       451,384 0 16,294
(13) DAVID DERAUF......................................................................
PRESIDENT
 1.00
.................
  		    X       0 0 0
(14) EMMANUEL KINTU......................................................................
SECRETARY
 1.00
.................
  		    X       0 0 0
(15) BETTY JANE OTT......................................................................
TREASURER
 1.00
.................
  		    X       0 0 0
(16) RICHARD TAAFFE......................................................................
VICE PRESIDENT
 1.00
.................
  		    X       0 0 0
(17) IRENE CARPENTER......................................................................
VICE PRESIDENT
 1.00
.................
  		    X       0 0 0
Form 990 (2021)
Form 990 (2021)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) TODD MORGAN........................................................................
CHIEF INFORMATION OFFICER
 40.00
.......................   		      X     349,399 0 34,140
(19) DR GARY OKAMOTO........................................................................
CHIEF MEDICAL DIRECTOR
 40.00
.......................   		      X     454,089 0 27,038
(20) JUNE MELLOR........................................................................
COMPLIANCE OFFICER
 40.00
.......................   		      X     184,273 0 26,140
(21) ESTHER UNDERWOOD........................................................................
DIRECTOR HUMAN RESOURCES
 40.00
.......................   		      X     153,216 0 12,179
(22) AMY FEELEY AUSTIN........................................................................
DIRECTOR OF QUALITY
 40.00
.......................   		      X     153,564 0 20,002
(23) HANH BANNISTER........................................................................
PHARMACY DIRECTOR
 40.00
.......................   		      X     244,022 0 22,454
(24) VICKI BORRELL........................................................................
POPULATION HEALTH OFFICER
 40.00
.......................   		      X     224,809 0 6,493
(25) STELLA CATALAN........................................................................
SENIOR DIRECTOR OF PROVIDER OPS
 40.00
.......................   		      X     229,705 0 15,446
(26) ANDREAS CRAVALHO........................................................................
SENIOR DIRECTOR OF PRODUCT MANAGEMENT
 40.00
.......................   		      X     214,463 0 17,533
(27) SAMRA A BRODERICK........................................................................
VICE PRESIDENT HEALTH SERVICES
 40.00
.......................   		      X     221,371 0 15,293
(28) PAULA ARCENA........................................................................
VP EXTERNAL AFFAIRS
 40.00
.......................   		      X     229,238 0 16,883
(29) PATRICK BRENNAN........................................................................
VP PLAN OPERATIONS
 40.00
.......................   		      X     276,815 0 26,424
(30) PATRICK HO........................................................................
CLINICAL PHARMACIST
 40.00
.......................   		        X   151,612 0 12,617
(31) YOSHIKO CARREL........................................................................
CONTROLLER
 40.00
.......................   		        X   153,238 0 12,664
(32) KRIS LUM........................................................................
DIRECTOR FINANCIAL PLANNING ANALYSIS
 40.00
.......................   		        X   139,992 0 23,004
(33) NILA PATEL........................................................................
DIRECTOR OF APPLICATION DEVELOPMENT
 40.00
.......................   		        X   166,845 0 20,644
(34) RYAN MAU........................................................................
SENIOR DIRECTOR OF BUSINESS SUPPORT SERVICES
 40.00
.......................   		        X   168,529 0 27,143
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 4,672,057 0 390,128
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet19
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
CHANGE HEALTHCARE

P O BOX 98347
CHICAGO,IL606938347 		DATA SUPPORT & VALIDATION 435,267
INTELLIRIDE INC

720 E BUTTERFIELD RD STE 300
LOMBARD,IL60148 		MEMBER TRANSPORTATION 407,750
THE INSTITUTE FOR HUMAN SERVICES INC

P O BOX 17040
HONOLULU,HI96817 		MEMBER HOUSING 171,540
AGK CONSULTING LLC

5610 W STRAIGHT ARROW LN
PHOENIX,AZ85083 		CONSULTING 143,438
MCDERMOTT WILL & EMERY LLP

PO BOX 1675
CAROL STREAM,IL601321675 		LEGAL 133,553
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet10
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet  
Program Service RevenueAmt Business Code
2a CAPITATION 624100 506,660,216 506,660,216    
b
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 506,660,216
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 142,080     142,080
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents     6a
b Less: rental expenses     6b
c Rental income or (loss)     6c
d Net rental income or (loss).......MediumBullet        
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   5,982,985 7a
b Less: cost or other basis and sales expenses 1,351 4,531,095 7b
c Gain or (loss) -1,351 1,451,890 7c
d Net gain or (loss).........MediumBullet 1,450,539     1,450,539
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a OTHER REVENUE 624100 123,926     123,926
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 123,926
12 Total revenue. See instructions.....MediumBullet 508,376,761 506,660,216 0 1,716,545
Form 990 (2021)
Form 990 (2021)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 1,893,008 1,893,008
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 160,116 160,116
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 5,062,185   5,062,185  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........ 16,217,592 574,445 15,643,147  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 699,951   699,951  
9 Other employee benefits ....... 3,042,949   3,042,949  
10 Payroll taxes ........... 1,597,580   1,597,580  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 220,872   220,872  
c Accounting ........... 242,925   242,925  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 67,323,159 67,323,159    
12 Advertising and promotion .... 768,384   768,384  
13 Office expenses ....... 37,357   37,357  
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 829,014   829,014  
17 Travel ............ 50,679   50,679  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 30,227   30,227  
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 2,374,077   2,374,077  
23 Insurance ... 341,869   341,869  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a OTHER EXPENSES - PROGR 395,728,162 395,728,162    
b OTHER EXPENSES - MANAGE 4,459,164   4,459,164  
c
d
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 501,079,270 465,678,890 35,400,380 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........   1  
2 Savings and temporary cash investments ......... 48,377,088 2 58,642,215
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 22,192,866 4 31,361,208
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ...........   7  
8 Inventories for sale or use ............   8  
9 Prepaid expenses and deferred charges ...... 2,679,438 9 2,062,630
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 11,783,309
b Less: accumulated depreciation 10b 4,321,269 6,723,217 10c 7,462,040
11 Investments—publicly traded securities . 65,085,817 11 79,293,524
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ...........   15  
16 Total assets. Add lines 1 through 15 (must equal line 33)... 145,058,426 16 178,821,617
Liabilities 17 Accounts payable and accrued expenses ..... 18,653,029 17 35,073,433
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities .........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 62,561,137 25 72,078,593
26 Total liabilities. Add lines 17 through 25.. 81,214,166 26 107,152,026
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 63,844,260 27 71,669,591
28 Net assets with donor restrictions ...........   28  
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 63,844,260 32 71,669,591
33 Total liabilities and net assets/fund balances ........ 145,058,426 33 178,821,617
Form 990 (2021)
Form 990 (2021)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
508,376,761
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
501,079,270
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
7,297,491
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
63,844,260
5
Net unrealized gains (losses) on investments ...............
5
527,840
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
0
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
71,669,591
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2021)
Form 990 (2021)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
ALOHACARE
 
Employer identification number

99-0309519
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
 
(ii) Related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment) 		(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....      
b Buildings ....        
c Leasehold improvements   5,223,256 1,467,831 3,755,425
d Equipment ....   6,560,053 2,853,438 3,706,615
e Other .....        
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 7,462,040
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 3
Part VII
Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 72,078,593
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 453,317,881
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a 951,740
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 1,351
e Add lines 2a through 2d ..................... 2e 953,091
3 Subtract line 2e from line 1.................. 3 452,364,790
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b 56,011,971
c Add lines 4a and 4b.................... 4c 56,011,971
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 508,376,761
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 445,068,650
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d 1,351
e Add lines 2a through 2d.................... 2e 1,351
3 Subtract line 2e from line 1................... 3 445,067,299
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b 56,011,971
c Add lines 4a and 4b..................... 4c 56,011,971
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 501,079,270
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF ASSETS RECLASSED FROM EXPENSE 1,351.
PART XI, LINE 4B - OTHER ADJUSTMENTS: PASS THROUGH REVENUE NETTED WITH EXPENSE 56,011,971.
PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF ASSETS RECLASSED FROM EXPENSE 1,351.
PART XII, LINE 4B - OTHER ADJUSTMENTS: PASS THROUGH EXPENSE NETTED WITH REVENUE 56,011,971.
Schedule D (Form 990) 2021


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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
ALOHACARE
 
Employer identification number
99-0309519
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) ALII HEALTH CENTER
PO BOX 30460
HONOLULU,HI968200460 		83-3321758 501 (C) 3 11,840 0     2020 QI INCENTIVE
(2) ALOHA UNITED WAY
200 N VINEYARD NO 700
HONOLULU,HI968173938 		99-0073494 501 (C) 3 17,415 0     2020 EMPLOYEE CONTRIBUTION MATCH
(3) ALOHA UNITED WAY
200 N VINEYARD NO 700
HONOLULU,HI968173938 		99-0073494 501 (C) 3 14,851 0     2021 EMPLOYEE CONTRIBUTION MATCH
(4) AMERICAN HEART ASSOCIATION INC
7272 GREENVILLE AVENUE
DALLAS,TX752315129 		13-5613797 501 (C) 3 21,500 0     HEART WALK
(5) AMERICAN LUNCH ASSOCIATION
810 RICHARDS STREET STE 750
HONOLULU,HI96813 		99-0080379 501 (C) 3 20,771 0     2021 GRANT MOLOKAI CESSATION
(6) ASSN OF ASIAN PACIFIC COMMUNITY HEALTH ORG
101 CALLAN AVE STE 400
SAN LEANDRO,CA94577 		94-3050247 501 (C) 3 40,000 0     JOURNEY CONFERENCE
(7) BAY CLINIC INC
450 KILAUEA AVE SUITE 105
HILO,HI96720 		99-0222784 501 (C) 3 108,473 0     2020 QI INCENTIVE
(8) BAY CLINIC INC
450 KILAUEA AVE STE 105
HILO,HI96720 		99-0222784 501 (C) 3 20,000 0     2021 ACCESS TO CARE GRANT
(9) BOYS AND GIRLS CLUB OF HAWAII
1000 BISHOP STREET SUITE 505
HONOLULU,HI96813 		99-6005407 501 (C) 3 7,500 0     CHRISTMAS MEALS
(10) COMMUNITY CLINIC OF MAUI
PO BOX 31000
HONOLULU,HI96849 		99-0303304 501 (C) 3 20,000 0     2021 ACCESS TO CARE GRANT
(11) COMMUNITY CLINIC OF MAUI
PO BOX 31000
HONOLULU,HI96849 		99-0303304 501 (C) 3 60,533 0     2020 QI INCENTIVE
(12) COMMUNITY PEOPLE MINISTRIES
1114 LAULOA STREET
KAILUA,HI967342739 		47-5334011 501 (C) 3 7,500 0     FOOD DISTRIBUTION
(13) HAMAKUA HEALTH CENTER INC
45-549 PLUMERIA ST
HONOKAA,HI96727 		99-0115515 501 (C) 3 13,688 0     2020 QI INCENTIVE
(14) HAMAKUA-KOHALA COMMUNITY HEALTH CENTER
45-539 PLUMERIA ST
HONOKAA,HI96727 		99-0115515 501 (C) 3 20,000 0     2020 QI INCENTIVE
(15) HANA HEALTH
PO BOX 14474
BELFAST,ME049154038 		99-0326154 501 (C) 3 6,384 0     2020 QI INCENTIVE
(16) HANA HEALTH
PO BOX 14474
BELFAST,ME049154038 		99-0326154 501 (C) 3 20,000 0     2021 ACCESS TO CARE GRANT
(17) HAWAII APPLESEED CENTER
733 BISHOP STREET STE 1180
HONOLULU,HI96813 		76-0748976 501 (C) 3 10,000 0     ACCESS TO CARE GRANT - HAWAII
(18) HAWAII CHILDREN'S ACTION NETWORK
850 RICHARDS ST STE 201
HONOLULU,HI96813 		94-3257650 501 (C) 3 10,000 0     2021 ACCESS TO CARE GRANT
(19) HAWAII COALITION FOR HEALTH
PO BOX 25426
HONOLULU,HI968250426 		94-3266455 501 (C) 3 12,780 0     2020 QI INCENTIVE
(20) HAWAII PRIMARY CARE ASSOC
1003 BISHOP ST STE 1810
HONOLULU,HI96813 		99-0268275 501 (C) 3 66,000 0     ACCESS TO CARE GRANT-JOINT PCMH
(21) HAWAII PUBLIC HEALTH INSTITUTE
850 RICHARDS STREET STE 201
HONOLULU,HI96813 		68-0637054 501 (C) 3 30,000 0     2021 GRANT REDUCING THE BURDEN
(22) HEALTH MANAGEMENT ASSOCIATES INC
120 N WASHINGTON SQUARE SUITE 705
LANSING,MI48933 		38-2599727   15,000 0     CONFERENCE SPONSORSHIP
(23) HHSC-KAUAI REGION CLINICS CLINIC OF WAIMEA
PO BOX 337
WAIMEA,HI96796 		83-2602270   7,520 0     2020 QI INCENTIVE
(24) HO'OLA LAHUI HAWAII
PO BOX 3990
LIHUE,HI96766 		99-0250542 501 (C) 3 10,764 0     2020 QI INCENTIVE
(25) KALIHI PALAMA HEALTH CENTER
PO BOX 17460
HONOLULU,HI968170460 		99-0161221 501 (C) 3 20,000 0     2021 ACCESS TO CARE GRANT
(26) KALIHI PALAMA HEALTH CENTER
PO BOX 17460
HONOLULU,HI968170460 		99-0161221 501 (C) 3 128,378 0     2020 QI INCENTIVE
(27) KAPIOLANI HEALTH FOUNDATION
55 MERCHANT STREET 26TH FLOOR
HONOLULU,HI96813 		99-0246364 501 (C) 3 10,000 0     SPONSORSHIP 15TH RADIOTHON
(28) KAPIOLANI MEDICAL CLINIC
PO BOX 30180
HONOLULU,HI96820 		99-0177350 501 (C) 3 10,820 0     2020 QI INCENTIVE
(29) KAUAI MEDICAL CLINIC
MAIL CODE 61113
HONOLULU,HI96820 		99-0326099 501 (C) 3 52,980 0     2020 QI INCENTIVE
(30) KIHEI WAILEA MEDICAL CENTER
C/O TEAM PRAXIS PO BOX 30460
HONOLULU,HI968200460 		99-0350911   5,980 0     2020 QI INCENTIVE
(31) KOKUA KALIHI VALLEY
2239 N SCHOOL ST
HONOLULU,HI96819 		99-0149797 501 (C) 3 86,500 0     2021 ACCESS TO CARE GRANT
(32) KOKUA KALIHI VALLEY
2239 N SCHOOL ST
HONOLULU,HI96819 		99-0149797 501 (C) 3 52,300 0     2020 QI INCENTIVE
(33) KOOLAULOA HEALTH CENTER
PO BOX 395
KAHUKU,HI967312052 		73-1681833 501 (C) 3 17,520 0     2020 QI INCENTIVE
(34) KOOLAULOA HEALTH CENTER
PO BOX 395
KAHUKU,HI967312052 		73-1681833 501 (C) 3 20,000 0     2021 ACCESS TO CARE GRANT
(35) LANAI COMMUNITY HEALTH CENTER
PO BOX 630142
LANAI CITY,HI96763 		20-2509287 501(C)(3) 20,000 0     2021 ACCESS TO CARE GRANT
(36) MARCH OF DIMES
1580 MAKALOA STREET STE 1200
HONOLULU,HI96817 		13-1846366 501 (C) 3 10,000 0     2021 MARCH FOR BABIES
(37) MAUI MEDICAL GROUP
2180 MAIN ST
WAILUKU,HI96793 		99-0176859   86,200 0     2020 QI INCENTIVE
(38) MOLOKAI COMMUNITY HEALTH CENTER
30 OKI PLACE
KAUNAKAKAI,HI96748 		51-0437659   20,000 0     2021 ACCESS TO CARE GRANT
(39) MOLOKAI GENERAL HOSPITAL
PO BOX 408
KAUNAKAKAI,HI96748 		99-0251372 501 (C) 3 7,900 0     2020 QI INCENTIVE
(40) MOLOKAI OHANA HEATHCARE INC
PO BOX 2040
KAUNAKAKAI,HI96748 		51-0437659 501 (C) 3 22,033 0     2019 QI INCENTIVE
(41) PANIOLO PEDIATRIC AND FAMILY MEDICINE INC
PO BOX 6149
KAMUELA,HI96743 		47-3826435   17,760 0     2020 QI INCENTIVE
(42) QUEEN EMMA CLINIC
PO BOX 30160
HONOLULU,HI96820 		99-0073524 501 (C) 3 23,680 0     2020 QI INCENTIVE
(43) QUEEN'S HEALTHCARE INC
PO BOX 30210
HONOLULU,HI968200210 		99-0240109   11,160 0     2020 QI INCENTIVE
(44) STRAUB CLINIC & HOSPITAL (CLINIC)
PO BOX 30180
HONOLULU,HI96820 		91-2151670 501(C)(3) 18,420 0     2020 QI INCENTIVE
(45) THE FOOD BASKET INC
40 HOLOMUA STREET
HILO,HI96720 		26-0349475 501 (C) 3 20,000 0     2019 USDA GUS SCHUMACHER MATCH
(46) UNIVERSITY CLINICAL EDUCATION & RESEARCH ASSOCIATES
550 S BERETANIA STREET SUITE 510
HONOLULU,HI96813 		99-0307152 501 (C) 3 21,940 0     2020 QI INCENTIVE
(47) VENTURE MEDICAL 21 INC
733 BISHOP ST STE 2945
HONOLULU,HI96813 		46-0641609   6,880 0     2019 QI INCENTIVE
(48) WAHIAWA CENTER FOR COMMUNITY HEALTH
PO BOX 21031
BELFAST,ME049154107 		45-5114944 501(C)(3) 20,000 0     2021 ACCESS TO CARE GRANT
(49) WAIANAE COAST COMPREHENSIVE HEALTH CENTER
86-260 FARRINGTON HWY
WAIANAE,HI96792 		99-0148164 501 (C) 3 293,058 0     2020 QI INCENTIVE
(50) WAIANAE COAST COMPREHENSIVE HEALTH CENTER
89-102 FARRINGTON HWY STE 3000
WAIANAE,HI96792 		99-0148164 501 (C) 3 105,000 0     2021 ACCESS TO CARE GRANT
(51) WAIKIKI HEALTH CENTER
935 MAKAHIKI WAY
HONOLULU,HI96826 		99-0159253 501 (C) 3 42,572 0     2020 QI INCENTIVE
(52) WAIMANALO HEALTH CENTER
41-1347 KALANIANAOLE HWY
WAIMANALO,HI96795 		99-0273205 501 (C) 3 26,834 0     2020 QI INCENTIVE
(53) WAIMANALO HEALTH CENTER
41-1347 KALANIANAOLE HWY
WAIMANALO,HI96795 		99-0273205 501 (C) 3 20,000 0     2021 ACCESS TO CARE GRANT
(54) WAIMEA MEDICAL ASSOCIATES
65-1267 KAWAIHAE RD
KAMUELA,HI96743 		99-0113534   6,400 0     2020 QI INCENTIVE
(55) WAIWAI COLLECTIVE HEALTH
1110 UNIVERSITY AVE UNIT 100
HONOLULU,HI96826 		81-3152982   5,236 0     SPONSORSHIP
(56) WEST HAWAII COMMUNITY HEALTH CENTER
75-5751 KUAKINI HWY STE 203
KAILUAKONA,HI96740 		20-0495394 501 (C) 3 70,938 0     2020 QI INCENTIVE
(57) WEST HAWAII COMMUNITY HEALTH CENTER
75-5751 KAAKINI HWY STE 203
KAILUAKONA,HI96740 		20-0495394 501 (C) 3 20,000 0     2021 ACCESS TO CARE GRANT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
41
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
10
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2021

Schedule I (Form 990) 2021
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1) QI INCENTIVE 15 143,780      
(2) GRANT BEHAVIORAL HEALTH 1 16,336      
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
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.
Schedule I (Form 990) 2021



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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
ALOHACARE
 
Employer identification number

99-0309519
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1FRANCOISE CULLEY-TROTMAN
CHIEF EXECUTIVE OFFICER 		(i)

(ii)		 375,486
-------------
0 		97,441
-------------
0 		32,566
-------------
0 		15,149
-------------
0 		22,588
-------------
0 		543,230
-------------
0 		0
-------------
0
2DR GARY OKAMOTO
CHIEF MEDICAL DIRECTOR 		(i)

(ii)		 356,205
-------------
0 		67,600
-------------
0 		30,284
-------------
0 		13,054
-------------
0 		13,984
-------------
0 		481,127
-------------
0 		0
-------------
0
3DAVID FIELD
CHIEF FINANCIAL OFFICER 		(i)

(ii)		 415,384
-------------
0 		0
-------------
0 		36,000
-------------
0 		16,294
-------------
0 		0
-------------
0 		467,678
-------------
0 		0
-------------
0
4TODD MORGAN
CHIEF INFORMATION OFFICER 		(i)

(ii)		 266,371
-------------
0 		52,744
-------------
0 		30,284
-------------
0 		14,138
-------------
0 		20,002
-------------
0 		383,539
-------------
0 		0
-------------
0
5PATRICK BRENNAN
VP PLAN OPERATIONS 		(i)

(ii)		 232,953
-------------
0 		23,673
-------------
0 		20,189
-------------
0 		10,356
-------------
0 		16,068
-------------
0 		303,239
-------------
0 		0
-------------
0
6HANH BANNISTER
PHARMACY DIRECTOR 		(i)

(ii)		 206,338
-------------
0 		26,000
-------------
0 		11,684
-------------
0 		9,965
-------------
0 		12,489
-------------
0 		266,476
-------------
0 		0
-------------
0
7PAULA ARCENA
VP EXTERNAL AFFAIRS 		(i)

(ii)		 196,559
-------------
0 		19,323
-------------
0 		13,356
-------------
0 		8,891
-------------
0 		7,992
-------------
0 		246,121
-------------
0 		0
-------------
0
8STELLA CATALAN
SENIOR DIRECTOR OF PROVIDER OPS 		(i)

(ii)		 190,310
-------------
0 		19,206
-------------
0 		20,189
-------------
0 		8,953
-------------
0 		6,493
-------------
0 		245,151
-------------
0 		0
-------------
0
9SAMRA A BRODERICK
VICE PRESIDENT HEALTH SERVICES 		(i)

(ii)		 221,371
-------------
0 		0
-------------
0 		0
-------------
0 		8,800
-------------
0 		6,493
-------------
0 		236,664
-------------
0 		0
-------------
0
10ANDREAS CRAVALHO
SENIOR DIRECTOR OF PRODUCT MANAGEMEN 		(i)

(ii)		 187,018
-------------
0 		18,270
-------------
0 		9,175
-------------
0 		5,044
-------------
0 		12,489
-------------
0 		231,996
-------------
0 		0
-------------
0
11VICKI BORRELL
POPULATION HEALTH OFFICER 		(i)

(ii)		 170,620
-------------
0 		34,000
-------------
0 		20,189
-------------
0 		0
-------------
0 		6,493
-------------
0 		231,302
-------------
0 		0
-------------
0
12JUNE MELLOR
COMPLIANCE OFFICER 		(i)

(ii)		 174,273
-------------
0 		10,000
-------------
0 		0
-------------
0 		6,138
-------------
0 		20,002
-------------
0 		210,413
-------------
0 		0
-------------
0
13RYAN MAU
SENIOR DIRECTOR OF BUSINESS SUPPORT 		(i)

(ii)		 152,529
-------------
0 		16,000
-------------
0 		0
-------------
0 		7,141
-------------
0 		20,002
-------------
0 		195,672
-------------
0 		0
-------------
0
14NILA PATEL
DIRECTOR OF APPLICATION DEVELOPMENT 		(i)

(ii)		 151,845
-------------
0 		15,000
-------------
0 		0
-------------
0 		6,660
-------------
0 		13,984
-------------
0 		187,489
-------------
0 		0
-------------
0
15AMY FEELEY AUSTIN
DIRECTOR OF QUALITY 		(i)

(ii)		 133,564
-------------
0 		20,000
-------------
0 		0
-------------
0 		0
-------------
0 		20,002
-------------
0 		173,566
-------------
0 		0
-------------
0
16YOSHIKO CARREL
CONTROLLER 		(i)

(ii)		 128,238
-------------
0 		25,000
-------------
0 		0
-------------
0 		6,171
-------------
0 		6,493
-------------
0 		165,902
-------------
0 		0
-------------
0
17ESTHER UNDERWOOD
DIRECTOR HUMAN RESOURCES 		(i)

(ii)		 140,109
-------------
0 		13,107
-------------
0 		0
-------------
0 		5,686
-------------
0 		6,493
-------------
0 		165,395
-------------
0 		0
-------------
0
18PATRICK HO
CLINICAL PHARMACIST 		(i)

(ii)		 145,962
-------------
0 		5,650
-------------
0 		0
-------------
0 		6,124
-------------
0 		6,493
-------------
0 		164,229
-------------
0 		0
-------------
0
19KRIS LUM
DIRECTOR FINANCIAL PLANNING ANALYSIS 		(i)

(ii)		 118,672
-------------
0 		21,320
-------------
0 		0
-------------
0 		5,244
-------------
0 		17,760
-------------
0 		162,996
-------------
0 		0
-------------
0
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 1A DISCRETIONARY SPENDING IS APPROVED BY BOARD OF DIRECTORS AS DOCUMENTED IN THE EMPLOYMENT CONTRACT.
Schedule J (Form 990) 2021

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
ALOHACARE
 
Employer identification number

99-0309519
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990) 2021
Schedule L (Form 990) 2021
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) DAVID DERAUF KOKUA KALIHI VALLEY EXEC DIR
  		DIRECTOR & PRESIDENT OF ALOHACARE'S BOD 1,948,196 SERVICES RENDERED   No
(2) JAMES CHEN WAIANAE COAST COMP HEALTH CENTER CFO
  		DIRECTOR OF ALOHACARE'S BOD 13,878,288 SERVICES RENDERED   No
(3) IRENE CARPENTER HAMAKUA HEALTH CENTER CEO
  		DIRECTOR & VP OF ALOHACARE'S BOD 514,333 SERVICES RENDERED   No
(4) RICHARD TAAFFE WEST HAWAII COMMUNITY HEALTH CENTER CEO
  		DIRECTOR & VP OF ALOHACARE'S BOD 1,694,789 SERVICES RENDERED   No
(5) BETTY JANE OTT MALAMA I KE OLA HEALTH CENTER CEO
  		DIRECTOR & TREASURER OF ALOHACARE'S BOD 1,699,190 SERVICES RENDERED   No
(6) EMMANUEL KINTU KALIHI PALAMA HEALTH CENTER EXEC DIR
  		DIRECTOR & SECRETARY OF ALOHACARE'S BOD 3,483,930 SERVICES RENDERED   No
(7) MARY ONEHA & CHRISTINA LEE WAIMANALO HEALTH CENTER EXEC DIR
  		DIRECTOR OF ALOHACARE'S BOD 1,150,632 SERVICES RENDERED   No
(8) QUEENS HEALTH SYSTEMS & GERARD AKAKA CMO QUEEN EMMA CLINICS
  		DIRECTOR OF ALOHACARE'S BOD 83,315,199 SERVICES RENDERED   No
(9) CHRISTIAN KIMO ALAMEDA BAY CLINIC INC CEO
  		DIRECTOR OF ALOHACARE'S BOD 2,030,878 SERVICES RENDERED   No
(10) PHYLLIS DENDLE WAIKIKI HEALTH CENTER CEO
  		DIRECTOR OF ALOHACARE'S BOD 2,165,831 SERVICES RENDERED   No
(11) HELEN KEKALIA MOLOKAI COMMUNITY HEALTH CENTER CEO
  		DIRECTOR OF ALOHACARE'S BOD 542,758 SERVICES RENDERED   No
(12) GIDGET RUSCETTA PALI MOMI MEDICAL CENTER CEO
  		DIRECTOR OF ALOHACARE'S BOD 8,824,021 SERVICES RENDERED   No
(13) KOOLAULOA COMMUNITY HEALTH CENTER
  		VACANT BOD POSITION 351,708 SERVICES RENDERED   No
(14) CHERYL VACONCELLOS HANA COMMUNITY HEALTH CENTER EXEC DIR
  		DIRECTOR OF ALOHACARE'S BOD 304,462 SERVICES RENDERED   No
(15) DIANA SHAW LANAI COMMUNITY HEALTH CENTER EXEC DIR
  		DIRECTOR OF ALOHACARE'S BOD 390,068 SERVICES RENDERED   No
(16) DEBORAH ZYSMAN HAWAII CHILDREN'S ACTION NETWORK EXECUTIVE DIRECTOR
  		DIRECTOR & PRESIDENT OF ALOHACARE'S BOD 10,000 ACCESS TO CARE GRANT   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990) 2021


Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
ALOHACARE
 
Employer identification number

99-0309519
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 1A 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 67,323,159. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 67,323,159.
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).
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


Additional Data


Software ID:  
Software Version: